#prevention effects

[artbymesa]

Sorry Shepard that was my bad. I didn't mean to embarrass you in front of your future husband stumbling into him like that.

[reasonsforhope]

"A large clinical trial in South Africa and Uganda has shown that a twice-yearly injection of a new pre-exposure prophylaxis drug gives young women total protection from HIV infection.

The trial tested whether the six-month injection of lenacapavir would provide better protection against HIV infection than two other drugs, both daily pills. All three medications are pre-exposure prophylaxis (or PrEP) drugs.

Physician-scientist Linda-Gail Bekker, principal investigator for the South African part of the study, tells Nadine Dreyer what makes this breakthough so significant and what to expect next.

Tell us about the trial and what it set out to achieve

The Purpose 1 trial with 5,000 participants took place at three sites in Uganda and 25 sites in South Africa to test the efficacy of lenacapavir and two other drugs.

Lenacapavir (Len LA) is a fusion capside inhibitor. It interferes with the HIV capsid, a protein shell that protects HIV’s genetic material and enzymes needed for replication. It is administered just under the skin, once every six months.

The randomised controlled trial, sponsored by the drug developers Gilead Sciences, tested several things.

The first was whether a six-monthly injection of lenacapavir was safe and would provide better protection against HIV infection as PrEP for women between the ages of 16 and 25 years than Truvada F/TDF, a daily PrEP pill in wide use that has been available for more than a decade.

Secondly, the trial also tested whether Descovy F/TAF, a newer daily pill, was as effective as F/TDF...

The trial had three arms. Young women were randomly assigned to one of the arms in a 2:2:1 ratio (Len LA: F/TAF oral: F/TDF oral) in a double blinded fashion. This means neither the participants nor the researchers knew which treatment participants were receiving until the clinical trial was over.

In eastern and southern Africa, young women are the population who bear the brunt of new HIV infections. They also find a daily PrEP regimen challenging to maintain, for a number of social and structural reasons.

During the randomised phase of the trial none of the 2,134 women who received lenacapavir contracted HIV. There was 100 percent efficiency.

By comparison, 16 of the 1,068 women (or 1.5%) who took Truvada (F/TDF) and 39 of 2,136 (1.8%) who received Descovy (F/TAF) contracted the HIV virus...

What is the significance of these trials?

This breakthrough gives great hope that we have a proven, highly effective prevention tool to protect people from HIV.

There were 1.3 million new HIV infections globally in the past year. Although that’s fewer than the 2 million infections seen in 2010, it is clear that at this rate we are not going to meet the HIV new infection target that UNAIDS set for 2025 (fewer than 500,000 globally) or potentially even the goal to end Aids by 2030...

For young people, the daily decision to take a pill or use a condom or take a pill at the time of sexual intercourse can be very challenging.

HIV scientists and activists hope that young people may find that having to make this “prevention decision” only twice a year may reduce unpredictability and barriers.

For a young woman who struggles to get to an appointment at a clinic in a town or who can’t keep pills without facing stigma or violence, an injection just twice a year is the option that could keep her free of HIV.

What happens now?

The plan is that the Purpose 1 trial will go on but now in an “open label” phase. This means that study participants will be “unblinded”: they will be told whether they have been in the “injectable” or oral TDF or oral TAF groups.

They will be offered the choice of PrEP they would prefer as the trial continues.

A sister trial is also under way: Purpose 2 is being conducted in a number of regions including some sites in Africa among cisgender men, and transgender and nonbinary people who have sex with men.

It’s important to conduct trials among different groups because we have seen differences in effectiveness. Whether the sex is anal or vaginal is important and may have an impact on effectiveness.

How long until the drug is rolled out?

We have read in a Gilead Sciences press statement that within the next couple of months [from July 2024] the company will submit the dossier with all the results to a number of country regulators, particularly the Ugandan and South African regulators.

The World Health Organization will also review the data and may issue recommendations.

We hope then that this new drug will be adopted into WHO and country guidelines.

We also hope we may begin to see the drug being tested in more studies to understand better how to incorporate it into real world settings.

Price is a critical factor to ensure access and distribution in the public sector where it is badly needed.

Gilead Sciences has said it will offer licences to companies that make generic drugs, which is another critical way to get prices down.

In an ideal world, governments will be able to purchase this affordably and it will be offered to all who want it and need protection against HIV."

-via The Conversation, July 3, 2024

[halorvic]

👇👇👇

[creekfiend]

man and re: the guy who owes me tens of thousands of dollars. that's not even counting the labor I did for him. and the utter lack of credit I get for being instrumental in building His Whole Thing like ... I did almost all the behind the scenes "soft labor" stuff for that initially, the networking, the community building, seeking out potential stud dogs, paying for transportation or other breeding related costs, helping with screening ppl for puppy placement, just the TALKING and social component, running the FB group. helping raise the puppies. uncompensated of course. did you know who came up with the name for it. LMAO. meeeeee

I avoided talking about this in any way for so long because I didn't want it to be perceived as some kind of call-out post or some kind of dogbook vague blog backbiting bullshit. and partially bc I'm sure if he saw it he would have Stories about how this was All Okay Actually or I Was Mean Too. but actually as it turns out I am allowed to talk about experiences that I had with a person that deeply impacted my life on my own fucking blog. :)

[seth-whumps]

consider a whumpee who would normally heal quickly, with magic or a healing factor, inflicted with a poison/illness/curse/just plain exhaustion that prevents any wounds from healing, hemopheliac style. going from standing up the day after a stab wound to watching the damn thing bleed, and bleed, and bleed, it won't even close, it stays stubbornly open.... caretakers putting pressure on it, desperate, "why isn't it working?!"

[bigfatbreak]

Wait so, the way the peacock works now is whenever it is used, anyone Ladybug loves receives the side effects of using the peacock instead of the user themselves. So before Marinette met Adrien she didn’t have someone to love so the effects just went to her? And now that she fell for Adrien the effects are going to him?

:) yup!

[welcomefortune]

I know I’m the only person who cares about this but it really bothers me that a Shadow Dragon Rook who is from a military family and from Ventus has nothing to say about how a few years ago the Antaam took the city and all the mages they could find were rounded up and forcibly lobotomized with qamek before being mercy killed and all the men were rounded up and press-ganged into the Qun. Not when Taash’s friend says he left the Antaam after being forced to participate in Ventus. Not during any of Taash’s quests about Qunari culture. Not in Treviso when the Antaam are occupying it and oppressing the mages there. And not even when they find out that the Antaam want to lobotomize everyone in Treviso! I feel like they should have some thoughts on that maybe! Especially if they are a mage! I feel like growing up in a nation that’s been at war with the Qunari for centuries, having your father actively fight against the Qunari your whole life and then living through a sack of a city that ends in the death of a bunch of your friends and neighbors by the Antaam should have some sort of impact on how Rook sees if not the Qun as a whole certainly at least the Antaam.

[canisalbus]

Hello, I'm not sure if you're aware, but tumblr is going to start helping midjourney gather data for their AI. You're one of the artists I follow here pretty actively and I wanted to warn you to maybe start nighshading your art before posting it here so it doesn't get swept up!

I've seen a couple of posts about it. Feeling disappointed but not that surprised. Also not excited about having to start nightshading/glazing my pieces but if there isn't going to be any serious regulations regarding data scraping and ai "art", there aren't a lot of choices.

Thank you for taking the time to warn me just in case, it was very thoughtful of you!

[emoclone]

i'm constantly oscillating between "yeah, wearing a mask is kind of annoying and inconvenient and some people have genuine barriers that prevent them from doing so" and "i truly believe that the majority of the population could tolerate wearing a mask in public at least 50% of the time, and if they bothered to do that, we would all be better off for it."

[captainjonnitkessler]

I think I've identified the reason I get so worked up about anarchism in relation to labor rights and safety in particular.

Three years ago I watched my coworker almost die when a piece of machinery we were moving unsafely fell on him. It missed his head by an inch and snapped his leg in half instead. It took months of recovery and multiple surgeries for him to walk again and he will be disabled for the rest of his life. And it didn't happen because of Capitalism or profit motive or because our evil bosses were forcing us to work unsafely. It happened because he'd done similar things a hundred times before and it had always been fine, and because I didn't know enough to clock just how dangerous what we were doing was, and just because of some plain shitty luck. Mentally it fucked me up for months in ways I didn't recognize until well after the fact.

And the thing is, almost every construction worker can tell you about the time they saw a fatal or near-fatal accident. An apprentice younger than me had a heart attack and was out of work for over a year after shocking himself on a live circuit. The woman who runs our apprenticeship program has a husband who had his arm blown off in an arc flash incident. One of my teachers had a coworker die after getting hung up on a live circuit and he wasn't found until the end of the day.

Construction is one of the single most dangerous industries to work in, and I believe this is why rates of drug and alcohol abuse and suicide are sky-high in the industry. I think many construction workers are low-key traumatized by knowing constantly that they could die or be permanently disabled due to a very simple mistake or oversight. It is simply inherently unsafe when you are working with live electricity, power tools, heights, thousands of pounds of machinery, cranes, etc. And so yes, I do believe that safety protocols and the ability to enforce them are absolutely necessary to preventing a massive amount of death. The number of worker deaths in the US has been slashed by 60% since OSHA was instated.

And so to get online and have someone who has never set foot on a jobsite in their life condescendingly explain to me that actually, we don't need OSHA or the ability to enforce safety standards because in a perfect world everyone will just suddenly start working perfectly safely, and I'm just too stupid or brainwashed to realize that The Real Villain Is Capitalism, and if we just get rid of that it will somehow also get rid of the inherent safety issues involved in the entire construction industry - well it turns out it pisses me off a little bit!

[serpentface]

SPIRITUAL POLLUTION, THE GESTURES AGAINST EVIL, AND ABLUTION: A POST

The concepts of spiritual purity and pollution are central to the Faith of the Seven Faced God (and similar takes on the concept predate it throughout and beyond the immediate Wardi cultural sphere). There is no clean cut distinction between physical and spiritual health in this belief system (these concepts exist as a heavily overlapping venn diagram) and many methods intended to cleanse spiritual pollution address both realms.

The word for the concept referred to as spiritual pollution is 'mesechitse', which can translate to 'blockage' or 'severance' depending on the context (its underlying meaning is a pathway that has been stopped in some capacity).

At its core, spiritual pollution is a corruption of the living spirit (which is carried by/IS the blood). It causes both physical and spiritual problems. Polluted blood flows improperly and does not maintain the body’s natural stasis or integrity, causing or allowing disease or other bodily dysfunctions to occur. Many ailments are seen as wholly physical and internal in nature, occurring directly due to polluted blood flowing improperly and affecting key organs. Other diseases (particularly contagious or infectious disease) are known to be caused by dagi, which are harmful spirits that enter the body through orifices or wounds. A limited number of ailments (most notably pronounced schizophrenia-spectrum disorders or cognitive disabilities, unfortunately) are thought to be caused by possession by more powerful evil spirits.

At its worst, severe spiritual pollution is thought to impact or sever one's connection to God. Summarized very basically, severe pollution = blockage of flow between one's own living spirit and the greater spirit of God, which deprives a person of God's blessings and protection, severs them from the natural cycling of life and death (and prevents their necessary participation) and can put their afterlife in jeopardy.

Some degree of corruption to the living spirit is seen as completely inevitable and managed by the body, which physically expels some polluting agents via urine and feces, as well as menstruation (thus all of these substances are themselves dirty and polluting agents). It is reckoned as impossible for any living body to exist in a Completely spiritually pure state. The goal of cleansing (and broader practices revolving around spiritual integrity) is rather to maintain stasis of the body's natural cycling (and by extension a connection to God's living spirit) and to keep pollution contained and minimized.

If one's immortal soul successfully reaches the afterlife, it is then reborn into a spiritually pure existence incapable of being 'severed' from God in any capacity. God Itself is a spiritually pure being, but Its body and living spirit (the world and its cycles, manifested as Faces) is vulnerable. The purity of God's living spirit (and therefore the life-sustaining functions of the world that all beings depend upon) must be sustained, protected, and restored through right practice, which is what much what the public religion revolves around.

Spiritual pollution is a separate but overlapping concept with:

-Metaphysical vulnerability, the word for which is 'namne couyibase' (literally ‘lacking integrity of Being’). This is a state in which the body and living spirit is considered vulnerable to great change, for good or for bad. These states can have vital and positive uses (they are utilized in many rituals, and it is what allows for conception and birth), but must be entered with caution and intentionality. Uncontrolled namne couyibase can otherwise leave one open to forms of spiritual harm. -Curses, which are targeted infliction of harm (of all sorts- bad luck, evil spirits, etc) onto a person, place, or thing. A spiritually polluted body is has less resistance to curses, and curses can intensify this pollution. -Possession, which is when evil spirits attach themselves to or inhabit the body. In the vast majority of cases, possession does not mean an evil spirit is Controlling the body, merely harming it. A spiritually polluted body has less resistance to possession, and possession can intensify this pollution. -Ritual uncleanliness, which is a state of intensified spiritual pollution that requires complete prohibition from a person from entering sacred spaces or participating in certain rituals until they are made clean. The most common reasons for ritual uncleanliness are active menstruation, being in the mourning period, or having performed a known dirtying action without its required ablution (see below).

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Multiple levels of religious-medical practice are centered around maintaining the body's stasis and cleansing it of mesechitse whenever possible. The methods are both active and passive.

Passive methods include the wearing of protective objects/amulets or having the motifs on household items or as decoration (the most ubiquitous are charms like the pelatoche (lit: '(ocean) eye') or odatochent (lit. 'Gods eyes'), the skimmer woman, or phalluses, and the wearing of gull feathers), in addition to other beneficial/protective iconography (guardian lions are most common, though physical representations of each Face of God have beneficial functions).

Active methods cover a broad swath of rites and behaviors (which is even broader in non-doctrinal folk practices). I'll be focusing here on the two main everyday methods of protection/cleansing (rather than more specialized rites) that are supported by core doctrine and may be performed by anyone, rather than being restricted to priests.

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Gestures against evil

These are the absolute most basic protection methods, comprised of three core gestures.

Purity of intent: the hand is held with the palm facing upward, the pointer and pinky finger extended and the thumb and inner two fingers pressed together. This is the most directly ‘cleansing’ gesture, it attempts to bind uncleanliness within the body and thus to prevent inevitable background level spiritual pollution from the body infecting a pure environment or another person. You mostly perform this gesture while entering/leaving a protected or vulnerable space (literal or figurative).

Protection of spirit: the hand is held with the first two fingers pointed together, held upwards for generalized use or pointed for directed use. This is the simplest of apotropaic gestures, aiming to protect the body and spirit from outside harm. This is commonly used before or while entering contexts seen as physically and/or spiritually dangerous, or to un-aggressively counter an evil eye curse.

Dispelling of evil: The hand is held with the first two fingers pointing together, touched to the lips, and flicked away from the body. In practice, this is most commonly used to prevent attachment by malicious or otherwise harmful spirits that may have been evoked (you might perform this after you speak of someone believed to be an earthbound ghost or refer to an evil spirit directly, or immediately after touching a potentially contagious sick person (ideally followed by ablution)). This will not help you if evil spirits have fully Attached themselves to you, but can remove ones that have been attracted to you. Doing this gesture and flicking in the direction of another person is very rude.

These gestures have separate uses, but will often be performed in conjunction (usually in the order given) as a quick means of protecting oneself and the spaces around them. It is not considered a doctrinal replacement for ablution as it does not actually cleanse the spirit, but it attempts to reduce harm (both sustained and produced by the user).

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Ablutions:

Ablution is spiritually and physically cleansing the body with clean water. The metric for clean water is fairly expansive- ocean water, any flowing water, any clear lake, shallow water sources that are clear and free of (obvious) polluting elements such as animal corpses or unclean animal feces, any clear collected water.

The core requirement of an ablution is for the hands to be cleaned in all circumstances, and for other body parts to be cleansed in addition if the situation requires it. One must fully wet the hands/other affected areas and scrub thoroughly, and then use fresh water to rinse. If you have to clean other parts of your body, you save your hands for last (as they will be used for the cleaning).

It is appropriate to perform ablutions cooperatively, but the person assisting you should participate as well (ie- if you have someone washing your back, they should scrub and rinse their own hands after). Someone considered to be in a ritually unclean state that ablution will not immediately fix (the most common are actively menstruating or being in the midst of the mourning period) should not perform ablutions on others.

Note that there is no Hard distinction between bathing for spiritual cleanliness and bathing for physical cleanliness (there is a separate set of cultural standards for physical hygiene, but most hygiene expectations are Covered by ablution). In most circumstances, ablution is just a regular, sometimes tedious everyday activity rather than a solemn or special occasion.

The ritualized requirements denote that only the hands + any given affected body parts Must be washed, but ablutions will often be an aspect of a full-body bathing routine to meet other hygiene standards. (ie: someone performing ablution before making offerings or eating a meal is only Required to wash their hands, but will very often wash their whole bodies and clean their hair- offerings and a meal are (typically) daily activities, so this is a good time to just get a full bath in while you’re at it). It may additionally involve washing the skin with oil or soap, moisturizing the hair with oil, scraping away dead skin, and applying perfumes. This is not a ritual requirement and is performed because generally, people like to feel clean and smell nice.

The hard physicality of cleansing WITH WATER is KEY to this practice. Per core doctrine, there are no DIY cleansing methods that replace washing with water. If one does not have access to clean water for ablutions, they should not perform offerings whatsoever (but are allowed to pray) until they can be cleansed, and accept that they are receiving spiritual pollution by performing ablution-required tasks in the meantime. A blessing from a priest is the only doctrine-supported spiritually cleansing replacement for water ablutions. In practice many people will use the gestures against evil as a replacement (which is not supported by doctrine and is more common in folk religious practice), and virtually everyone will find ways to get physical contaminants off of their body either way (if you step in dog shit and don't have any water nearby, you're going to wipe it the hell off even if that doesn't make you ritually clean).

Times when such an ablution is generally considered a hard requirement:

Before bloodletting in prayer or making other offerings

Before meals

Before assisting in a birth

After menstruation ends

After receiving penetrative sex

After defecating

After urinating (this isn't as ubiquitously seen as a hard requirement, in a lot of cases people interpret it as 'only if you actually get pee on your hands')

After touching urine

After touching feces (many lines of thought make exceptions for the excrement of cattle and khait due to their clean and sacred status- this makes life a easier for the majority of people who have to use dry dung as fuel)

After touching a dead body (human or animal)

At the end of your mourning period for dead kin (traditionally as part of a larger ritual involving full body submergence in flowing water, rather than as a common ablution)

After touching someone else's blood (aside from rites that require it, in which the blood is expected to be clean and the cross-pollution of living spirit is intentional) (technically includes semen but this does not come up very often)

After touching most sick people (particularly with contagious diseases or any skin ailments)

After recovering from an illness (ablutions will be performed as an aspect of treatment as well)

Before entering most temple's inner shrines (and some temples altogether)

Also a requirement for participation in certain specific rites and/or festivals

The exact nuances on how hard these requirements are sometimes vary, particularly in instances revolving around touch. Official doctrine is that any unclean touch requires ablution, but in common practice this is sometimes reinterpreted as only a hard requirement when the touch occurs to the hands. Most practitioners do not perform an ablution immediately after an unclean touch occurs (if you're a field laborer and step in dung, you're probably going to wait to wash until you retire for the night), and not everyone performs ablutions every single time they 'should'.

Only drawing I have related to ablution under the cut (nudity)

This is one way to do it

[ariadne-mouse]

I mentioned in this post that I thought it would take a life or death choice about Imogen for Liliana to flip, situationally, as opposed to the party being able to convince her to change her ideology (cult juice is strong), and it seems we may have gotten an element of that in Liliana flying to Imogen's aid against Otohan. I'd be very curious what Liliana would have done if she'd gotten there in time to fight, but we'll never know, so we have to digest the moment we got. I also think FCG's death adds another dimension both in-game and above the table. Since we dropped out literally mid-scene after her arrival this post may get stale immediately after the first few minutes of next week's episode, but for now I think it's safe to say that at least for the time Liliana spends with the party right now she will not be an active antagonist. Her daughter called for help and she answered, and her first act was trying to comfort her. Matt also wouldn't hit the players with another big battle fresh off the first (and with that outcome), so if they do have to face Liliana as an enemy it would be later under evolved circumstances.

To be clear I don't think FCG dying means Matt nerfs the threat of Liliana or that this situation means she has flipped permanently, but rather, it neatly interrupts the established dynamic between Liliana and Imogen thus far and creates a chance for new dialogue that doesn't just repeat all the same things as before. Imogen hasn't needed her mother - not really - and maybe still doesn't, but she called for help and is grieving now and the conversation doesn't necessarily have to be the same old "Liliana renounce your cause" but rather "help your daughter here and now" and to connect with her through that emotion. This is probably the best opportunity they'll ever get to flip Liliana in a more than "last ditch in a crisis moment" kind of way or lay the groundwork for that happening later. Now, the party - and Imogen in particular - may rightly be angry with Liliana as an ally of Otohan, and that FCG died because of the cause Liliana supports. Liliana may want to comfort her daughter while also believing that FCG's death was unfortunate but not ultimately a reason to doubt the cause or escape what she sees as inevitable. It's messy! But it's a very interesting situation and FCG's death is such a visible wound on Imogen that it may elicit Liliana to do or consider things she wouldn't, otherwise.

[gl1tchr]

To justify why I think Edward would just Die if exposed to a high dose of fear toxin - I think the Levels of fear toxin works to slowly break away at the conscious and unconscious coping mechanisms one has to defend against fear, and I think the more you strip Edward of his defenses, the more his body is actually going to REACT to all of the anxiety he's been experiencing for his entire 30-odd years of life. Anxiety takes a physical toll, and I think the lowest dose doesn't do much to him because his defenses are just THAT used to dealing with fear that low dose fear toxin is "normal" for him. The medium dose would break down all of his CONSCIOUS coping mechanisms and force him into catatonia, like we see when he has the breakdown after his second encounter with the man outside his apartment. And the highest dose would break down all of his SUBCONSCIOUS defenses, e.i. shutting down. It would force his mind and body to react fully to the fear and I think years of anxiety has made him extremely physically fragile and I don't think his heart could take it.

basically

Edward's first line of defense is his numbness, his second line of defense when faced with anxiety that surpasses his numbness are the few coping mechanisms he has learned to exercise, and his final line of defense is shutting down. And I don't think his body can handle much after the shutting down phase

[artbyblastweave]

What are your thoughts on on the comic Kingdom Come?

I think that it's one of the strongest, if not the strongest thing Mark Waid has ever written, and the second strongest project Alex Ross has been involved in (first being Marvels.) I wasn't really aware until recently of the degree to which Alex Ross was a major creative driver on that project outside of the art, which was a major shortcoming on my end. When I figured this out the throughline became apparent- Between this, Earth X, Marvels and Project Superpowers, the man loves his bittersweet superheroic gotterdammerungs, and given the baroque grandiosity of his paintings, that makes a lot of sense.

Anyway, out of all the riffs by subsequent artists that came out of people stripping Moore's Twilight of the Superheroes pitch for parts, I definitely think Kingdome Come remains one of the stronger ones. Part of this is the first-mover effect- they got it out the door before such elseworlds became like half of all published superhero books. Part of this is that Ross's interiors are fundamentally unbeatable and would be a good reason to read the book even if the story was dogshit. And partly I suspect there may have been a reining-in-George-Lucas dynamic by having Ross and Waid work together; I think that Ross can get a little gratuitous when he's the primary writer, and I say this as someone who liked Earth X on balance.

[cogentranting]

We call those 🎵 evasions 🎵

[clericofshadows]

saw a fanart of Kaidan in this armor that I reblogged earlier today, and felt like attempting it for myself

I may also give this to mshep, and will likely put this in my main armory mod for Kaidan. we'll see :) I'm still tweaking it and deciding how I feel about it.

ngl I feel like I managed to fit it well to the masc body & it kind of reminds me of the ME1 light armors but with more shit going on, so I am leaning more towards making it public