#rita a rubin

[may12324]

Recently I had the joy of reading "A Ballad for Slayers and Monsters" by Rita A Rubin , and I enjoyed it a bunch! I'm excited for you all to meet these two hotties, it comes out in April! Lets just say, its like The Witcher, but its sapphic 👩‍❤️‍💋‍👩

[bookshelvesandtealeaves]

✨ BOOK REVIEW ✨

Of Knights and Books and Falling in Love by Rita A Rubin

⭐️⭐️⭐️

[instagram]

This was such a sweet, cosy, low-stakes fantasy. I found this really light and easy to read which is a great way to end my November reading.

Jayce is a great main character. He’s been through so much and holds onto so much guilt for the things he’d been forced to do, but this story focusses on his resilience, his big heart, and it just left me feeling really fluffy and hopeful.

The romance is super sweet and a bit of a slow burn. Idiots in love and mutual pining at its finest.

I definitely recommend if you’re looking for a cosy, easy read with not a lot of plot.

[hayleyreadssapphicbooks]

A Ballad for Slayers & Monsters by Rita A. Rubin

“A Ballad for Slayers & Monsters” by Rita A. Rubin is a sapphic fantasy novel, featuring the main characters of Kas, a monster slayer, and Claudia, a half “vampyric” monster. The two form an unlikely alliance to stop, Serisa, a full vampyric from using a relic to reawaken dragons and doom humanity.

Between fierce battles, the heart of the story is a lovely romance between two sworn enemies. Both carrying the baggage of traumatic pasts, they reluctantly team up and realize, along the way, that they have more in common than they once thought.

The novel has a good premise, especially with a classic enemies-to-lovers trope, and has an interesting world full of monsters. However, the way so many magical creatures were included felt like going through bullet points or a list of monsters. I also assumed (my fault) that the book is YA, but the slaying and battle scenes can get quite violent. So, if you, like me, assumed the age range based on the cover, just know this book does include fairly explicit scenes of violence and sex.

The book includes multiple perspectives from characters including Kas, Claudia, and Serisa. I enjoy reading multiple perspectives but the switches in this book were often sudden and short-lived and slightly overlapped each other. I found that switching so often took me out of the story a bit, especially when reading the same dialogue as the previous page.

Although I had some issues with the pacing and wished some things were given more time to flesh out, I enjoyed the book. I think “A Ballad for Slayers & Monsters” is a super fun fantasy and romance novel with lots of action scenes too. I love the inclusion of queer characters and I am a fan of the star-crossed lovers, enemies-to-lovers, vibes. I think the book feels a bit like a dnd campaign, so if these vibes are for you, I definitely recommend reading!

Thanks to NetGalley and the author for the digital ARC!

POV: third person, past tense, multiple POVs

Spice: 🔥/3

Rating: ⭐️⭐️⭐️/5

[heavenlycinema]

In the Heights (2021)

Jon M. Chu (Dir)

“The streets were made of music.”

[historical-hollywood]

Lillian Harvey with Rita and Rubin and a snowman friend in I Am Suzanne! (1933)

[biblionerdreflections]

Book Review - Of Knights and Books and Falling in Love

Hello, everyone! Today I’m reviewing Of Knights and Books and Falling in Love by Rita Rubin. I stumbled upon this one while doom-scrolling one day on Twitter and thought it looked cute. I’ve been in the mood for something cozy and adorable since I haven’t been feeling well recently, and Of Knights and Books and Falling in Love seemed like the perfect book to help me feel better. Jayce has little…

[betterbooksandthings]

"There is no one reason why a particular romance novel hasn’t been widely discovered, but budget, bias, and luck play a role. Independent romance authors often have to market their books entirely out of pocket and online. Without placement in most bookstores, indie authors rely on self-funded and self-run social media campaigns. Even when romance authors secure a traditional publishing deal, marketing budgets are not guaranteed. Although more bookstores might stock their books, they are also largely in charge of marketing their romance books online.

Bias also comes into play. Marginalized authors are often under added pressure to give their books a broader (i.e., whiter, straighter, etc.) appeal. It is easy for a publisher to point to a book’s potentially limited appeal as a reason behind a limited marketing budget.

Then, if a romance book does have a marketing budget and hasn’t had any issues with bias at any point in the publishing process, a certain amount of luck still factors in. Hitting the right audience at the right time and taking off is no easy task.

That is to say, it can be difficult for romance books to find a platform, so there is every chance these are the best romance books you haven’t read. To narrow down my list, I sorted my Goodreads books to show books with the least number of ratings and selected every romance novel under 500 ratings. I then narrowed that list down to nine books."

[esonetwork]

Hollywood Sex Goddesses | Tales From Hollywoodland

New Post has been published on https://esonetwork.com/hollywood-sex-goddesses-tales-from-hollywoodland/

Hollywood Sex Goddesses | Tales From Hollywoodland

Dive into the glamorous and seductive world of Hollywood’s most iconic sex goddesses in this captivating episode of the Tales from Hollywoodland Podcast. We explore the lives, careers, and lasting legacies of the silver screen sirens who defined an era with their beauty, charisma, and talent. From Marilyn Monroe to Rita Hayworth, discover how these enchanting women captivated audiences and became timeless symbols of allure. Whether you’re a classic film enthusiast or curious about Hollywood’s golden age, this episode offers a fascinating look at the stars who redefined glamour.

Tales From Hollywoodland on Facebook https://www.facebook.com/talesfromhollywoodland 

Tales From Hollywoodland on Instagram https://www.instagram.com/talesfromhollywoodland/

Tales From Hollywoodland on YouTube https://www.youtube.com/channel/UCdLX2kbwHqdn47FNN6vVN7Q 

We want to hear from you! Feedback is always welcome. Please write to us at  talesfromhollywoodland@gmail.com and why not subscribe and rate the show on Apple Podcast, Spotify, iHeartRadio, Goodpods, PlayerFM, YouTube, Pandora, Amazon Music, Audible, and wherever fine podcasts are found. 

#HollywoodSexGoddesses #IconicActresses #SilverScreenSirens #ClassicFilmStars #HollywoodGlamour #MarilynMonroe #RitaHayworth #GoldenAgeofHollywood #HollywoodBeautyIcons #LegendaryActresses #FilmHistory #HollywoodLegends #VintageHollywood #HollywoodBeautyStandards #HollywoodsGoldenEra #TalesFromHollywoodland #Podcast

[eklaize]

Book recs?

Hey capri community! I would love to hear some book recs from you! Setting: prefer fantasy/otherworldly/period over the real current world. Gender doesn't really matter, there can be romance and spice (slowburn is always fun). Can have darker topics if done well.

Most importantly I really want to feel what the characters experience. Can be love/deep connection, fear/panic or whatever emotion but I want to gasp or laugh when reading… It's really hard to describe. Pacat gave all that to me, but it's hard to find in other books so far. (Freya's A Marvellous Light was one of the ones that managed to do it, the second book less so tho, haven't read the third yet.)

So if anyone has a recommendation, please drop it in the comments. 👉👈 EDIT: OMG thank you so much for all the recommendations! I compiled them in alphabetical order, so other people can refer to the list in case they need a recommendation as well:

A-Z

A Ballad for slayers & Monsters - Rita A Rubin A Gentleman's Guide to Seducing a Scoundrel - KJ Charles A Master of Djinn - P. Djeli Clark A Spear cuts through water - Simon Jimenez A Strange and Stubborn Endurance - Foz Meadows A taste of Gold and Iron - Alexandria Rowland All for the game - Nora sakavic Angels & man - Nicolás Rafael Angels before man - Nicolás Rafael Ballad of Sword and Wine: Qiang Jin Jiu Crier's War - Nina Varela Glitterland - Alexis Hall Heaven Official's Blessing Iron Breakers Trilogy Zaya Feli Long Live Evil - Sarah Rees Brennan Lymond Chronicles - Dorothy Dunnett Iron Widow - Xiran Jay Zhao Murderbot Series - Martha Wells Nightrunner Series - Lynn Flewelling of Knights and Books - Rita A Rubin Silver Blood - TL Morgan Something human - Aj Demas The Goblin Emperor - Katherine Addison The Hands of the Emperor - Victoria Goddard The husky and his white cat (Trigger Warnings) The Magpie Ballads- Vale Aida The Magpie Lord Series- Kj Charles Parasol Protectorate - Gail Carriger Realm of the Elderlings/Farseer Trilogy -Robin Hobb Reforged - Seth Haddon Scum villain's self saving system Simon Snow Trilogy - Rainbow Rowell Six of Crows - Leigh Bardugo Something Human by Aj Demas Skulduggery pleasant - Derek Handy The Alexander Trilogy - Mary Renault the Grandmaster of demonic cultivatio (Mo Dao Zu Shi) - Mo Xiang Tong Xiu The Left Hand of Darkness - Ursula K. Le Guin The Queen's thief - Megan Whalen Turner The Raven Cycle by Maggie Stiefvater The Rifter Series - Ginn Hale The Scottish Boy - Alex de Campi The Traitor Baru Cormorant -Seth Dickinson Tiger, Tiger (Webcomic) Will Darling Adventures - KJ Charles Untamed - Anna Cowan

the following ones were mentioned as well, but i've already read them or are currently reading the book: Dark Rise - Pacat Priory of the Orange Tree - Samantha Shannon Song of Achilles - Madeline Miller Tarot Sequence Series by K.D. Edwards (trigger Warnings) The Last Binding Trilogy - Freya Marske Winter’s orbit - Everina Maxwell

[the-bi-library]

Happy April! Here are bi books out in April.

This is not an exhaustive list.

Books listed:

Blood Cypress by Elizabeth Broadbent

Where Shadows Meet by Patrice Caldwell

Venom Bound (Blood Tethered #2) by I.S. Belle

Love, Unexpected by Shannon O'Connor

Steamy on Set by D.S. Walls

Iron Tongue of Midnight (The Forge & Fracture Saga #3) by Brittany N. Williams

Bone Dresser by Nico Vincenty

Fluid: A Guide for People with Flexible Sexuality by Mark Cusack

Girl Crush by C.H. Williams

A Drop of Corruption (Shadow of the Leviathan, #2) by Robert Jackson Bennett

Advocate (The Warden, #3) by Daniel M. Ford

The Coven Tendency by Zoe Hana Mikuta

Make the Play by Lucky Hart

Accidentally Joining His Cult by Lexi Amber

Futbolista by Jonny Garza Villa

All Fired Up by M.K. England

Waiting for a Witch by Brigid Hunt

Once Upon You and Me by Timothy Janovsky

Nightingale by Frances M. Thompson

Roll for Love by M.K. England

Just a Peck by Chelsea Jean

Coded in Control by KL Hill

Eat the Ones You Love by Sarah Maria Griffin

Into The Fiery Woods by Riley Taylor

Road Trip by Lisa Henry

A Ballad for Slayers & Monsters by Rita A. Rubin

The Assassin and the Sorceress by N.R.G. Selove

Flirting Lessons by Jasmine Guillory

Penance Paid in Blood (The Blood of Tenazeryth Book 3) by Maria J. Hart

Love at First Spin by Lauren R. Stephens

Tonight, I Bleed (The Witches of Halstett, #2) by Katharine J. Adams

Faithbreaker (Fallen Gods, #3) by Hannah Kaner

The Raven Scholar (The Eternal Path, #1) by Antonia Hodgson

Resisting The Temptation by Daisy Wren

A Vow of Wrath and Ruin (The Mind Breaker, #2) by K.W. Foster

Vincent & Sivan by Cali Kitsu

[battyaboutbooksreviews]

💙💜🩷 Upcoming Bisexual Book Releases of 2025

💜 My little bisexual heart is SO excited for this upcoming bisexual book releases of 2025. Which ones are you adding to your TBR?

🩷 Say a Little Prayer - Jenna Voris 🩷 Love in Focus - Lyla Lee 🩷 We Are the Match - Mary E. Roach 🩷 Roll for Love - M.K. England 🩷 Solo Stan - Talia Tucker 🩷 Dream On, Ramona Riley - Ashley Herring Blake 🩷 Hopelessly Teavoted - Audrey Goldberg Ruoff 🩷 My Lady Hiraya - Steven Sy 🩷 The Gryphon King - Sara Omer 🩷 We Are the Match - Mary E. Roach

💙 Daughters of the Blue Moon - Millie Abecassis 💙 A Gentleman's Gentleman - T.J. Alexander 💙 Last Hellos and First Goodbyes - Elba Luz 💙 Tenderly, I Am Devoured - Lyndall Clipstone 💙 If I Dig You - Colby Wilkens 💙 Tenderly, I Am Devoured - Lyndall Clipstone 💙 Modern Divination - Isabel Agajanian 💙 Don't Drag This Out - Emery Lee 💙 For One Night Only - Jessica James

💜 Death Card - Jasmine Smith 💜 The Cuffing Game - Lyla Lee 💜 Lovely Dark and Deep - Elisa A. Bonnin 💜 A Ballad for Slayers & Monsters - Rita A. Rubin 💜 The Transition - Logan-Ashley Kisner 💜 A Vow of Wrath and Ruin - K.W. Foster 💜 A Fix of Light - Kel Menton 💜 No Body No Crime - Tess Sharpe 💜 The Trial Period - Auburn Morrow

💟 A Traitorous Heart - Erin Cotter 💟 Tarnished - Erica Rose Eberhart 💟 This Raging Sea - De Elizabeth 💟 An Arcane Inheritance - Kamilah Cole 💟 Nobody in Particular - Sophie Gonzales 💟 Better Catch Up, Krishna Kumar - Anahita Karthik 💟 The Afterdark - E. Latimer 💟 A Murderous Business - Cathy Pegau 💟 Her Dark Grace - Rae Valtera

🩷 The Broposal - Sonora Reyes 🩷 It's a Love/Skate Relationship - Carli J. Corson 🩷 Futbolista - Jonny Garza Villa 🩷 Holly Jolly July - Lindsay Maple 🩷 Homegrown Magic - Jamie Pacton & Rebecca Podos 🩷 Murder Land - Carlyn Greenwald 🩷 Iron Tongue of Midnight - Brittany N. Williams 🩷 Behooved - M. Stevenson 🩷 A Legionnaire's Guide to Love and Peace - Emily Skrutskie

💙 The Coven Tendency - Zoe Hana Mikuta 💙 Serial Killer Support Group - Saratoga Schaefer 💙 How to Survive a Slasher - Justine Pucella Winans 💙 Well, Actually - Mazey Eddings 💙 Unromance - Erin Connor 💙 Medievally Blonde - Cait Jacobs 💙 Hazelthorn - C.G. Drews 💙 Savage Blooms - S.T. Gibson 💙 The Incandescent - Emily Tesh

💜 Backhanded Compliments - Katie Chandler 💜 Build a Girlfriend - Elba Luz 💜 Virulence - Toni Duarte 💜 This Feast of a Life - Cynthia So 💜 On Her Terms - Amy Spalding 💜 Wooing the Witch Queen - Stephanie Burgis 💜 Love Points to You - Alice Lin 💜 The Sun and the Moon - Rebekah Faubion 💜 Thrill of the Chase - Kathryn Nolan

💟 Exquisite Ruin - AdriAnne May & A.M. Strickland 💟 Alice Rue Evades the Truth - Emily Zipps 💟 Lucky Day - Chuck Tingle 💟 Dawn of the Obsidian Sun - R.N. Barbosa 💟 The Billion Dollar Dynasty - Dominique Davis 💟 Cyrus - A.E. Cosby 💟 Now She's Dead - Roselyn Clarke 💟 Voidwalker - S.A. MacLean 💟 Of Abrasion - S.J. Lee

🩷 Tavern Tale - Kristina W. Kelly 🩷 An Honored Vow - Melissa Blair 🩷 Love on the Sunny Side - Cozy DuBois 🩷 Advocate - Daniel M. Ford 🩷 TSWR: Love At First Flight - S Sidney 🩷 Vessel of Shadows - Rowan Redfield 🩷 Flirting Lessons - Jasmine Guillory 🩷 Love At First Fright - Nadia El-Fassi 🩷 French Pressed Love - M.C. Hutson

[bookshelvesandtealeaves]

🩷💛💙 PAN PRIDE DAY 💙💛🩷

QOTD: What’s a book you’ve enjoyed with a pan main character?

Happy Pansexual Pride Day to all my pan pals!

I still feel pansexuality is severely under represented in fiction (and when it’s there it’s often alluded to through wording rather than specifically differentiated from bisexual), but I’ve definitely come across way more (some intentionally and some by pure happy accident) since making my first ever pan post with only 5 books in it, some of the rep in that first post not even being main characters.

So here are some recs and some still on my tbr for you to add to yours if you’re looking for some pan rep to brighten your shelves!

[instagram]

Fantasy

- Of Knights and Books and Falling in Love by Rita A Rubin

- A Dowry of Blood by ST Gibson

- The Sound of Storms by Anya Keeler

- Evergreen by Devin Greenlee

- A Dark and Hollow Star by Ashley Shittleworth

- Loki: Where Mischief Lies by Mackenzi Lee

Romance

- How to Bang a Billionaire by Alexis Hall

- Verona Comics by Jennifer Dugan

- Count Your Lucky Stars by Alexandria Bellefleur

- Love & Other Disasters by Anita Kelly

- Get it Right by Skye Kilaen

- Their Troublesome Crush by Xan West

Other

- Who Could Love You, Astor Price? by Amy Jane Lehan

- The Many Half-Lived Lives of Sam Sylvester by Maya MacGregor

- The Long Way to a Small Angry Planet by Becky Chambers

- We Could Be Something by Will Kostakis

TBR

- We Are the Ants by Shaun David Hutchison

- We Deserve Monuments by Jas Hammonds

- In the Ravenous Dark by AM Strickland

- Summer at the Scottish Castle by Rachel Bowdler

- Beating Heart Baby by Lio Min

- For Never & Always by Helena Greer

- Once & Future by AR Capetta and Cory McCarthy

- Stars Collide by Rachel Lacey

- A Song of Salvation by Alechia Dow

[thistlearts]

Welcome, a new book cover art I made for Rita Rubin as part of her romantasy series about to bi men being hopelessly in love with each other!

[ofmdrecaps]

08/05-06/2024 Daily OFMD Recap

TLDR; David Jenkins; Rhys Darby; Taika Waititi; Vico Ortiz; Samson Kayo; Kristian Nairn; Ruibo Qian; David Fane; Rachel House; Minnie Driver; Dominic Burgess; Aug 7 WBD Q2 Earnings Call: Fuckery; Articles; National Maritime Museum in Cornwall; Fan Spotlight: Cast Cards; Never Left Podcast; Love Notes; Daily Darby/Today's Taika;

Well, best intentions and all that-- another two dayer because that's just how this month has been. Lots and Lots going on with our cast & crew, friends <3

= David Jenkins =

Well David tried to give us all heart attacks yesterday.

And then today he sent some love after Astroglide brought tears to our eyes on twitter.

Source: David Jenkins Twitter

= Rhys Darby =

Lots of Cryptid Factor sightings! Reminder! Cryptid Factor is in London this Friday!

Video of a sighting of Indiana Buttons

Also! Dan and Stede The Nessiehunter gave us some quick live videos of their trip to Lochness!

View this post on Instagram

A post shared by Dan Schreiber (@schreiberland)

View this post on Instagram

A post shared by Dan Schreiber (@schreiberland)

View this post on Instagram

A post shared by Steve Feltham (@steve_the_nessiehunter)

= Taika Waititi =

Another AppleTV spotlight of Time Bandits! Reminder, new episodes out tomorrow, Aug 7!

View this post on Instagram

A post shared by Apple TV (@appletv)

Then Rita pulled Taika into another Tiktok trend.

View this post on Instagram

A post shared by RitaBot | UK Owen (@ritabotowen)

= Samson Kayo =

Samson out with Yvonne Orji <3

Source: Yvonne Orji's Instagram

= Kristian Nairn =

Kristian is reminiscing about Game Of Thrones- his book is coming out on September 24th, 2024-- you can still preorder it online!

Source: Kristian Nairn's Instagram

= Vico Ortiz =

Vico asked what quite a lot of us have wondered about before. IYKYK.

View this post on Instagram

A post shared by Vico Ortiz (@puertoricaninja)

Source: Vico Ortiz Instagram

And some more photos of Vico with their loves.

Source: Vico Ortiz Instagram

= Ruibo Qian =

Ruibo is inviting everyone to join her on Aug 8, at 12am PST for a meditation. You can access it on Ruibo Qian's Youtube!

Source: Ruibo Qian's Instagram

= David Fane =

Some of you may remember that our dear Fang, David Fane, was awarded the Fulbright-Creative New Zealand Pacific Writer's Residency! Now, I'm not 100% sure, but I know that Fulbright partners with the Kennedy Center, and so I'm thinking that's what David's referring to in his most recent instagram story. Good luck David! We are rooting for you!

Source: David Fane's Instagram Stories

= Rachel House =

Rachel's movie, The Mountain (Temaunga) has been officially selected for the Toronto International Film Festival! Congrats Rachel and everyone involved in the film! Learn more on TIFF's website!

Source: Rachel House's Instagram

= Minnie Driver =

Minnie was featured in Rose & Ivy!

Source: Rose and Ivy Journal Instagram

= Dominic Burgess =

Everything about this photo makes me smile.

Source: Dominic's Twitter

== #DontStreamOnMax: Fuckery Reminder ==

Our friends over at @adoptourcrew are calling on everyone to help with the fuckery tomorrow during the Q2 Earnings Call. Remember to flood social media with #DontStreamOnMax and #FireDavidZaslav!

Source: Adopt Our Crew Twitter

== Articles ==

Thank you to Meowzawowza_ on twitter for sharing the contents of this article!

https://if.com.au/allen-marshall-palmer-on-the-benefits-of-shooting-in-new-zealand/

Source: Meowzawowza_ Twitter

= National Maritime Museum Cornwall =

A HUGE thanks to @merryfinches for sharing this absolutely awesome find with us-- and thank you for bringing letting me share it in the recap Kylie! You continue to be one of the sweetest, kindest, most amazing folks on the planet <3 Please visit Kylie's blog here for more info! Here's a quick excerpt! "The exhibit is running until early 2025, so if you’re in Cornwall before it closes then you should go down and stare at a go at floating cardboard cutout of Ed for a bit 🥰💕"

Source: @merryfinches Tumblr

== Fan Spotlight ==

= Cast Cards =

Thank you so much to @melvisik for keeping these up! It's still so amazing to think of just how many people made our show happen! First up is Bradley Rubin, another one of our Production Designers! Second up is Brigid M. who is apparently unspecified (according to https://ofmd-crew.com/)! Mel thinks she may be an action talent!

And last but not least - Stephen Dudro is one of the art directors for the show!

Source: @melvisik's Twitter

== Never Left Podcast ==

Episode 29 is out, and Never Left is continuing with their discussion on flowers! You may remember last weeks episode sparked the butterfly realization to many of the fans! Always great stuff coming out of our friends over at Never Left Podcast! Check them out on your favorite listening platforms here!

Source: Never Left Podcast Instagram

== Love Notes ==

Hey there lovelies! How's your week going? Are you feeling the buzz? There's been lots of news all over the world, some good, some bad, but it feels like a lot of stuff is starting to upturn, even if it's just a little. I've had a few things on my mind the last couple days and I wanted to get them out and send some love. This is a bit of a long one and it's gonna get a bit heavy, so please skip to below the === if you don't feel up for it.

CW: Intrusive Thoughts Sometimes your brain likes to tell you things that you don't really believe (or shouldn't) when things are hard. Sometimes it tells you, you're not good enough, or capable enough, or smart enough, or skilled enough, or you don't deserve good things. Sometimes it tells you things would be better for other people if you weren't around, if you quit your job, or ran away. Sometimes it tells you you don't belong where you are, for any array of reasons. Sometimes it tells you you're unforgivable, or incapable of change.

It's wrong, dearies. It's so very wrong. Your brain sometimes lies to you because it's been trained to do so. By society, by leaders, by people trying to shape you into their worldview. There's nothing wrong with you if it does, it's actually pretty darn normal to feel those things. We deal with so much anxiety in our day to day lives, and our bodies are still stuck on thousands of years of defence mechanisms, and it doesn't know how to cope with the constant micro-stressors we deal with in modern times.

So it learns and adapts to your environment. Your brain is so damn smart-- that it takes what it hears over and over and it turns that inward because it thinks that's what you need. What it doesn't know is that when life is crazy, and the world continues to be this chaotic black hole of unending bad news, it'll adapt and turn things more and more negative. That's why so many people do daily affirmations-- because you can train your brain to do AMAZING things. It takes a long time, and constant reminders, but eventually it gets easier. Toxic positivity isn't helpful, but when you have unending darkness coming in waves around you, sometimes even just a little candle of hope can keep that at bay, and eventually help break up the darkness itself.

============================= So today, I'm gonna push a couple affirmations... and they kinda show up already in my love notes here and there-- but I'd like you take a moment to say them out loud if you can, and take a deep breath in between them --Give yourself a little support for today.

I found some that speak to me here, but you can find them all over the place on the web if they don't speak to you.

----------------

I am still learning so it’s okay to make mistakes.

I am loved and worthy.

I alone hold the truth of who I am.

I belong here, and I deserve to take up space.

I am allowed to feel good.

---------------- You are all of those things Lovelies. You truly are. Do you know why I call you all "Lovelies" so often? Because that's the word that encompasses so much of the good in the world to me-- and that's what you are.

You are lovely, just the way you are.

You are wonderful just the way you are.

You are worthy, and you are loved, and I know sometimes it's so hard to remember that, but keep telling yourself that, and one day it'll come a lot easier. Sending so much love. You deserve so many good things lovelies, please remember that.

== Daily Darby / Tonight's Taika ==

No theme tonight, just them <3 Gif courtesy of our friend @captain-flint!

[drrubinspomade]

#rita hayworth

STILL ROCKIN’.

We post glorious pinups like this one all day, every day, all unique! If you dig this pic we’ve found online, u should investigate the creator/subjects of the work and fan them, follow them, hire them.

If you’d like us to remove, or you know who made this so that we can credit, DM. Thanks and greetings from Los Angeles.

YOU ARE THE LIGHT

Dr Rubin’s Pomade

[covid-safer-hotties]

The Latest Research About Paxlovid: Effectiveness, Access, and Possible Long COVID Benefits - Published Sept 6, 2024

By: Rita Rubin, MA

As another COVID-19 summer surge hit the US this year, many infected people likely were prescribed the antivirals nirmatrelvir and ritonavir, better known as Paxlovid, for the first time. Or for the fourth time. Or somewhere in between.

Nirmatrelvir-ritonavir, the only approved oral therapy for COVID-19, is recommended for treating mild to moderate SARS-CoV-2 infections among people who are at high risk of progression to severe disease. This includes people aged 50 years or older, especially those 65 years or older, as well as younger individuals who have any of a long list of comorbidities that increase the risk of severe COVID-19.

The clinical trials leading to the US Food and Drug Administration (FDA) authorizing emergency use of nirmatrelvir-ritonavir in December 2021 and approving it in May 2023 were conducted with unvaccinated people who were infected with the now long-gone SARS-CoV-2 Delta variant. This has led to questions about its effectiveness for people who have been vaccinated or have been infected with subvariants of Delta’s successor Omicron, which have been circulating for nearly 3 years.

But recent observational studies suggest nirmatrelvir-ritonavir still protects people at high risk against hospitalization and death from COVID-19. That is if they’re able to get a prescription for it—research has uncovered racial and ethnic disparities in which eligible patients get a prescription for the treatment.

And as the number of people with postacute sequelae of SARS-CoV-2 infection (PASC), or long COVID, grows, scientists have been investigating whether nirmatrelvir-ritonavir might be useful in protecting against or treating the condition.

Does It Still Prevent Severe COVID-19?

Because the nirmatrelvir-ritonavir phase 2 and 3 trial involved unvaccinated adults without prior COVID-19 infection when the Delta variant dominated, questions have remained about its relevance today.

Scientists from Pfizer, which markets nirmatrelvir-ritonavir, and coauthors recently published a systematic literature review examining that question. They searched for real-world studies reported from December 2021 through March 2023 and identified 18 that met their final selection criteria.

The evidence showed that nirmatrelvir-ritonavir was effective regardless of age, underlying high-risk conditions, or vaccination status. The treatment significantly reduced the postinfection risk of all-cause and COVID-19–related mortality both within the first 30 days and in the long-term. Treatment started within 5 days of symptom onset, as recommended on the label, was associated with the greatest reduction in postinfection risk.

“We remain very confident in Paxlovid’s clinical effectiveness at preventing severe outcomes, including hospitalization and death, from COVID-19 in patients at high risk of severe disease,” Pfizer spokesperson Kit Longley said in an early August email.

Another recently published study reached a somewhat different conclusion. That study, conducted by University of Manitoba researchers, analyzed results from 4 randomized trials and 16 real-world studies, some of which had not yet been peer-reviewed, with a total of nearly 2 million adults aged 18 years or older.

The evidence suggested nirmatrelvir-ritonavir has a small but significant efficacy in reducing COVID-19 hospitalization and all-cause mortality among people with laboratory-confirmed mild to moderate infections, but the evidence is weak, so more studies are needed, the authors concluded.

At Risk but No Script

COVID-19 laid bare health disparities in the US, and nirmatrelvir-ritonavir has been no exception, according to a study published in August.

Using National COVID Cohort Collaborative (N3C) data, researchers studied individuals 18 years of age or older who were diagnosed with COVID-19 between January 2022 and December 2023; up until the end of that period, the US government covered the cost of nirmatrelvir-ritonavir for everyone who needed it.

About 1.26 million people in the N3C cohort were at high risk of progressing to severe disease, making them eligible for nirmatrelvir-ritonavir treatment. But overall, nearly two-thirds of those who were eligible weren’t prescribed the treatment, the authors observed. After accounting for age, sex, and clinical characteristics, the researchers found that non-Hispanic Black and Latino individuals were nearly a third less likely to have used nirmatrelvir-ritonavir than non-Hispanic White individuals.

Patients may not seek care or may not seek it out early enough for the treatment to be effective, coauthor Hemalkumar Mehta, PhD, a core member of the N3C, speculated in an interview with JAMA Medical News.

Another reason could be that patients don’t have a regular source of primary care whom they could ask for a prescription, noted Mehta, a pharmacist and epidemiologist at the Johns Hopkins Bloomberg School of Public Health. They likely don’t know that the FDA has authorized state-licensed pharmacists to prescribe nirmatrelvir-ritonavir, he said.

Mehta acknowledged that until he conducted his study, even he didn’t realize that pharmacists could prescribe the COVID-19 treatment. Publicizing that fact by simply hanging a sign in pharmacies would help, he pointed out.

However, the FDA created an obstacle to quick prescribing of nirmatrelvir-ritonavir by pharmacists, a 2023 article noted. Prior to prescribing, pharmacists must assess patients’ liver and kidney function through health records from the previous 12 months or consultation with their clinician. Other prescribers can simply ask patients about their liver and kidney function and take their word for it, the authors explained. In addition, there is no standardized pathway for pharmacists to bill payors for assessing patients to see if they’re eligible for nirmatrelvir-ritonavir, which typically takes 15 to 30 minutes, according to the American Pharmacists Association.

When people do get a prescription for nirmatrelvir-ritonavir, most get it filled, a recently published study of Walgreens pharmacies nationwide data found. The retrospective study included people 12 years of age or older for whom a nirmatrelvir-ritonavir prescription was ordered from Walgreens pharmacies between December 2021 and August 2023.

A total of about 2.1 million nirmatrelvir-ritonavir prescriptions were ordered for about 2 million individuals. Among the 95% of people who were prescribed only 1 course of the treatment, 88% filled their prescription. Improving uptake of nirmatrelvir-ritonavir requires increasing patient and prescriber awareness, reducing prescribing disparities, and ensuring treatment initiation within 5 days of symptom onset, the authors concluded.

Treat Acute Infection, Prevent Long COVID?

Taking nirmatrelvir-ritonavir for acute COVID-19 might protect against long COVID, although research into that topic has had mixed results.

For example, 2 recent studies, neither of which had yet been peer-reviewed, reached different conclusions.

A preprint posted in June reported observational study results from the Researching COVID to Enhance Recovery (RECOVER) initiative funded by the US National Institutes of Health (NIH). The study population included nearly 500 000 people who tested positive for SARS-CoV-2 between March 2022 and February 2023. Of those, about 165 000 were treated with nirmatrelvir-ritonavir within 5 days after becoming infected.

Compared with no treatment, nirmatrelvir-ritonavir therapy was associated with a 12% lower risk of developing long COVID within 180 days of infection, or an absolute risk reduction of about 3 cases per 100 people. However, no such risk reduction was seen in people at low risk of severe COVID-19 infection who received nirmatrelvir-ritonavir.

“There are quite a few patients who are not at risk but who received a Paxlovid prescription,” first author Fei Wang, PhD, explained in an interview with JAMA Medical News. “This provides us an opportunity to evaluate a low-risk population that got COVID.”

Another preprint, posted this summer, used N3C electronic health records. It found that nirmatrelvir-ritonavir treatment of acute COVID-19 was not significantly associated with reducing long COVID overall, although it was linked to fewer cognitive and fatigue symptoms.

The mixed findings between the 2 studies aren’t surprising, said Wang, an assistant professor of health care policy and research at Weill Cornell Medicine.

Some information, such as COVID-19 vaccination history and nirmatrelvir-ritonavir use, isn’t always encoded in electronic health records, Wang pointed out. Although he and his colleagues “spend a lot of effort” to make sure they have complete patient information, Wang explained, “there’s no way we can evaluate how complete that is.”

He added that not having a consensus definition of long COVID is another critical issue. The N3C’s definition isn’t the same as RECOVER’s, and the 2 cohorts have different patient populations. “All these can lead to different results,” he said.

For Wang, it makes sense that taking nirmatrelvir-ritonavir, an antiviral, for acute COVID-19 would protect against long COVID. The severity of acute SARS-CoV-2 infections is correlated with the risk of long COVID, he said, and one theory about the cause of PASC is the persistence of SARS-CoV-2 in the body.

However, Yale cardiologist Harlan Krumholz, MD, SM, pointed out that unidentified confounders, not nirmatrelvir-ritonavir itself, might be at play in the relationship between treating acute SARS-CoV-2 infection and long COVID risk. “People who take Paxlovid might be different in many other ways,” he noted.

A Long COVID Treatment?

Many individuals with long COVID didn’t have the opportunity to take nirmatrelvir-ritonavir when they first became ill with acute COVID-19. They might have been infected before the treatment became available, or they weren’t considered to be at high risk for severe disease, so they weren’t eligible for it.

Some case reports have suggested that it might not be too late for people who’ve had long COVID for months to benefit from nirmatrelvir-ritonavir. For example, in early 2023 internist Linda Geng, MD, PhD, codirector of Stanford’s PASC clinic, and coauthors reported the case of a patient who’d had long COVID for 7 months, around which time the symptoms of acute COVID-19 returned. Although rapid antigen test results were negative, the patient had been exposed to multiple people with COVID-19, so a primary care physician prescribed nirmatrelvir-ritonavir. Not only did the acute flu-like symptoms resolve, but so did the long COVID symptoms, which included severe fatigue and cognitive difficulties.

That patient spurred Geng and her colleagues to conduct what they say is the first published randomized trial of nirmatrelvir-ritonavir to treat PASC, which appeared in June in JAMA Internal Medicine. The trial enrolled 155 participants with long COVID, all but 2 of whom had received the primary COVID-19 vaccination series. On average, the time between their initial SARS-CoV-2 infection and randomization into the trial was about a year and a half.

The trial found that the longer 15-day course of nirmatrelvir-ritonavir it used was generally safe. However, the treatment didn’t significantly improve long COVID symptoms compared with the control group.

It’s far from the final answer about nirmatrelvir-ritonavir’s effectiveness against long COVID, though, Geng noted. “This is just the first step in many investigations that need to be done.”

The NIH is funding several clinical trials targeting long COVID under the RECOVER initiative umbrella. One, the Platform Protocol to Measure the Effects of Antiviral Therapies on Long COVID Symptoms (RECOVER-VITAL), is testing an even longer course of nirmatrelvir-ritonavir among an estimated 900 participants at centers throughout the US.

And Krumholz and colleagues at Yale University are in the process of analyzing data from their placebo-controlled randomized trial of nirmatrelvir-ritonavir in 100 patients with long COVID. (The trial received funding and design input from Pfizer.)

“We’re not sure it works,” said Krumholz, founder and director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation. “What I think we need are a lot more studies of 100 people or 200 people, trying a lot more things” to treat long COVID.

Participants in the Yale trial were all highly symptomatic and lived throughout the contiguous US. Instead of having them go to participating centers, the trial came to them. “Setting up centers is expensive,” Krumholz explained, noting that the trial’s decentralized design could help cut costs and could work for a variety of conditions and treatments.

Participants were shipped the medication. They gave blood and saliva samples at a local laboratory or at home and answered questions about their symptoms in a digital diary. Yale colleague Akiko Iwasaki, PhD, who studies antiviral immunity and viral disease pathogenesis, is looking at the blood and saliva samples for differences between people who appeared to respond to nirmatrelvir-ritonavir and those who didn’t.

Paxlovid 2.0?

Meanwhile, Pfizer is working to eliminate what one recent publication referred to as nirmatrelvir-ritonavir’s Achilles’ heel: the limited metabolic stability of nirmatrelvir, a protease inhibitor that requires ritonavir to boost it to the target therapeutic range.

The problem is that ritonavir boosts the plasma levels of a long list of other medications beyond the therapeutic range, so nirmatrelvir-ritonavir is contraindicated for people taking them, unless they can temporarily stop or reduce the dose of the concomitant drugs while taking the COVID-19 treatment. Ritonavir is also the source of the metallic taste many individuals who take Paxlovid experience.

Pfizer’s second-generation protease inhibitor for treating COVID-19 is called ibuzatrelvir. Although it’s structurally related to nirmatrelvir, ibuzatrelvir has greater bioavailability when taken orally, so it doesn’t require a ritonavir boost.

Pfizer has completed a phase 2B trial testing the safety and efficacy of a 5-day course of ibuzatrelvir treatment. Participants were nonhospitalized individuals aged 18 to 65 years with confirmed COVID-19 whose symptoms began within 5 days of randomization. Ibuzatrelvir showed robust antiviral activity in the trial, with statistically significant, dose-dependent decreases in viral load at days 3 and 5 compared with placebo, Pfizer researchers reported in April at the European Congress of Clinical Microbiology and Infectious Diseases.

“It is premature to speculate on potential timing of phase 3, but we are considering next steps and plan to share updates as they are available,” Pfizer spokesperson Longley said.

Meanwhile, SARS-CoV-2 continues to evolve along with attitudes toward COVID-19, Krumholz said. Many people “are treating it like a head cold,” he explained. “They’ve obviously made the determination that it’s not dangerous, but it is dangerous.”

Published Online: September 6, 2024. doi:10.1001/jama.2024.16432