#There would be triple the suffering this year if I didn't. T-T

[ends-of-the-wayward-storm]

YEEAAAHHHH MASQUERADE RERUUUUNNN!!!🎉🎉🎉🎉 (Wait does this mean they're gonna drop Playful Land after this?? 'Cause if they are, I'm toast.🥲)

AZUL, YOU'RE NEXT ON MY LIST.

[salty-professor]

The Big Grift

There is growing concern about student loan debt in America. It is a real concern. We should be fucking concerned. The current number being bandied about is 1.7 trillion dollars. Yeah. With a fucking T. Which rhymes with B which stands for bullshit.

It isn’t bullshit that this is the amount of money that is owed. That is the reported number. I believe it. I believe in math. However, it is hard to know exactly how much of that money is interest and how many people who racked up that debt actually earned a degree. We do know that students who don’t graduate end up defaulting on the student loans at triple the rate of those who did graduate AND we know that unless you die, student debt is forever.

You could take out billions in loans and default, declare bankruptcy, fuck all the small businesses who did the work for you and only pay them pennies on the dollars they are owed even though they paid their employees the full amount, walk away, and then do it over and over again. And again. And AGAIN. AND you could be rewarded for all of that by becoming the president. BUT, if you take out 20K in student loans for a degree you didn’t earn, you will have to have your wages garnished, your tax returned seized, all while the interest racks up and that 20K becomes 50 or 60 in no time.

I do think that people who take out loans should pay them back. I do. I think if you take out loans for a business, or for a degree, you owe that money back. I am OK with that. There is some nuance to it thought and that needs to be considered.

Some of those people who took out loans for degrees they didn’t earn, actually didn’t even go to class and yet, they still owe the money. That is like applying for a car loan but you never finalize the loan, sign your name, or pick it up from the dealership but still somehow you owe the money even though they sold that car to someone else.

When I first started teaching, professors could, have students removed from classes if they didn’t participate after two consecutive weeks. Now, the rule is, and this is a federal rule, not just the rule at my school, if the student doesn’t participate in week one, the student is dropped. There is no financial aid distributed and it is a no harm no foul situation.

However, if the student shows up and naps in the back row of class OR posts one word to one discussion in an online course, that student is “active” and is enrolled for the rest of the term. The money is distributed and that is that. Even if the student never shows up again, the student can’t be dropped.

It is different if a student shows up for half the classes, doesn’t put in effort and doesn’t pass. That is an object lesson. The student needed to get kicked in the wallet on that one. However, if I student ghosts after day one, the student isn’t really enrolled in the class and the money should be returned. We are not required to marry the people we ghost after one bad date, so why do we make sure the student suffers this pain?

It could be that the student is scamming the system by collecting student loan checks for two years and fucking off with the money without knowing that the money will be owed back no matter what. Some students do get cost of living loans and some students get refunds. I get it. Some of them steal. That is a scam. Fuck those fuckers. Still, it is more likely that the student assumed by not showing up, there would be a drop and so the student didn't do anything. If you stopped showing up to work, you would expect to be fired. Same principle here.

The real insidious thing about it is that the schools collect the money but don’t have to do any of the work and THAT is the main reason why this law isn’t changing. Colleges and universities rake in tons of money from the federal government in financial aid. Some schools survive on tuition money alone. If they drop a student who quit attending after one third of the class was complete and had to give back 66 percent of the money, that would be bad for bottom lines. So, instead of doing the ethical thing, they do nothing. Fucking NOTHING.

Last term I had six students who didn’t pass the course. Five of them submitted two assignments total. One of them only submitted one. The college collected that money and even though I’ve pushed and begged to have the students dropped, I was told, “not to get too worked up about it.”

Really? Fuck you. Fuck that. I am worked up about it because in 10 years, that student is going to plan on using a tax refund for something, but there will be no joy at that person’s house, because that money will be taken to repay for a class, he probably thought he dropped. AND if he wants to take out a loan to help cover the costs of anything, or buy a car, or a house, that will not happen because his credit is ruined.

Education should not be a fucking business built on the back of predatory loans.

It is a fucking right.

 FUCK!

[natebuzzlover344]

First of all, i’m sorry for my english and grammar. And this is a chapter of one of my wattpad stories named “Cliché”

It’s a Mitch Rapp fanfiction, if you like it i will continue to translate it in english.

I don’t own this gif (take it from pinterest)

I stand in front of the mirror looking at my sad reflex. My skin is whiter than milk, and the dark circles around my eyes look awful to me, the redness of the bruise around my eyes has been pierced by small thin veins.

I'm in a tough, tough time. I do not feel well. It was as if all evil had come upon me. I take a foundation with two shades darker from the cherry blush on the table. I need to have a little color, I look like a corpse.

I pour a few drops into my palms and start stretching in front of me. My blue eyes, like the sea, watched as my face began to come to life.

At just twenty-three, my embers-black hair begins to turn white at the roots. The stress is too great. I'm surrounded by people, but I feel lonely. Empty inside.

After applying a layer of mascara on my long lashes, I get up from my chair and take my red dress off the bed.

The bitter taste of sadness is the only aroma I have been feeling for more than three years. The judgment of the people around me depresses me, as if cutting me in the flesh.

My name is Jenna Lockwood and I'm probably the most fake person you've ever met.

After I put on the dress, I look in the mirror and struggle to smile. The red dress fit perfectly on my waist, and the square neckline highlighted my golden necklace, received as a gift from a good friend. I untie my hair and let it fall, reaching close to my hips.

Now that I'm ready, it's time to leave for a new white night in which I will hide my sadness and insecurities behind a mask. White Nights for black days.

I walk in the door of the club excited by the colorful strobe lights and the catchy music that sings so loud it seems to shake the club. The smell of liquor and expensive perfume was all that pleased my nasal senses. People dancing perfectly to the music, lovers making obscene signs without inhibitions, drunks and drunks falling on the stairs in the bathroom, that's my world. The world without prejudices.

I make room using my elbows through the crowd to reach the bar on the side of the club. It seems that the handsome blonde with long hair up to his ears was working hard flaming a few glasses.

“Ohoo, my man!” I yell at him to hear the music and I lean over the bar to clap with him.

He has been my friend since childhood, somehow our friendship lasted despite the years. Although he does not agree with my lifestyle, he understands my pain and respects my decisions.

"Lanna, I thought you'd miss the party!" Michael replies with a wide smile on his face.

The blonde returns to take the bottle of bacardi, already knowing what I usually order, but tonight I thought of drinking something new.

"Why don't you make me a margarita?" I ask, raising both my eyebrows.

Michael smiles at me and takes a glass of daisy from his stand, then greases the top of the glass with water, then dips it in salt and then pours tequila and triple dry.

I could already feel salivating seeing the beautiful pale green liquid poured into the glass. To make matters worse, Michael squeezes another lemon and hands me my glass.

I take the money out of the black envelope but Michael stops me.

“You know the start is from me!” he says friendly.

“ I always forget, some interesting people?” I ask, sipping my glass.

"About that, I understand that friends of the owner will be coming tonight, some dubious ones, be careful ..." Michael informed me, looking around.

I nod and offer a kiss on the cheek. I wink at them, then walk away to the bar and join the crowd of people dancing as if there were no more tomorrow.

I begin to move to the rhythms of the song Feel so close, occasionally sipping from my glass. The taste of tequilla caresses my taste buds.

A tall man with an enviable athletic body had appeared in front of me. He wore a black T-shirt and a pair of jeans of the same color, torn, accessorized with a chain. His beard was a little overgrown, and his hair was quite long with a gorgeous brown.

I approached the charming man in the rhythm of the dance, putting the glass of daisies around his neck, then leaving it on a nearby table.

The mysterious brunette moved in decline with me, giving me a small smile. He wasn't the kind of boy you'd see everywhere, he had a unique face that stood out from the rest of the males around here. The rhythm of the music pushed me closer and closer to him.

I took the opportunity to look at him closely and feel my amber-colored eyes soften in his eyes, not to mention the small drops of honey that were hiding in his iris.

“I've never seen you here and believe me I come very often!” I whisper in his ear to hear the music.

“It’s the first time, this pleace is awesome!” He replied very excited.

The guy grabs my hand and spins me around, and with a strong pull I get to stick my chest tightly to his. I notice a few strands of hair settling over his eye so I reach for his hand and place his hair on his back.

It had been a while since we had been dancing, the songs seemed to change from second to second.

The rest of the evening I felt like in a story. I danced until I felt my sandals tighten and the kamikaze shots flowed incessantly around our necks. I was at the entrance of the club, the cool summer breeze drying the drops of water that flowed on my body. The handsome brunette takes a pack of cigarettes from his jeans pocket, then carries a cigarette with an orange filter in his mouth.

"My name is Lanna, I think you should know that we've been dancing for more than five hours," I say sarcastically.

“I’m Mitch, very glad to meed you, ma’ lady” he say very charming.

I watched him curiously as he drew so pathetically from the cigarette that it was almost over. It seemed to me that he was stressed, I had never seen anyone smoke a cigarette so quickly.

As soon as he throws the cigarette in the ashtray, he lights another cigarette. The silence of the night put me back in my bitter thoughts, I didn't want peace anymore. The silence depresses me. I stared blankly under the starry sky, searching for a lifeline in my own thoughts.

"Look up!" he tells me with a smile.

His voice instantly woke me from my thoughts, as if it were a crack that pulled me out of my trance.

I conform quickly and feel him wipe the underside of my eye with his fingertips.

"Your mascara had spread," he announced, smiling.

"Oh, thank you," I say through gritted teeth.

I look back at a fixed point and am blocked again by thoughts. I have become addicted to noise, the silence is stifling.

Two young people in love leave the club. A couple who have been visiting the area for more than half a year. I always tried them with admiration, in their case it seems that love and fun are on the same waterline.

This time they didn't come out with a smile up to their ears and holding hands. They seemed to be arguing.

"I'll put my hand in the fire in a few seconds because the guy will slap him," Mitch says, laughing as he looks at the two of them.

I see the skinny blonde slap him hard on the face, turning her head completely.

"She's going to leave now," Mitch continued, as if anticipating the couple's every move.

Indeed, the girl walks away, but the man grabs her arm and turns her away. The variety continues to quarrel, vaguely hearing the girl's tickled voice screaming at him. Probably fed up with the conversation, the man hurried back and entered the club nervously, leaving the girl with his eyes "in the sun".

"Sad show," He commented, lighting a third cigarette.

I take a pack of slim cigarettes out of my envelope and light one. I watched the blonde sit on the curb and cry with her head in her hands.

I never felt the taste of love, I had a few relationships, but I didn't bother. I didn't think anyone would ever love me, after all, if I don't love myself, what can I expect from people?

"I didn't think love hurt," I say, looking at the girl as she wipes her makeup off her face.

"It hurts harder than anything," He says seriously.

“Love shouldn't hurt ... Loneliness hurts, rejection hurts, losing a person hurts, envy hurts”

“Did you list some examples, or did you say what hurts you?” he asks, looking me straight in the eye.

His question had hit me in the head, keeping my mouth wide open looking at him confused. His question was like a slap in the face.

"Forgive me, I didn't mean to make you uncomfortable.You've changed since I went out, what's the matter with you, Lanna?”

Mitch kept in touch, emphasizing everything with his hand over mine. I look at him confused, trying to convey a state of frustration, then I start laughing amused. Confusion had appeared instantly on his face.

“Sorry, but I remembered those cliché scenes when the guy asks the girl if she's fine-“

"She's lying to him, telling him she's fine," he continued.

“Exactly!”

"Then let's do something else, what would you tell me Maybe we won't meet again, maybe the roads will bring us back again. Maybe we will become the memory of a pleasant night. We don't know what life has in store for us. You have nothing to lose.

His realism intrigued me. It implied to me that he was open-minded. I sigh, as if without that sigh I wouldn't have had the strength to speak.

“Have you ever felt depressed?" Instead of reassuring you, does it feel like eating live? I ask, sitting down on the metal bench next to me.

“ Yes, I have moments, but all these worries have a cause.”

“ I feel like I want to break up, like me. Sadness, suffering, hot tears and annoying looks.” I say sad

"Have you ever thought we'll drive too much?" he asks in a melancholy tone.

“We think too much about everything, every look, every text.”

“Maybe we should blame ourselves, maybe we will break our hearts, but personal mistakes that are just the basis of suffering. We build the walls ourselves.”

His words seemed to caress my soul, opening my eyes to new perspectives. Is it my fault for these cruel states? For years I threw the arrows of blame on my mother.

Stubborn by nature, I did not want to attest to the fact that I could be the creator of my own agony.

I watch the sky light up, helping the sun to reveal its hot rays, indicating to me that I should go home.

"And another night has passed," he sats, looking at the beautiful sunrise painting the sky in beautiful shades of pink and red.

"I think I should go home," I say, taking my phone out of the envelope and ordering an uber.

"Let's smoke one more cigarette," he says, as if he doesn't want tonight to end.

His words form a smile on my face. I take out a new cigarette and hold it to my lips, and he lights it with a lighter. Our eyes meet, and for a few seconds I forgot I had to smoke.

Looking at him more closely, I noticed small scarred cuts running down his rough face. I was so curious about him. What he does, what his passions are, what brings a smile to his face. On second thought, I didn't want this night to end either.

"I know it may sound cliché, and you may already know that, but you're very beautiful," he says, lost in my eyes.

I thank him and see a blue bay parked right in front of us. Looks like my uber has arrived and will break me from this desired moment.

"Looks like my car has arrived," I say through gritted teeth.

“I really liked this night, Lanna, I hope we meet again, maybe life will last with us” he blushed sincerely kissing my hand.

"I hope so."

I say goodbye to the man who gave me the most beautiful night and I get in the car, looking nostalgically as I walk away from him.

[whereareroo]

BURKINA FASO

WF THOUGHTS (1/25/22).

I'm always astounded by how much I DON'T know. My lack of knowledge keeps me humble.

Today, at 6:37 a.m., the following headline came across my newsfeed from CNN: "Burkina Faso's Military Takes Over Country."

My initial reaction was: "Who the hell is Burkina Faso and what country did he take over?" From the headline, I assumed that Burkina Faso was some crazy general and that he had taken over some third-world country. I was disappointed by the uninformative headline. Shouldn't the headline give the full story? The headline writers at CNN should be ashamed of themselves.

The news writers at CNN should be ashamed of themselves too. After reading the whole article, I still didn't know who Burkina Faso was. I was starting to get the idea that Burkina Faso might be a country, but the article did not expressly say that it was a country. I was still confused. What's wrong with the folks at CNN? Isn't clear communication their job?

After poking around some other sources, I got a better handle on the situation. Totally unbeknownst to me (and maybe you too?), Burkina Faso is a country in Africa. Some military general--not named Burkina Faso--has conducted a military coup and installed a new military government. Why couldn't CNN just say that?

In an effort to salvage my self-esteem and justify my ignorance, I told myself that Burkina Faso must be a little place like Rhode Island and that nobody should know anything about it. I suspect that many smart people across the globe couldn't pinpoint Rhode Island on a world map.

After I convinced myself that it was OK to know nothing about Burkina Faso, I should have moved on to the other stories in my newsfeed. Of course, I didn't do that. I had to PROVE to myself that it was OK to know nothing about Burkina Faso. That was a mistake.

Over the course of the next hour or so, I learned that I'm an arrogant American with woefully inadequate knowledge of world geography. Here are some of the things I learned about Burkina Faso:

▪To me, Africa looks somewhat like a stubby version of Florida. It has a "panhandle" area. Burkina Faso is in the panhandle near the elbow. The rest of that area is occupied by some countries that you've heard of: Mali; Niger, and Nigeria.

▪Burkina Faso is not a small place like Rhode Island. It's bigger than half of the countries in the world. For instance, it's bigger than: the U.K.; New Zealand; Greece, and; North Korea. If it was a state in America, Burkina Faso would be the 7th largest state behind: Alaska; Texas; California; Montana; New Mexico, and; Arizona.

▪Burkina Faso has a big population of 21 million. It has more people than 150 other countries. It's population is double the populations of places like Greece, Sweden, Portugal, and Israel. The population in Burkina Faso is triple the population of places like Denmark, Norway, and Ireland.

How did I know nothing about such a sizable, populous, country? It's embarrassing. Did you know about Burkina Faso?

Burkina Faso (known as Upper Volta until 1984) is a former French colony that became independent in 1960. It has an unusual democratic form of government (called a semi-presidential government) that features an elected president, a prime minister, a cabinet, and an elected legislature. It is similar to the democratic forms of government that exist in France and Portugal.

Historically, Burkina Faso suffers from two persistent problems. First, it is a very poor country. With more than 40% of the population living in poverty, it is always listed as one of the 20 poorest countries on earth. Secondly, it is situated in a very volatile region of the world. Violent outbursts arise from disputes related to cultural differences, religious differences, tribal differences, and economic injustice.

Not surprisingly, Burkina Faso has had its fair share of military coups. There were coups in 1966, 1980, 1982, 1983, and 1987. From October of 1987 until today, a period of almost 35 years, there hasn't been a coup. The winning streak ended today.

Military coups occur in democratic societies. Military coups occur in sizable countries. Military coups occur in populous countries. We need to know more about other countries because there are lessons to be learned. By lunchtime today, militants in Burkina Faso were calling for a new partnership with Russia to bring stability to the country. Do you think that Russia might have had a hand in causing the recent uprisings?

Democracy is fragile. I feel terrible about the events that occurred in Burkina Faso today, but I'm glad the coup was a top headline in the news today. It is food for thought. I'm going to try to be a more informed citizen of the world. How about you?

[xtruss]

Jacob Kingsley, 12, visits a bakery that was off-limits before he began oral immunotherapy for a peanut allergy.

A revolutionary treatment for allergies to peanuts and other foods is going mainstream—but do the benefits outweigh the risks?

New research out this week suggests that antibodies to peanut protein appear in the gut, which could help explain the allergy’s origins. Check out this 2018 News from Science Feature that explored the benefits and risks of novel treatment.

— By Jennifer Couzin-Frankel, Staff Writer | Oct. 18, 2018 | ScienceMag.Org

Jacob Kingsley was 9 years old when he was handed the poison he'd shunned since before he could walk and told to swallow it as medicine. Obediently, he gulped down a few micrograms of peanut flour—less than 1/1000 of a peanut—diluted in grape Kool-Aid. His mother and a nurse hovered, ready to inject him with epinephrine if an itchy throat and wheezing struck.

Jacob's mother, Jennifer Kingsley, had driven him 2 hours from their home in Columbus to this doctor's office in Cincinnati, Ohio, for the first of dozens of sessions of peanut immunotherapy. Giving Jacob gradually increasing doses of peanuts, she hoped, would desensitize his immune system.

It's a strategy Kingsley hadn't pursued until she reached her breaking point. A year earlier, Jacob had swallowed a handful of popcorn that, unbeknownst to him, was laced with peanut product. He suffered a particularly frightening reaction: two bouts of intense symptoms about 6 hours apart. The incident marked his second peanut-related trip to the emergency room, and Kingsley was terrified that the next encounter could be fatal. "I decided, ‘I can't live like this,’" she says. "I was desperate."

As Jacob sat through the hourslong appointment in Cincinnati, playing video games and swigging increasing doses of peanut-spiked Kool-Aid, he joined legions of children writing food allergy's next chapter. Today, more than 3000 people worldwide, most of them children, have undergone peanut immunotherapy, with the goal of protecting them if they accidentally encounter the food. Other children are trying immunotherapy for allergies to milk, eggs, and tree nuts. Some, like Jacob, get treatment in allergists' offices, where doctors share protocols informally and in published papers. Other children have enrolled in clinical trials, including those run by two companies racing to introduce a peanut-based capsule or skin patch. Both plan to apply for approval from the Food and Drug Administration (FDA) this year. The agency's blessing would dramatically boost immunotherapy's credibility and reach.

In a field that for decades has had nothing to offer patients beyond avoidance, immunotherapy marks a seismic shift. As it edges closer to mainstream, "There's mixed feelings, with a whole range of enthusiasm," says Corinne Keet, a pediatric allergist-immunologist at Johns Hopkins Medicine in Baltimore, Maryland. Fear that it might cause harm is mingling with euphoria that children living constrained lives could be set free. Doctors who offer immunotherapy describe families eating in Chinese restaurants for the first time and home-schooled children rejoining their peers.

Like many medical firsts, the therapy is not perfect. "This is version 1.0," says Brian Vickery, a pediatric allergist-immunologist at Emory University in Atlanta. He has conducted peanut immunotherapy trials and worked for 2 years at Aimmune Therapeutics, headquartered in Brisbane, California, one of the companies whose products are nearing approval. Physicians fret about oral immunotherapy's rigors—treatment must continue indefinitely—and its risks, which include the same allergic reactions it aims to prevent. Last year in Japan, a child suffered brain damage during a trial of immunotherapy for milk allergies.

Meanwhile, physicians on the front lines are navigating hazy science. No one knows exactly how immunotherapy works or who's most likely to be helped or hurt by it. "For me," Keet says, "it's really not clear for an average child with peanut allergy whether it will make sense to do oral immunotherapy or not."

Like many who study food allergies, Keet was enticed by their mystery. Animal models are poor. The intensity of allergic reactions varies unpredictably, even in the same person over time. Why one child outgrows an allergy and another doesn't is unknown.

"This was something we didn't cover much in medical school" in the 1990s, says Matthew Greenhawt, a pediatric allergist-immunologist at Children's Hospital Colorado in Denver. Greenhawt's career trajectory tracks with a surge in food allergies, and these days, he can barely keep up with the stream of affected children who visit his hospital. Today, between 1% and 2% of people in the United States, the United Kingdom, and several other countries are allergic to peanuts—a rate that has roughly tripled since the mid-1990s. Other food allergies, such as those to tree nuts, are also on the rise. What's causing the increase is not well understood.

Despite rising caseloads, deaths from food allergies remain rare. Precise numbers are hard to come by, and estimates range from fewer than 10 to more than 150 a year in the United States. But even though an affected child is more likely to be struck by lightning than to die of a food allergy, the risk can feel ever-present. Parents never know when their children will happen upon culprit foods and how they'll be affected if they do. "We live in a complex world—people move food all over the place," says David Bunning, a businessman whose two sons, now adults, have multiple food allergies. "The impact on children in terms of their confidence to explore their environment can be extreme." Bunning's family almost never traveled or ate out. At their grandparents' house, the boys were usually confined to one room where food wasn't allowed.

Bunning now chairs the board of directors at Food Allergy Research & Education (FARE), an advocacy group in McLean, Virginia. Families like his, and the doctors who cared for their children, began to agitate for new treatments about a decade ago. Immunotherapy was the obvious candidate: Injections that desensitize the immune system to pollen, grass, pet dander, and bee venom have been around for decades.

Whether for an allergy to cats or pistachios, immunotherapy aims to disrupt the cells that swing out of control when faced with an allergen. When a child who is allergic to a food eats it, food proteins cross from the digestive tract into the bloodstream. An antibody called immunoglobulin E (IgE), which is bound to white blood cells called mast cells in tissues, recognizes the culprits. IgE activates the mast cells, which release histamine and other chemicals. In the skin, that response can lead to hives; in the respiratory tract, wheezing; and in the gut, vomiting. The most serious symptoms, such as a swollen throat or a reaction throughout the body, mark anaphylaxis, which is what families fear the most. Allergy shots blunt production of IgE, in part, researchers believe, by boosting levels of certain T cells that prompt a cascade of immune changes.

Brief testing decades ago indicated that shots for food allergies weren't safe. So around the mid-2000s, scientists began to feed children the allergen instead. One watershed moment came in 2005, when the National Institutes of Health formed a consortium for food allergy clinical trials. A second was in 2011, when advocates sponsored a symposium at Harvard Medical School in Boston to standardize goals and strategy for the pioneering immunotherapy efforts. About 60 people attended. "The patients were very clear," says Carla McGuire Davis, a pediatric allergist-immunologist at Texas Children's Hospital in Houston. They didn't care about eating a peanut butter sandwich; they wanted protection if they accidentally encountered one. Trialists set their end dose at a couple of peanuts and pressed ahead.

The results of early clinical trials were promising, says Hugh Sampson, a pediatric allergist-immunologist at the Icahn School of Medicine at Mount Sinai in New York City, who has studied immunotherapy in food allergies for many years. After 6 to 12 months of treatment, he says, about 70% to 80% of patients could handle higher doses of the food than before. Lab data were encouraging, too: Ingesting allergens over time seems to make mast cells less reactive, inhibiting their release of harmful chemicals. The therapy also produces other immunoglobulins: IgG4, which further inhibits mast cell activity, and IgA, which helps keep food allergens from escaping the gut.

The 2011 conference inspired the founding of the company now called Aimmune, fueled by more than $3.5 million from FARE. A second company, DBV Technologies, based in Montrouge, France, and New York City, expanded a few years later. Aimmune began to develop an oral product, essentially a capsule of powder derived from peanut flour with proteins held to consistent levels. In February, the company announced in a press release the results of a phase III trial involving 496 children and teenagers, with a regimen stepping up every 2 weeks through 11 dose levels. Among the 372 people in the treatment group, about 20% dropped out for various reasons, including side effects. After about a year, 96% of people who completed treatment could consume one peanut with no more than mild symptoms, 84% could tolerate two, and 63% could tolerate at least three.

DBV's skin patch represents a more conservative strategy: It delivers tiny amounts of peanut protein, the equivalent of one peanut over 3 years. Last year, DBV announced that in its phase III trial of almost 400 patients, after a year, those using the patch could, on average, eat three peanuts over the course of several hours before experiencing clinical symptoms such as vomiting or hives; before the trial, the average was just under one peanut. Outcomes varied substantially from person to person.

If one or both products are approved by FDA in the coming months, expectations are high that they'll be welcomed: Aimmune is now worth about $1.5 billion on the U.S. stock exchange. In 2016, FARE sold its share in Aimmune for $47 million.

“What people don’t understand is this level of protection fluctuates. … It is not guaranteed, nor is it constant.”

— Mimi Tang, Murdoch Children’s Research Institute

Meanwhile, some doctors embrace another route: offering peanut immunotherapy in their practices. "I can treat 20 patients with $5.95 of peanut flour," says Richard L. Wasserman, a pediatric allergist-immunologist in Dallas, Texas.

Wasserman ventured into food allergy immunotherapy 11 years ago. He developed a protocol based partly on published case reports and protocols for allergy shots, and he put IVs into his first five peanut allergy patients in case he had only seconds to rescue them from severe anaphylaxis. "When they all sailed through the first day, we stopped doing IVs," he says. "But that's a measure of how concerned I was."

Wasserman has since treated more than 300 children with peanut allergies and more than 400 with other food allergies. Other practitioners are joining in, among them the Cincinnati allergist whom the Kingsley family sought out: Justin Greiwe at Bernstein Allergy Group. Greiwe joined the practice in 2014, straight out of medical training. "It was a little nerve-wracking at the beginning," he says, because no officially sanctioned oral immunotherapy protocol existed. He took precautionary measures, such as lung testing before every treatment, to help ensure patient safety.

Some clinicians—and executives at the companies developing products—aren't happy about the doctor's office treatments. "That gives a lot of us pause," says Sampson, who in addition to his academic post is chief scientific officer of DBV. "We're very afraid that if this goes on enough, somebody is going to have an accident or a fatal reaction, and that's really going to change the FDA's viewpoint" about the products in development, he says.

Wasserman agrees about the need for caution. "Not every practicing allergist should be doing oral immunotherapy," he says. Greiwe suggests the treatment requires a dedicated staff, and he gives every immunotherapy family his cellphone number.

Jacob was one of Greiwe's first immunotherapy patients. His mother remembers Jacob's ears burning—a minor reaction that subsided on its own. "Or he said he hated peanuts and wanted to quit," she says. Worst was about 6 months in, when Kingsley discovered that for 2 weeks, Jacob had hidden his dose to avoid eating it. That was "the only time we ever felt danger," she says. Stopping treatment can quickly alter the immune system, says Cecilia Berin, an immunologist at Mount Sinai, because immunotherapy requires constant exposure. When Jacob squirreled away his daily dose, the changes induced in his immune system almost certainly started to fade out, putting him at risk. Greiwe restarted him on a lower dose and, his mother says, "We got through it."

Food allergies are becoming more common, and a handful of foods accounts for the vast majority of allergies. But small doses of the foods can blunt allergic reactions.

Even children who faithfully follow instructions face risks. The immune system can react to even subtle pressures, and the list of what can provoke a reaction to treatment is long. Exercising within a couple of hours of the dose can do it; so can a cold, a stomach virus, menstruation, or a hot shower. An asthma attack can trigger a reaction—many children with allergies have asthma as well—and so can stress. "We had a patient who had just played the violin on a stage, came down, and about 15 minutes later … took the dose and had a reaction," Davis says.

Berin posits that external pressures such as physical activity or illness make the gut more permeable, pushing more of the immunotherapy dose into the bloodstream. But that remains hypothesis. Regardless, it's becoming clear that "there are people who react years down the road to a maintenance dose," Keet says. For Jacob, such a moment came 9 months in. One evening while watching a movie, he downed his peanut M&M's and later ran outside with his cousins to dance in a rainstorm. He broke out in hives head to toe. Kingsley dialed Greiwe's number, and Jacob got a double dose of an allergy medication.

The most tragic data point to date is the case in Japan. A child had enrolled in a trial of immunotherapy for milk allergies at the Kanagawa Children's Medical Center in Yokohama. He'd raised what he could ingest from less than 8 milliliters to 135 milliliters—about half a glass of milk. After 3 months on that maintenance dose, he swallowed it and soon complained of pain. Within minutes, he had stopped breathing. His heartbeat was later restored in the emergency room, but he'd gone too long without it and sustained severe brain damage, according to a statement from the hospital's president, Sumimasa Yamashita, in November 2017. Kanagawa Children's Medical Center declined to comment, saying only that the incident remains under investigation.

In its statement, the hospital noted the boy had suffered an asthma attack the day before the catastrophic dose. He also was on a protocol that aimed to rapidly escalate the volume of milk he could drink over less than 3 weeks. But why the child reacted so disastrously to that glass of milk is unknown.

"What people don't understand is this level of protection fluctuates," says Mimi Tang, a pediatric allergist-immunologist at Murdoch Children's Research Institute in Melbourne, Australia. "It is not guaranteed, nor is it constant."

One of the few long-term analyses was published in 2013 in The Journal of Allergy and Clinical Immunology. Keet, pediatric allergist-immunologist Robert Wood at Johns Hopkins Medicine, and their colleagues sought out 32 children who'd been in a milk immunotherapy trial. Three to 5 years later, "The results were surprising in a sobering kind of way," Wood says. Only about a quarter "were doing great … tolerating unlimited quantities of milk without side effects." Another quarter had abandoned the protocol and returned to strict avoidance. The rest were eating dairy products inconsistently, with intermittent or even frequent allergic reactions. "It's hard to know which comes first, whether they got complacent" about ingesting it "or backed off because [they were] having too many symptoms," Wood says.

“It made me nervous, really nervous, to put something in my daughter’s mouth that she was allergic to.”

— Divya Balachandar, mother of Leena Wong

More and more families are willing to live with those uncertainties because the alternative is greater anxiety. "We were scared senseless," says Divya Balachandar, whose daughter Leena Wong, now 7 years old, had her first episode of anaphylaxis at age 4 after being touched by a cashew. Testing revealed Leena also was allergic to sesame, eggs, milk, other tree nuts, and peanuts. Balachandar, a pediatric pulmonologist in New York City, and her husband enrolled Leena in a federally funded oral immunotherapy trial for peanut allergy in 2015. "It made me nervous, really nervous, to put something in my daughter's mouth that she was allergic to," Balachandar says. She gravitated toward a trial over treatment with a local allergist because, she says, "there were no rules" about how to treat in private practice. By this spring, Leena could eat two spoonfuls of peanut butter—about 25 peanuts—without a problem. She started second grade sitting with her classmates at lunchtime, liberated from a separate nut-free table.

Both companies developing peanut-based treatments say they had more volunteers for their trials than they could accommodate. Private practitioners usually have a waiting list; Greiwe's runs more than 4 months. At Stanford University in Palo Alto, California, which has a large food allergy research program, more than 2000 patients are waitlisted to enroll in the university's clinical trials, says Sharon Chinthrajah, an allergist-immunologist there.

More treatments are on the horizon. In Australia, Tang is working with a company that's testing an approach she pioneered, a combination of a probiotic and oral peanut immunotherapy. The probiotic should tilt the body toward producing the subset of T cells that tolerate the allergen and away from making cells that attack it, she says. Chinthrajah and others are enthusiastic about combining oral immunotherapy with a monoclonal antibody called omalizumab, which is FDA approved to treat allergic asthma. Clinical trials are also gearing up to test other monoclonal antibodies that target molecules involved in allergic inflammation.

Jacob's and Leena's families are eager to see what comes next. Jacob is also allergic to pistachios and cashews, but because he finds those foods easier to avoid than peanuts, the family has rejected immunotherapy that targets them. Leena's family is the opposite. With her older sister and her parents, Leena attends Indian functions regularly, where tree nuts are a common ingredient in sauces. In August, another episode of anaphylaxis landed her in the emergency room: She began to vomit and suffered chest tightness and eye swelling after eating Indian food her parents suspect contained cashews—despite having triple-checked with the restaurant that it did not. "I would love to do tree nuts," Balachandar says, once immunotherapy "becomes more available and better understood."

Physicians with deep roots in food allergy immunotherapy hope those new to it tread carefully. Doctors who offer such treatments "have to know the data cold," including published results and side effects that may crop up, Greenhawt says. Still, he's thrilled that peanut immunotherapy treatments may soon be approved. The other day, talking with a peanut-allergic 4-year-old and his mother, Greenhawt shared what the next year might bring. "I said, ‘I'm going to see you a year from now; hopefully, we will have two products that are approved, and we can talk about which one might be best for you.’" The mother looked startled and delighted, Greenhawt says. "I've never seen somebody smile as brightly as that."