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<title>24 May, 2023</title>
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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>The impact of age and psychosocial factors on cognitive and auditory outcomes during the COVID-19 pandemic</strong> -
<div>
Purpose: In March 2020, the UK government announced that people should isolate to reduce the spread of the virus that causes COVID-19. Outside a pandemic, psychosocial factors, such as socialisation and mental health, may impact the relationship between hearing loss and increased dementia risk. We aim to report the impact of psychosocial factors, including social isolation, depression, and engagement in activities, on hearing and cognitive function in younger and older adults during the COVID-19 pandemic. Method: An online survey and experiment assessed self-reported psychosocial factors, self-reported hearing ability and speech-in-noise perception, and cognition. Data were collected between June 2020 and February 2021. Older (N = 112, MAGE = 70.08) and younger (N = 121, MAGE = 20.52) monolingual speakers of English, without any language or neurological disorders participated. Multiple linear regression models were employed to investigate hypothesised associations between psychosocial factors, and hearing and cognition, in older and younger adults. Results: Multiple regression analyses indicated that older adults displayed poorer speech-in-noise perception and poorer performance on one of four cognitive tasks, compared to younger adults; and increased depression was associated with poorer subjective hearing. Other psychosocial factors did not significantly predict hearing or cognitive function. Conclusions: Data suggest that self-reported hearing and depression are related. This conclusion is important for understanding the associations between hearing loss and cognitive decline in the long-term, as both hearing loss and depression are risk factors for dementia.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/rqfjy/" target="_blank">The impact of age and psychosocial factors on cognitive and auditory outcomes during the COVID-19 pandemic</a>
</div></li>
<li><strong>Smaller preferred interpersonal distance for joint versus parallel action</strong> -
<div>
During social interaction, humans prefer to keep a certain distance between themselves and other individuals. This preferred “interpersonal distance” (IPD) is known to be sensitive to social context, and in the present study we aimed to further investigate the extent to which IPD is affected by the specific type of social interaction. In particular, we focused on the contrast between joint actions, where two or more individuals coordinate their actions in space and time to achieve a shared goal, and parallel actions, where individuals act alongside each other but individually. We predicted that joint action would be associated with a smaller preferred IPD compared to parallel action. Additionally, given that this research took place in the midst of the COVID-19 pandemic, we aimed to assess whether IPD preferences are affected by individuals’ concerns about infection in general, as well as COVID-19 in particular. We predicted that higher individual concerns would be associated with greater preferred IPD. To test these hypotheses, we asked participants to imagine different social scenarios (involving either joint or parallel actions alongside a stranger) and indicate, on a visual scale, their preferred IPD. The results of two experiments (n = 211, n = 212) showed that participants preferred a shorter distance when they imagined acting jointly compared to when they imagined acting in parallel. Moreover, participants who reported higher discomfort for potential pathogen contact and who were more aware of the COVID-19 context in which the study took place preferred a larger IPD in general. Our results provide further evidence that different types of social interaction shape IPD preference. We discuss potential reasons for this phenomenon and highlight remaining questions for future research.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/8za3r/" target="_blank">Smaller preferred interpersonal distance for joint versus parallel action</a>
</div></li>
<li><strong>Vaccine-mediated protection against merbecovirus and sarbecovirus challenge in mice</strong> -
<div>
The emergence of three distinct highly pathogenic human coronaviruses, SARS-CoV in 2003, MERS-CoV in 2012, and SARS-CoV-2 in 2019, underlines the need to develop broadly active vaccines against the Merbecovirus and Sarbecovirus betacoronavirus subgenera. While SARS-CoV-2 vaccines are highly protective against severe COVID-19 disease, they do not protect against other sarbecoviruses or merbecoviruses. Here, we vaccinate mice with a trivalent sortase-conjugate nanoparticle (scNP) vaccine containing the SARS-CoV-2, RsSHC014, and MERS-CoV receptor binding domains (RBDs), which elicited live-virus neutralizing antibody responses and broad protection. Specifically, a monovalent SARS-CoV-2 RBD scNP vaccine only protected against sarbecovirus challenge, whereas the trivalent RBD scNP vaccine protected against both merbecovirus and sarbecovirus challenge in highly pathogenic and lethal mouse models. Moreover, the trivalent RBD scNP elicited serum neutralizing antibodies against SARS-CoV, MERS-CoV and SARS-CoV-2 BA.1 live viruses. Our findings show that a trivalent RBD nanoparticle vaccine displaying merbecovirus and sarbecovirus immunogens elicits immunity that broadly protects mice against disease. This study demonstrates proof-of-concept for a single pan-betacoronavirus vaccine to protect against three highly pathogenic human coronaviruses spanning two betacoronavirus subgenera.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.22.540829v1" target="_blank">Vaccine-mediated protection against merbecovirus and sarbecovirus challenge in mice</a>
</div></li>
<li><strong>Tracing the origin of SARS-CoV-2 Omicron-like Spike sequences detected in wastewater</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: The origin of divergent SARS-CoV-2 spike sequences found in wastewater, but not in clinical surveillance, remains unclear. These cryptic wastewater sequences have harbored many of the same mutations that later emerged in Omicron lineages. We first detected a cryptic lineage in municipal wastewater in Wisconsin in January 2022. Named the Wisconsin Lineage, we sought to determine the geographic origin of this virus and characterize its persistence and evolution over time. Methods: We systematically sampled maintenance holes to trace the origin of the Wisconsin Lineage. We sequenced spike RBD domains, and where possible, whole viral genomes, to characterize the evolution of this lineage over the 13 consecutive months that it was detectable. Findings: The persistence of the Wisconsin Lineage signal allowed us to trace it from a central wastewater plant to a single facility, with a high concentration of viral RNA. The viral sequences contained a combination of fixed nucleotide substitutions characteristic of Pango lineage B.1.234, which circulated in Wisconsin at low levels from October 2020 to February 2021, while mutations in the spike gene resembled those subsequently found in Omicron variants. Interpretation: We propose that prolonged detection of the Wisconsin Lineage in wastewater represents persistent shedding of SARS-CoV-2 from an infected individual, with ongoing within-host viral evolution leading to an ancestral B.1.234 virus accumulating Omicron-like mutations. Funding: The Rockefeller Foundation, Wisconsin Department of Health Services, Centers for Disease Control and Prevention (CDC), National Institute on Drug Abuse (NIDA), and the Center for Research on Influenza Pathogenesis and Transmission.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.10.28.22281553v3" target="_blank">Tracing the origin of SARS-CoV-2 Omicron-like Spike sequences detected in wastewater</a>
</div></li>
<li><strong>Wildlife exposure to SARS-CoV-2 across a human use gradient</strong> -
<div>
The spillover of SARS-CoV-2 into humans has caused one of the most devastating pandemics in recorded history. Human-animal interactions have led to transmission events of SARS-CoV-2 from humans to wild and captive animals. However, many questions remain about how extensive SARS-CoV-2 exposure is in wildlife, the factors that influence wildlife transmission risk, and whether sylvatic cycles can generate novel variants with increased infectivity and virulence. We sampled 22 different wildlife species in Virginia, U.S.A. We detected widespread exposure to SARS-CoV-2 across six wildlife species. Using quantitative reverse transcription polymerase chain reaction, we detected SARS-CoV-2 RNA in the Virginia opossum and had equivocal detections in six additional species. Furthermore, we used whole genome sequencing to confirm the presence of SARS-CoV-2 and compare mutations present to known circulating strains. Species that exhibit peridomestic tendencies had high seroprevalence, ranging between 62%-71%, and sites with high human presence had three times higher seroprevalence than low human-use areas across all species combined. SARS-CoV-2 genomic data from an opossum and molecular modeling exposed one previously uncharacterized change to an amino acid residue in the Spike receptor binding domain (RBD), which predicts improved binding between the Spike protein and human angiotensin-converting enzyme (ACE2) compared to the dominant variant circulating at the time of collection. Overall, our results highlight widespread exposure to SARS-CoV-2 in wildlife and suggest that areas with high human activity may serve as important points of contact for cross-species transmission. Furthermore, this work highlights the potential role of wildlife as reservoirs for SARS-CoV-2.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.11.04.515237v2" target="_blank">Wildlife exposure to SARS-CoV-2 across a human use gradient</a>
</div></li>
<li><strong>Wastewater-based reproduction numbers and projections of COVID-19 cases in multiple cities in Japan, 2022</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Wastewater surveillance has expanded globally to monitor the spread of infectious diseases. An inherent challenge is substantial noise and bias in wastewater data due to their sampling and quantification process, leading to the limited applicability of wastewater surveillance as a monitoring tool and the difficulty. Aim: In this study, we present an analytical framework for capturing the growth trend of circulating infections from wastewater data and conducting scenario analyses to guide policy decisions. Methods: We developed a mathematical model for translating the observed SARS-CoV-2 viral load in wastewater into effective reproduction numbers. We used an extended Kalman filter to infer underlying transmissions by smoothing out observational noise. We also illustrated the impact of different countermeasures such as expanded vaccinations and non-pharmaceutical interventions on the projected number of cases using three study areas in Japan as an example. Results: Our analyses showed an adequate fit to the data, regardless of study area and virus quantification method, and the estimated reproduction numbers derived from wastewater data were consistent with notification-based reproduction numbers. Our projections showed that a 10-20% increase in vaccination coverage or a 10% reduction in contact rate may suffice to initiate a declining trend in study areas. Conclusion: Our study demonstrates how wastewater data can be used to track reproduction numbers and perform scenario modelling to inform policy decisions. The proposed framework complements conventional clinical surveillance, especially when reliable and timely epidemiological data are not available.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.22.23290332v1" target="_blank">Wastewater-based reproduction numbers and projections of COVID-19 cases in multiple cities in Japan, 2022</a>
</div></li>
<li><strong>Distinct T cell functional profiles in SARS-CoV-2 seropositive and seronegative children associated with endemic human coronavirus cross-reactivity</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
SUMMARY SARS-CoV-2 infection in children typically results in asymptomatic or mild disease. There is a paucity of studies on antiviral immunity in African children. We investigated SARS-CoV-2-specific T cell responses in 71 unvaccinated asymptomatic South African children who were seropositive or seronegative for SARS-CoV-2. SARS-CoV-2-specific CD4+ T cell responses were detectable in 83% of seropositive and 60% of seronegative children. Although the magnitude of the CD4+ T cell response did not differ significantly between the two groups, their functional profiles were distinct, with SARS-CoV-2 seropositive children exhibiting a higher proportion of polyfunctional T cells compared to their seronegative counterparts. The frequency of SARS-CoV-2-specific CD4+ T cells in seronegative children was associated with the endemic human coronavirus (HCoV) HKU1 IgG response. Overall, the presence of SARS-CoV-2-responding T cells in seronegative children may result from cross-reactivity to endemic coronaviruses and could contribute to the relative protection from disease observed in SARS-CoV-2-infected children. Key words: SARS-CoV-2, Children, IgG responses, T cell response, Polyfunctional profile, endemic HCoV
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.05.16.23290059v1" target="_blank">Distinct T cell functional profiles in SARS-CoV-2 seropositive and seronegative children associated with endemic human coronavirus cross-reactivity</a>
</div></li>
<li><strong>Dynamic Expedition of Leading Mutations in SARS-CoV-2 Spike Glycoproteins</strong> -
<div>
Throughout the coronavirus disease 2019 (COVID-19) pandemic, the continuous genomic evolution of its etiological agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has generated many new variants with enhanced transmissibility and immune escape capabilities. Being an essential mediator of infections and a key target of antibodies, mutations of its spike glycoprotein play a vital role in modulating its evolutionary trajectory. Here, we present a time-resolved statistical method, Dynamic Expedition of Leading Mutations (deLemus), to analyze the evolutionary dynamics of the SARS-CoV-2 spike. Together with analysis of its single amino acid polymorphism (SAP), we propose the use of <span class="math inline"><strong>L</strong></span>-index in quantifying the mutation strength of each amino acid site, such that the evolutionary mutation pattern of the spike glycoprotein can be unravelled.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2021.12.29.474427v2" target="_blank">Dynamic Expedition of Leading Mutations in SARS-CoV-2 Spike Glycoproteins</a>
</div></li>
<li><strong>Partial Fertility Recuperation in Spain Two Years After the Onset of the COVID-19 Pandemic</strong> -
<div>
Following the onset COVID-19 pandemic’s, a host of countries first saw drastic fertility declines and then a variety of fertility patterns afterwards. Yet, it remains unclear whether these initial baby busts have been recuperated, and if so, if the recuperation is equally distributed. We assess period fertility recuperation as the cumulative difference in observed fertility trends compared to a predicted counterfactual trend simulating fertility trends without the pandemic in Spain, the European country experiencing the most severe fertility decline of the pandemic. We use vital statistics on Spain and ARIMA models to forecast counterfactual trends in total and group-specific fertility rates for the month where fertility could be affected by the pandemic. By calculating the cumulative residual between modelled/forecasted trend and observed fertility rates, we can calculate fertility deficit and recuperation. By December 2021, Spain had only seen a partial recuperation of the fertility relative to expected trend with large heterogeneity. Births from mothers at the beginning and the end of the reproductive age and those transitioning to first child have not yet recuperated, whereas mother in the middle of the fertility window and higher order births have fully recuperated. We suggest a way to assess period fertility recuperation as the cumulative difference in observed fertility trends compared to a predicted counterfactual trend simulating fertility without the pandemic, and we show a lack of period fertility recuperation. If this translates into cohort fertility decline, there may be consequences for childlessness and population structure in Spain.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/2m5pr/" target="_blank">Partial Fertility Recuperation in Spain Two Years After the Onset of the COVID-19 Pandemic</a>
</div></li>
<li><strong>Inflammation durably imprints memory CD4+ T cells</strong> -
<div>
Adaptive immune responses are induced by vaccination and infection, yet little is known about how CD4+ T cell memory differs when primed in these two contexts. Notably, viral infection is generally associated with higher levels of systemic inflammation than is vaccination. To assess whether the inflammatory milieu at the time of CD4+ T cell priming has long-term effects on memory, we compared Spike-specific memory CD4+ T cells in 22 individuals around the time of the participants’ third SARS-CoV-2 mRNA vaccination, with stratification by whether the participants’ first exposure to Spike was via virus or mRNA vaccine. Multimodal single-cell profiling of Spike-specific CD4+ T cells revealed 755 differentially expressed genes that distinguished infection- and vaccine-primed memory CD4+ T cells. Spike-specific CD4+ T cells from infection-primed individuals had strong enrichment for cytotoxicity and interferon signaling genes, whereas Spike-specific CD4+ T cells from vaccine-primed individuals were enriched for proliferative pathways by gene set enrichment analysis. Moreover, Spike-specific memory CD4+ T cells established by infection had distinct epigenetic landscapes driven by enrichment of IRF-family transcription factors, relative to T cells established by mRNA vaccination. This transcriptional imprint was minimally altered following subsequent mRNA vaccination or breakthrough infection, reflecting the strong bias induced by the inflammatory environment during initial memory differentiation. Together, these data suggest that the inflammatory context during CD4+ T cell priming is durably imprinted in the memory state at transcriptional and epigenetic levels, which has implications for personalization of vaccination based on prior infection history.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.11.15.516351v2" target="_blank">Inflammation durably imprints memory CD4+ T cells</a>
</div></li>
<li><strong>An Atlas of Adaptive Evolution in Endemic Human Viruses</strong> -
<div>
Through antigenic evolution, viruses like seasonal influenza evade recognition by neutralizing antibodies elicited by previous infection or vaccination. This means that a person with antibodies well-tuned to an initial infection will not be protected against the same virus years later and that vaccine-mediated protection will decay. It is not fully understood which of the many endemic human viruses evolve in this fashion. To expand that knowledge, we assess adaptive evolution across the viral genome in 28 endemic viruses, spanning a wide range of viral families and transmission modes. We find that surface proteins consistently show the highest rates of adaptation, and estimate that ten viruses in this panel undergo antigenic evolution to selectively fix mutations that enable the virus to escape recognition by prior immunity. We compare overall rates of amino acid substitution between these antigenically-evolving viruses and SARS-CoV-2, showing that SARS-CoV-2 viruses are accumulating protein-coding changes at substantially faster rates than these endemic viruses.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.19.541367v1" target="_blank">An Atlas of Adaptive Evolution in Endemic Human Viruses</a>
</div></li>
<li><strong>Breakthrough infections by SARS-CoV-2 variants boost cross-reactive hybrid immune responses in mRNA-vaccinated Golden Syrian Hamsters</strong> -
<div>
Hybrid immunity to SARS-CoV-2 provides superior protection to re-infection. We performed immune profiling studies during breakthrough infections in mRNA-vaccinated hamsters to evaluate hybrid immunity induction. mRNA vaccine, BNT162b2, was dosed to induce binding antibody titers against ancestral spike, but inefficient serum virus neutralization of ancestral SARS-CoV-2 or variants of concern (VoCs). Vaccination reduced morbidity and controlled lung virus titers for ancestral virus and Alpha but allowed breakthrough infections in Beta, Delta and Mu-challenged hamsters. Vaccination primed T cell responses that were boosted by infection. Infection back-boosted neutralizing antibody responses against ancestral virus and VoCs. Hybrid immunity resulted in more cross-reactive sera. Transcriptomics post-infection reflects both vaccination status and disease course and suggests a role for interstitial macrophages in vaccine-mediated protection. Therefore, protection by vaccination, even in the absence of high titers of neutralizing antibodies in the serum, correlates with recall of broadly reactive B- and T-cell responses.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.22.541294v1" target="_blank">Breakthrough infections by SARS-CoV-2 variants boost cross-reactive hybrid immune responses in mRNA-vaccinated Golden Syrian Hamsters</a>
</div></li>
<li><strong>The COVID-19 mRNA vaccine Comirnaty induces anaphylactic shock in an anti-PEG hyperimmune large animal model: Role of complement in cardiovascular, hematological, and inflammatory mediator changes</strong> -
<div>
Background: Comirnaty, Pfizer-BioNTech's polyethylene-glycol (PEG)-containing Covid-19 vaccine, can cause hypersensitivity reactions (HSRs) in a small fraction of immunized people which can, very rarely, culminate in life-threatening anaphylaxis. A role of anti-PEG antibodies (Abs) has been proposed, but causality has not yet been proven in an animal model. This study aimed to provide such evidence using anti-PEG hyperimmune pigs (i.e., pigs displaying very high levels of anti-PEG Abs). We also sought to find evidence for the role of complement (C) activation and thromboxane A2 (TXA2) release in blood as contributing effects to anaphylaxis. Methods: Pigs (n=6) were immunized with 0.1 mg/kg PEGylated liposome (Doxebo) i.v. the rise of anti-PEG IgG and IgM was measured in serial blood samples with ELISA. After 2-3 weeks, during the height of seroconversion, the animals were injected i.v. with 1/3 human vaccine dose (HVD) of Comirnaty, and the hemodynamic (PAP, SAP), cardiopulmonary (HR, EtCO2,), hematological parameters (WBC, granulocyte, lymphocyte, and platelet counts) and blood immune mediators (anti-PEG IgM and IgG Abs, C3a and TXA2) were measured as endpoints of HSRs. Results: A week after immunization of 6 pigs with Doxebo, the level of anti-PEG IgM and IgG rose 5-10-thousands-fold in all animals, and they all developed anaphylactic shock to i.v. injection of 1/3 HVD of Comirnaty. The reaction, starting within 1 min, led to the abrupt decline of SAP along with maximal pulmonary hypertension, decreased pulse pressure amplitude, tachycardia, granulo- and thrombocytopenia, and paralleling rises of plasma C3a and TXB2 levels. These vaccine effects were not observed in non-immunized pigs. Conclusions: Consistent with previous studies with PEGylated nano-liposomes, these data show a causal role of anti-PEG Abs in the anaphylaxis to Comirnaty. The reaction involves C activation, and, hence, it represents C activation-related pseudo-allergy (CARPA). The setup provides the first large-animal model for mRNA-vaccine-induced anaphylaxis in humans.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.05.19.541479v1" target="_blank">The COVID-19 mRNA vaccine Comirnaty induces anaphylactic shock in an anti-PEG hyperimmune large animal model: Role of complement in cardiovascular, hematological, and inflammatory mediator changes</a>
</div></li>
<li><strong>Stress, Genetics and Mood: Impact of COVID-19 on a College Freshman Sample</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objectives: Use a longitudinal approach to study the impact of the Covid-19 pandemic on the emergence of symptoms of depression and/or anxiety in college freshmen. Define the interplay between genetic risk and psychosocial factors in shaping vulnerability or resilience to pandemic stress. Methods: University of Michigan freshmen were characterized at baseline using multiple psychological instruments. They were genotyped and polygenic risk score for depression (MDD-PRS) was calculated. Daily physical activity was captured. They were sampled at multiple time points throughout the freshman year on clinical rating scales, including GAD-7 and PHQ-9 for anxiety and depression, respectively. The 2019-2020 cohort (N=122) was compared to an earlier cohort (N=106) to assess the impact of the pandemic. Results: Across cohorts, 25%-57% of freshmen developed significant symptoms of anxiety or depression. In the 2019-2020 cohort, measures of anxiety and depression increased significantly after the onset of COVID-19. Physical activity was dramatically reduced by the pandemic and was associated with the emergence of mood symptoms. Low MDD-PRS subjects exhibited lower relative risk for depression/anxiety during a typical freshman year, but they were more negatively impacted by the pandemic than High MDD-PRS subjects. Conversely, a cluster of psychological indices at baseline predicted resilience in High MDD-PRS subjects who did not develop a mood disorder post-stress. Conclusions: The pandemic had a profound impact on college freshmen triggering depression and anxiety symptoms. Pandemic stress overrode the advantage conferred by “genetic resilience”. By contrast, “psychosocial resilience” was protective even in the face of high genetic risk and pandemic stress.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.12.13.22283409v2" target="_blank">Stress, Genetics and Mood: Impact of COVID-19 on a College Freshman Sample</a>
</div></li>
<li><strong>Power users: Canadian sex workers’ use of technology post COVID</strong> -
<div>
Background: The transition from physical to online advertising by sex workers in Canada has been well documented. However, few studies use rigorous sampling methods. This study considers how a technically sophisticated group of advertisers from a large Canadian sex work classifieds site used multiple online resources to promote or provide services during the COVID-19 pandemic. Methods: Advertisers were identified from internal chat names found in a collection of 891695 ads downloaded between September 15, 2021 and September 22, 2022. Advertisers qualified for the study if they used a URL as part of their contact information and were actively advertising between August 23 and September 22, 2022. A random sample of 1000 of these advertisers were selected for further study out of which 783 had accessible contact URLs. Thematic analysis was performed on downloaded website texts and ad metadata was used to identify demographic and behavioral variables. Results: Almost all (99%) sampled advertisers provided in person services and most (70%) provided online services. They advertised more frequently, were more affluent and were more likely to be trans-female, White, and collective. Themes of security, health, identity, and social networks were identified. Advertisers emphasized physical, emotional, and financial security. Most workers did not work in isolation and many participated in extensive social networks. Conclusions: Rigorous sampling methods are feasible in sex work research. The sampled advertisers represented distinct subgroups underlining the need for researchers to provide context for samples used in research. Advertisers showed considerable adaptability in the wake of the COVID-19 pandemic.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/u5kd2/" target="_blank">Power users: Canadian sex workers’ use of technology post COVID</a>
</div></li>
</ul>
<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Standard of Care Combined With Glucocorticoid in Elderly People With Mild or Moderate COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: Glucocorticoid<br/><b>Sponsor</b>:   Huashan Hospital<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Investigation of the Effect on Cognitive Skills of COVID-19 Survivors</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Other: green walking and intelligence gam<br/><b>Sponsors</b>:   Bayburt University;   Karadeniz Technical University<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Conducting Clinical Trials of the Medicine “Rutan Tablets 0.1g” No. 10 in the Complex Therapy of COVID-19</strong> - <b>Condition</b>:   Patients With COVID-19<br/><b>Interventions</b>:   Drug: The drug “Rutan 0.1”.;   Other: Basic treatment<br/><b>Sponsor</b>:   Research Institute of Virology, Ministry of Health of the Republic of Uzbekistan<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Effect of Special Discharge Training in the COVID-19</strong> - <b>Condition</b>:   COVID-19 Pneumonia<br/><b>Intervention</b>:   Other: COVID-19 Discharge Education<br/><b>Sponsor</b>:   Kilis 7 Aralik University<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Arginine Replacement Therapy in COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Drug: Arginine Hydrochloride<br/><b>Sponsor</b>:   Emory University<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effectiveness of a Second COVID-19 Vaccine Booster in Chinese Adults</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: Intramuscularly administered Ad5-nCoV vaccine;   Biological: Aerosolized Ad5-nCoV;   Biological: DelNS1-2019-nCoV-RBD-OPT1;   Biological: SYS6006<br/><b>Sponsor</b>:   Jiangsu Province Centers for Disease Control and Prevention<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Studying the Efficiency of the Natural Preparation Rutan in Children in the Treatment of COVID-19, ARVI</strong> - <b>Condition</b>:   COVID-19 Respiratory Infection<br/><b>Interventions</b>:   Drug: Rutan 25 mg;   Other: Control group<br/><b>Sponsor</b>:   Research Institute of Virology, Ministry of Health of the Republic of Uzbekistan<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Pilot Study Evaluating the Efficacy of the Vielight Neuro RX Gamma in the Treatment of Post COVID-19 Cognitive Impairment</strong> - <b>Condition</b>:   Post COVID-19 Cognitive Impairment<br/><b>Interventions</b>:   Device: Vielight Neuro RX Gamma active device;   Device: Vielight Neuro RX Gamma sham device<br/><b>Sponsor</b>:   Vielight Inc.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>PAxlovid loNg cOvid-19 pRevention triAl With recruitMent In the Community in Norway</strong> - <b>Conditions</b>:   Post COVID-19 Condition, Unspecified;   SARS-CoV2 Infection;   COVID-19<br/><b>Interventions</b>:   Drug: Nirmatrelvir/ritonavir;   Drug: Placebo<br/><b>Sponsors</b>:   Haukeland University Hospital;   University of Bergen<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Use of a Hypochlorous Acid Spray Solution in the Treatment of COVID-19 Patients : COVICONTROL Study .</strong> - <b>Condition</b>:   SARS CoV 2 Infection<br/><b>Interventions</b>:   Other: Spray with Hypochlorous Acid Group;   Other: Spray with Placebo Group<br/><b>Sponsor</b>:   University of Monastir<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Telerehabilitation Program and Detraining in Patients With Post-COVID-19 Sequelae</strong> - <b>Condition</b>:   COVID-19 Acute Respiratory Distress Syndrome<br/><b>Intervention</b>:   Other: Telerehabilitation program<br/><b>Sponsor</b>:   Campus docent Sant Joan de Déu-Universitat de Barcelona<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 Vaccine Uptake Amongst Underserved Populations in East London</strong> - <b>Conditions</b>:   COVID-19;   Influenza;   Vaccination Refusal<br/><b>Intervention</b>:   Device: Patient Engagement tool<br/><b>Sponsors</b>:   Queen Mary University of London;   Social Action for Health<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>REVERSE-Long COVID-19 With Baricitinib Pilot Study</strong> - <b>Condition</b>:   Post-Acute COVID-19 Syndrome<br/><b>Intervention</b>:   Drug: Baricitinib 4 MG<br/><b>Sponsors</b>:   Vanderbilt University Medical Center;   Emory University;   University of California, San Francisco;   University of Minnesota;   Vanderbilt University;   Yale University<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Post Covid-19 Dysautonomia Rehabilitation Randomized Controlled Trial</strong> - <b>Conditions</b>:   Post-Acute COVID-19 Syndrome;   Dysautonomia<br/><b>Interventions</b>:   Procedure: Rehabilitation;   Procedure: Standard of Care<br/><b>Sponsors</b>:   Evangelismos Hospital;   National and Kapodistrian University of Athens;   LONG COVID GREECE;   414 Military Hospital of Special Diseases<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>RADx-UP- Impact of Community Health Worker Deployment</strong> - <b>Conditions</b>:   Diabetes;   COVID-19;   Community Health Workers;   Health Behavior;   Health Knowledge, Attitudes, Practice<br/><b>Intervention</b>:   Behavioral: Impact of Community Health Worker Home Deployment on COVID-19 Vaccine Confidence and Uptake<br/><b>Sponsor</b>:   Morehouse School of Medicine<br/><b>Active, not recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Culture and pandemic control at cross-roads: navigating the burial guidelines for COVID-19-related deaths in a Ghanaian setting</strong> - CONCLUSIONS: Insensitivity to socio-cultural practices compromised the implementation of the COVID-19 pandemic control interventions, particularly, the COVID-19-related death and burial protocols. Some compromises that were not sanctioned by the protocols were reached to allow health officials and families respectfully bury their dead. These findings call for the need to prioritize the incorporation of sociocultural practices in future pandemic prevention and management strategies.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rational Design of Covalent Kinase Inhibitors by an Integrated Computational Workflow (Kin-Cov)</strong> - Covalent kinase inhibitors (CKIs) hold great promise for drug development. However, examples of computationally guided design of CKIs are still scarce. Here, we present an integrated computational workflow (Kin-Cov) for rational design of CKIs. The design of the first covalent leucine-zipper and sterile-α motif kinase (ZAK) inhibitor was presented as an example to showcase the power of computational workflow for CKI design. The two representative compounds, 7 and 8, inhibited ZAK kinase with…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Essential Oil Derived from Underutilized Plants <em>Cymbopogon khasianus</em> Poses Diverse Biological Activities against “<em>Aspergillosis</em>” and “<em>Mucormycosis</em>”</strong> - Palmrosa essential oil (PEO) from Cymbopogon khasianus, is used as complementary and traditional medicine worldwide. The present study aimed at compositional profiling of PEO and molecular docking of PEO bioactive compound geraniol against fungal enzymes chitin synthase (CS), UDP-glycosyltransferase (UDPG) and glucosamine-6-phosphate synthase (GPS), as apposite sites for drug designing against “Aspergillosis” and “Mucormycosis” and in vitro confirmation. Compositional profile of PEO was…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Detection of SARS-CoV-2 Antibodies: Comparison of Enzyme Immunoassay, Surrogate Neutralization and Virus Neutralization Test</strong> - CONCLUSIONS: sVNT appeared to be a reliable method for the assessment COVID-19 serology in patients with high antibody levels, while false-negative results were frequently observed in patients with low NT titers.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Elucidating Atomistic Insight into the Dynamical Responses of the SARS-CoV-2 Main Protease for the Binding of Remdesivir Analogues: Leveraging Molecular Mechanics To Decode the Inhibition Mechanism</strong> - To combat mischievous coronavirus disease followed by continuous upgrading of therapeutic strategy against the antibody-resistant variants, the molecular mechanistic understanding of protein-drug interactions is a prerequisite in the context of target-specific rational drug development. Herein, we attempt to decipher the structural basis for the inhibition of SARS-CoV-2 main protease (M^(pro)) through the elemental analysis of potential energy landscape and the associated thermodynamic and…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Risk connectedness between crude oil, gold and exchange rates in China: Implications of the COVID-19 pandemic</strong> - This study examined the risk connectedness and its asymmetry between oil, gold, and foreign exchange under the realized volatility, spillover index framework, and high-frequency data during the COVID-19 pandemic. It was found that: (1) At the beginning of the pandemic outbreak, the total volatility spillover in the system declined, which may indicate that the pandemic cuts the trading activities in the financial markets by inhibiting personnel mobility, then, the spillover experienced a…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Prognostic immune markers identifying patients with severe COVID-19 who respond to tocilizumab</strong> - CONCLUSIONS: We found that tocilizumab has pleiotropic effects and that clinical response to this drug remain heterogenous. Our data suggest that it is possible to identify patients who will respond to treatment and that the administration of tocilizumab is able to restore the immune balance through the re-establishment of different cell populations affected by SARS-COV-2 infection, highlighting the importance of temporal examination of the pathological features from the diagnosis.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immunogenicity of NVX-CoV2373 in PREVENT-19: A Phase 3, Randomized, Placebo-Controlled Trial in Adults in the United States and Mexico</strong> - CONCLUSIONS: NVX-CoV2373 elicited robust humoral immune responses against ancestral SARS-CoV-2 virus 2 weeks following the second vaccination in adult PREVENT-19 participants, consistent with previously reported high vaccine efficacy. PREVENT-19 ClinicalTrials.gov number, NCT04611802.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Hydroxychloroquine and azithromycin alter the contractility of living porcine heart slices</strong> - The cardiotoxicity risk of hydroxychloroquine (HCQ) and azithromycin (AZM) has been the subject of intensive research triggered by safety concerns in COVID-19 patients. HCQ and AZM have been associated with QT interval prolongation and drug-induced arrhythmias, however other cardiotoxicity mechanisms remain largely unexplored. Our group has pioneered the living heart slice preparation, an ex-vivo platform that maintains native cardiac tissue architecture and physiological electrical and…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Thrombotic thrombocytopenic purpura following ChAdOx1 nCov-19 vaccination: A case report</strong> - Vaccine-associated thrombotic thrombocytopenic purpura (TTP) is a rare type of acquired TTP recently reported after COVID-19 vaccination. Merely four cases are ascribed to the ChAdOx1 nCoV-19 vaccine in the medical literature till the preparation of this study. In this case report, we describe a 43-year-old man who developed symptoms of TTP four days after receiving the second dose of the ChAdOx1 nCoV-19 vaccine. Peripheral blood smear demonstrated multiple schistocytes. Given a high plasmic…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Honokiol Inhibits SARS-CoV-2 Replication in Cell Culture at a Post-Entry Step</strong> - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019, and the resulting pandemic has already caused the death of over 6 million people. There are currently few antivirals approved for treatment of the 2019 coronavirus disease (COVID-19), and more options would be beneficial, not only now but also to increase our preparedness for future coronavirus outbreaks. Honokiol is a small molecule from magnolia trees for which several biological effects have been reported, including…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Marked elevations in lung and plasma ceramide in COVID-19 linked to microvascular injury</strong> - The pathogenesis of the marked pulmonary microvasculature injury, a distinguishing feature of COVID-19 acute respiratory distress syndrome (COVID-ARDS), remains unclear. Implicated in the pathophysiology of diverse diseases characterized by endothelial damage, including ARDS and ischemic cardiovascular disease, ceramide and in particular palmitoyl ceramide (C16:0-ceramide) may be involved in the microvascular injury in COVID-19. Using deidentified plasma and lung samples from COVID-19 patients,…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Inhibition of SARS-CoV-2-mediated thromboinflammation by CLEC2.Fc</strong> - Thromboinflammation is the major cause of morbidity and mortality in COVID-19 patients, and post-mortem examination demonstrates the presence of platelet-rich thrombi and microangiopathy in visceral organs. Moreover, persistent microclots were detected in both acute COVID-19 and long COVID plasma samples. However, the molecular mechanism of SARS-CoV-2-induced thromboinflammation is still unclear. We found that the spleen tyrosine kinase (Syk)-coupled C-type lectin member 2 (CLEC2), which was…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong><em>In silico</em> identification and validation of phenolic lipids as potential inhibitor against bacterial and viral strains</strong> - The recurrence of coronavirus disease and bacterial resistant strains has drawn attention to naturally occurring bioactive molecules that can demonstrate broad-spectrum efficacy against bacteria as well as viral strains. The drug-like abilities of naturally available “anacardic acids” (AA) and their derivatives against different bacterial and viral protein targets through in-silico tools were explored. Three viral protein targets [P DB: 6Y2E (SARS-CoV-2), 1AT3 (Herpes) and 2VSM (Nipah)] and four…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Potential role of PIM1 inhibition in the treatment of SARS-CoV-2 infection</strong> - CONCLUSION: 2-pyridone PIM1 inhibitor could hinder cellular entry of SARS-CoV-2 and modulate several pathways implicated in immunity, suggesting a potential benefit in the development of anti-SARS-CoV-2 therapeutic approach.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What Is Biden’s Endgame in the Debt-Ceiling Standoff?</strong> - The Administration is examining all its options to avoid a technical default should there be no agreement by the “X-Date.” - <a href="https://www.newyorker.com/news/our-columnists/what-is-bidens-endgame-in-the-debt-ceiling-standoff">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How to Find a Missing Person with Dementia</strong> - Searching for people with cognitive disabilities presents special challenges. Can we solve them? - <a href="https://www.newyorker.com/news/annals-of-inquiry/how-to-find-a-missing-person-with-dementia">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why the Pro-Life Movement Can’t Quit Trump</strong> - The former President is less committed than the other 2024 G.O.P. front-runners on the subject of abortion. Shouldn’t advocates of tighter restrictions be jumping ship? - <a href="https://www.newyorker.com/news/q-and-a/why-the-pro-life-movement-cant-quit-trump">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Battle Rap’s Unwoke Representation Politics</strong> - Even if the point of battle rap is trading increasingly offensive insults, the whole thing functions on a certain system of trust. - <a href="https://www.newyorker.com/news/our-columnists/battle-raps-unwoke-representation-politics">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Far-Seeing Faith of Tim Keller</strong> - The pastor created a new blueprint for Christian thought, showing how traditional doctrine could address the crisis of modern life. - <a href="https://www.newyorker.com/news/postscript/the-far-seeing-faith-of-tim-keller">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>The Wild West of streaming TV is here and it’s free</strong> -
<figure>
<img alt="Silhouetted person with headphones watching a large TV screen displaying bright vertical bars of light." src="https://cdn.vox-cdn.com/thumbor/FDta-GGwGHVK80SUiEL9s2JTlc4=/695x0:6820x4594/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72308360/GettyImages_1243367408.0.jpg"/>
<figcaption>
Thomas Winz/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Welcome to FAST: The free, ad-supported, streaming television bargain bin.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6j0Zdj">
I was looking for <em>Night Court</em>, for <a href="https://www.vox.com/culture/2023/1/18/23560919/night-court-reboot-review">research purposes</a>. Not the new version; the original, which went off the air in 1992. Much to my surprise, I found all nine seasons on a streaming app that I’d never heard of before, and that I didn’t have to pay for, called Freevee. The catch? I just had to watch a few ads.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UyuoCt">
A free streaming service? In this subscription <a href="https://www.vox.com/economy">economy</a>? What is this magic?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2EBAGv">
I dove into my TV’s app listings and discovered a cornucopia of similar offerings, with strange names like Tubi, Pluto, and Xumo. If they don’t sound familiar, you’ll recognize their owners: <a href="https://www.theverge.com/2020/3/17/21184294/fox-tubi-acquisition-streaming-wars-news-sports-xumi-comcast-pluto-viacomcbs">Fox</a>, <a href="https://techcrunch.com/2019/01/22/viacom-buys-the-free-video-streaming-service-pluto-tv-for-340-million/">Paramount</a>, and <a href="https://www.cnbc.com/2020/02/25/comcast-to-buy-xumo-for-ad-supported-streaming-service-and-technology.html">Comcast</a>, respectively. Freevee is owned by <a href="https://www.vox.com/amazon">Amazon</a>. Even my TV has its own free streaming app, Samsung TV Plus. Content can vary, but the format is pretty standard: They offer hundreds of linear live channels and on-demand libraries of thousands of hours of TV shows and <a href="https://www.vox.com/movies">movies</a>. The content ranges from old and obscure to recent reruns and castoffs. You might see a few original shows in there, too. And maybe a few <a href="https://www.vanityfair.com/hollywood/2023/05/jury-duty-amazon-freevee-show">your</a> <a href="https://www.nytimes.com/2022/11/03/movies/weird-the-al-yankovic-story-review.html">friends</a> recommended.
</p>
<aside id="h5Hw0v">
<div>
</div>
</aside>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xMVSJ4">
These are free, ad-supported, streaming TV — also known as FAST — services. They’re kind of having a moment. Viewers are finding them as they look for alternatives to costly cable and premium streaming subscriptions. Studios, cable companies, and streaming device manufacturers are turning to them as they look for ways to grab new eyeballs and ad dollars, wring more money out of their archives, and promote their other paid services and products. If you’ve only known a world of paying for subscriptions (or using your parents’ password) to watch streaming movies and TV shows, FAST might seem like a novel idea. If you’re older, it probably looks like an updated digital version of an old friend called basic cable.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ey0WMk">
FAST is a throwback to <a href="https://www.vox.com/tv">television</a> before <a href="https://www.vox.com/netflix">Netflix</a>. It may also be a big part of its future, according to Alan Wolk, media analyst and co-founder of TVREV.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WxbfbN">
“Once Netflix and <a href="https://www.vox.com/disney">Disney</a> and all of them get their ad product up and running,” Wolk said, “the big advertisers who’ve been hesitant to spend money on streaming because it’s still mostly reruns are going to go, ‘Oh, I get it. Netflix, that’s the new primetime, FAST is the new cable. This is how I’ll spend the money.’”
</p>
<h3 id="LfbPcT">
The rise and mechanics of FAST
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9LEBHy">
Wolk knows the world of FAST pretty well because he’s the one who came up with the term around the end of 2018. It was a way to distinguish completely free streaming services with paid streamers that had a cheaper ad tier. This is also around the time when FAST started to take off, with major media companies and device manufacturers buying them up or starting their own. They often rely on third parties to fill up their libraries and channels, which resemble what you’ll find on traditional television. Some have their own original or exclusive content.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fDciBj">
You’ll also, of course, find those unskippable ads plopped in the middle of it. These companies aren’t providing FAST services and content out of the goodness of their hearts. For something like Paramount, which <a href="https://techcrunch.com/2019/01/22/viacom-buys-the-free-video-streaming-service-pluto-tv-for-340-million/">bought Pluto</a> for $340 million in January 2019, FAST is a way to reach whoever isn’t watching Paramount’s broadcast and cable channels and doesn’t want to pay for its premium streaming service, Paramount+. It’s also a way to monetize its voluminous archives of television and movies, and give free users a taste of what they can get on Paramount+.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QwAlFI">
“Our ecosystems complement each other,” Scott Reich, senior vice president of programming at Pluto, said. While Paramount+ has the new season of <em>RuPaul’s Drag Race All Stars, </em>Pluto’s got the previous season and the first episode of the new one.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9jOnvW">
“We’re helping upsell over to Paramount+ to see the new season,” Reich said. “You can use Pluto TV as a way of catching up and previewing. And then you go behind the paywall on Paramount+ to continue.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IwTMty">
Or maybe you’re Fox, which doesn’t have a paid streaming service (aside from Fox Nation, which is a niche product) to lose billions of dollars a year on. So it can put a little piece of money into Tubi, which it does. Those investments have helped Tubi amass the largest library of all the FAST services, and they’ve helped it make big gains in viewership and ad revenue. Fox bought Tubi for <a href="https://www.theverge.com/2020/3/17/21184294/fox-tubi-acquisition-streaming-wars-news-sports-xumi-comcast-pluto-viacomcbs">$440 million</a> in March 2020. It <a href="https://www.bloomberg.com/news/articles/2023-02-10/fox-turns-down-2b-offer-to-buy-tubi-on-multi-billion-dollar-potential">reportedly</a> turned down offers of up to $2 billion three years later, and Fox Corporation CEO Lachlan Murdoch <a href="https://www.fiercevideo.com/advertising/fox-boasts-stellar-quarter-tubi">recently said</a> its performance has been “nothing short of stellar.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xfaSvV">
“We make money when people consume content, so deep engagement is really the key,” said Adam Lewinson, Tubi’s chief content officer. “In this world we live in these days, where everyone is down their own rabbit hole, if I made a judgment call that everyone is going to watch this one piece of content, it’s a very risky bet. As opposed to saying well, across 50,000 titles, we truly have something for everyone. And, frankly, a lot of it.”
</p>
<figure class="e-image">
<img alt="“Weird Al” Yankovic and Daniel Radcliffe promote “Weird: The Al Yankovic Story.”" src="https://cdn.vox-cdn.com/thumbor/BSHbU8Ro1vJJXqeC87u0puXyooI=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24675994/GettyImages_1438717379.jpg"/> <cite>Slaven Vlasic/Getty Images for the Roku Channel</cite>
<figcaption>
“Weird Al” Yankovic and Daniel Radcliffe show off The Roku Channel’s new movie, which is free for anyone to watch on the Roku Channel.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VxTaP8">
For a device manufacturer like Roku, FAST is a way to monetize the exclusive access it has to users. It can put its own Roku Channel front and center on users’ menus, and it can use the <a href="https://www.usatoday.com/story/tech/columnist/komando/2023/01/26/your-tv-may-spying-you-but-heres-how-stop-it/11113419002/">data it collects</a> on what they watch to target ads to them. Yes, your TV is spying on you, unless you’ve <a href="https://www.consumerreports.org/electronics/privacy/how-to-turn-off-smart-tv-snooping-features-a4840102036/">opted out</a> of being watched while you’re watching. That’s why Roku is happy to offer the Roku Channel to non-Roku users too. Like most of these services, Roku Channel is available as a standalone app and on the internet. You don’t have to own a Roku or even a television.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uDup5e">
And if you’re a third-party provider, FAST offers another way to distribute and make money off of your content. Some companies try to get their shows on as many platforms as possible, which is why you can find 24/7 channels of <em>Forensic Files </em>reruns on seemingly every FAST service. Or they may do exclusive deals or partnerships with FAST services, like Samsung TV Plus’s <a href="https://news.samsung.com/us/conan-obrien-tv-available-only-on-samsung-tv-plus/">new</a> Conan O’Brien TV, Freevee’s <a href="https://www.washingtonpost.com/pr/2023/05/02/washington-post-announces-fast-channel-launch-amazon-freevee/">Washington Post Television</a>, or Roku’s <a href="https://variety.com/2023/digital/news/rhett-and-link-mythical-free-streaming-fast-roku-channel-1235553547/">Mythical 24/7</a>. If you can make money off of mostly repackaged content or episodes of <a href="https://tubitv.com/tv-shows/612506/"><em>Topper</em></a>, a show that peaked at 24 in the Nielsen ratings in 1954, well, why not?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iwg7vC">
FAST channels typically have <a href="https://www.protocol.com/entertainment/roku-tv-fast-channels-abuse">revenue-sharing deals</a> with distributors, in which case they’re both getting paid based on how many ads are served. Sometimes that’s a good deal,<strong> </strong><a href="https://www.indiewire.com/features/general/inside-the-strange-and-prickly-world-of-ad-supported-indie-film-distribution-1234807779/">sometimes it’s not</a>. But the FAST service isn’t taking a risk either way.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HvcvBL">
“They make money on them together, and only if people are watching,” David Offenberg, a finance professor at Loyola Marymount University said. “If nobody watches the show, no ads get served, then nobody makes any money. And it doesn’t cost anybody. … The economics are vastly different than all the subscription services.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8zKK57">
If they’re owned by a company with its own archives, like Pluto and its Paramount library, then that’s an easy enough source. Or they may have licensing agreements, where they just pay a set fee for access to the content. The platforms won’t tell you exactly how their various deals are structured, but Tubi’s Lewinson told Vox that the platform has more than 450 content partners, from major studios on down to tiny independent distributors, and that the industry in general has “all different kinds of business models.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KCvQhl">
“It’s very Wild West still,” Wolk said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nSQC43">
Speaking of the West, you may have noticed that <em>Westworld</em> isn’t on Max (formerly known as <a href="https://www.vox.com/hbo-max">HBO Max</a>) anymore. It’s on FAST. In an effort to cut costs, Warner Bros. Discovery decided it was time to get rid of old content that wasn’t bringing in enough viewers to justify the cost of hosting it on the platform, like paying out residuals. Some of those shows got a <a href="https://www.vulture.com/article/hbo-max-tv-shows-tubi-roku-channel.html">second home</a> on Tubi and Roku. Expect to see this kind of deal happen a lot more as premium streaming services that spent like crazy to win the streaming wars realize that they have to have a sustainable business model, too. Disney <a href="https://deadline.com/2023/05/disney-remove-series-streaming-disney-plus-hulu-big-shot-willow-y-dollface-turner-hooch-pistol-1235372512/">just cut</a> dozens of shows, including the ’80s fantasy reboot <em>Willow</em> from Disney+ and <a href="https://www.vox.com/hulu">Hulu</a>. You’ll probably see some of them pop back up on FAST. Some shows are still pretty fresh too; <em>Willow</em>’s last episode came out just a few months ago.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pISJ6d">
This all gets back to a major reason why FAST is coming into its own as an alternative revenue stream and distribution model. The <a href="https://www.vox.com/recode/2019/5/2/18518666/bundle-tv-hbo-disney-netflix-apple-amazon-war">streaming wars</a> saw several major media companies launch their own premium streaming services, complete with big libraries and exclusive content. It cost them billions, but they needed to win over the viewers and their pocketbooks as their traditional television audiences kept shrinking.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yb9zZI">
Now, it’s clear even to the most anti-ad streamer — <a href="https://www.vox.com/recode/23065689/streaming-netflix-ads-tv-peter-kafka">Netflix</a> — that ad-free streaming alone isn’t enough. The company is adding ad tiers, cutting back on content, and looking for ways to monetize the stuff that’s not bringing in subscribers. They’re also hoping to reach the audiences that can’t or won’t pay for streaming or cable. FAST is a way to do all of those things.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uzEyIl">
“They’re serving two different markets, really. The subscription service is serving the higher-end consumer, and the FAST service is serving the lower-end consumer,” Offenberg said.
</p>
<figure class="e-image">
<img alt="Evan Rachel Wood riding a horse in a rocky lanscape. " src="https://cdn.vox-cdn.com/thumbor/F-j3MUKQU2dyVpL9fk2PzWwH4iQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/11584671/ba3ade48f5da8ce299032103d902049d3aadb58547d72e7ad0ae630bba66e2cc47296099d1079eca0bdd681d58cba29d.jpg"/> <cite>HBO</cite>
<figcaption>
Evan Rachel Wood stars in <em>Westworld</em>, now streaming on Tubi and Roku — and not Max.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nArE2v">
It seems to be working. People are tuning in, and advertisers are responding accordingly. <a href="https://www.nielsen.com/insights/2022/sports-provide-a-lift-to-broadcast-tv-in-september-but-all-signs-still-point-to-streaming/">Pluto</a> and <a href="https://corporate.tubitv.com/press/tubi-makes-debut-on-nielsens-the-gauge-as-it-reaches-1-total-viewing-minutes/">Tubi</a> recently met the viewership minutes threshold to break into Nielsen’s The Gauge ratings report, which measures total minutes viewed on television screens, becoming the first FAST services to do so. Pluto, Tubi, and Roku combined had just 2.7 percent of all television viewing in March 2023, Nielsen told Vox. Netflix alone had <a href="https://www.nielsen.com/insights/2023/march-madness-fuels-a-rebound-in-viewing-across-cable-in-march/">7.3 percent</a> that month. But that 2.7 was a 53 percent increase from just a year ago. Pluto had <a href="https://techcrunch.com/2019/01/22/viacom-buys-the-free-video-streaming-service-pluto-tv-for-340-million/">12 million</a> monthly active users in 2019; it now has <a href="https://ir.paramount.com/static-files/73058afe-92c5-4456-a600-4a79d83cb168">80 million</a>. Tubi <a href="https://corporate.tubitv.com/press/tubi-releases-new-findings-on-streaming-tv-trends-in-its-annual-report-the-stream-2023-actionable-audience-insights-for-brands/">currently</a> has 64 million monthly active users, up from 25 million three years ago.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lfyeoW">
“Cable TV numbers are just falling through the floor,” Offenberg said. “As we speak, probably another million people have dropped. FAST is an easy, free alternative.”
</p>
<h3 id="efTr9m">
Why you’ll be watching a FAST service soon (if you aren’t already)
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z1ZKIw">
A FAST service probably isn’t going to replace your current television habits, be they subscription streaming or traditional television. But it could make for a nice supplement, especially if you’re looking for ways to cut costs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qbl0PD">
Frankly, cable and subscription streaming companies have given us plenty of reasons to leave them. Cable bills kept going up, so we cut the cord and subscribed to a streaming service instead. Much less money and plenty of stuff to watch, including the big shows everyone was talking about and maybe some of the network and cable shows you were missing, shown shortly after they aired. Then another streamer came along, so you subscribed to that, too. Then a third. A fourth. And then they all raised their prices. They took some of your favorite shows off the platform entirely. You’re paying more and getting less. If you’re going to have to watch ads, well, you might as well not be paying money to do it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Vqt5xC">
Or maybe you’ll discover FAST because you followed a show you liked that got kicked off a paid platform and put on a free one. Maybe you heard about an original show on Freevee, or you’re into Tubi’s no-budget horror movies, or you really <a href="https://trekmovie.com/2023/02/28/pluto-tv-adding-star-trek-voyager-trek-shows-to-be-available-live-and-on-demand/">want to watch</a> <em>Star Trek: Voyager</em>, but not enough to pay for Paramount+.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="t3q9ND">
Maybe you just want to turn the television on, channel surf, and then let Pluto’s exclusive all-<em>Blue Bloods</em> channel or the platform-agnostic Bob Ross channel feed you content instead of spending <a href="https://www.cbsnews.com/newyork/news/netflix-streaming-search-app/">several minutes</a> sifting through an on-demand library picking what you want to watch next. There’s something to be said for that tried-and-tested TV-watching formula. According to a <a href="https://blog.tivo.com/tivo-for-business/data-and-advertising/new-tivo-video-trends-report-q4-2022/">recent survey</a> from Tivo, people are about 50-50 on whether they prefer FAST channels or the on-demand libraries.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Jtt5or">
As to which FAST service you should watch, you don’t have to make any kind of commitment or, in most cases, even make an account to start watching. <a href="https://www.tvguide.com/news/best-free-streaming-services/">Here</a> <a href="https://collider.com/free-streaming-apps-freevee-tubi-pluto/">are</a> a <a href="https://www.theverge.com/23680217/fast-services-tubi-roku-pluto-tv">few</a> <a href="https://www.tomsguide.com/best-picks/best-free-streaming-services">guides</a> to FAST platforms that’ll get you started on that journey. They offer a lot of the same third-party channels, so the differences lie in their interface (you might find some easier to use or search than others) and whatever they have that no one else does. Pluto prides itself on its human curators who program its exclusive channels, and it has all that Paramount content. Tubi’s recent <a href="https://musebycl.io/super-bowl/lets-all-slide-down-streaming-rabbit-hole-foxs-tubi">Super Bowl ad</a> (being owned by the network that’s airing the game has its benefits) showed large rabbits throwing people down holes of content, because Tubi’s strategy is to have the largest possible library with something for everyone, including niche and underserved audiences. Freevee and Roku have had a few breakthrough original shows. And now that they’re getting more viewers and ad money, the quality of the content is improving. Wolk, the guy who coined the term, says the evolution of FAST is reminiscent of the early days of cable.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EGmTCx">
“They’re getting better shows, more recent shows, shows from premium networks,” he said. “In the old days, cable was how you reached a larger audience. You would hit your audience on primetime. And then all the people you missed on primetime, that’s why you advertised on cable, to reach them. We’re going to see a similar thing.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Pbusbj">
There is one thing missing from that, Wolk said, and that’s money. Subscription streamers spend and lose a lot of it, for the most part. TV and film writers are <a href="https://www.vox.com/culture/23696617/writers-strike-wga-2023-explained-residuals-streaming-ai">currently on strike</a> because streamers pay them so much less than traditional television did. Well, FAST pays even less than that. For decades, broadcast and cable channels had a major source of revenue in billions of dollars worth of fees that cable companies (and their customers) paid to carry them, known as <a href="https://www.spglobal.com/marketintelligence/en/news-insights/blog/economics-of-broadcast-tv-retransmission-revenue-2020">retransmission</a> and <a href="https://variety.com/vip/pay-tv-true-cost-free-1234810682/">carriage fees</a>. Those don’t exist in the world of FAST. Or premium streaming, for that matter.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="44smmW">
That said, you get what you pay for. Unless you came in because it had a show that you specifically wanted, like my <em>Night Court</em> journey, FAST services may not have exactly what you’re looking for. But they’ll probably have something you’d like.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gyqLzn">
Perhaps the best way I can illustrate this is through Betty White. Across the FAST landscape, you can find a lot of shows from White’s prodigious career, from her early ’50s sitcom <a href="https://pluto.tv/en/search/details/series/601b32c72678b7001a85e7a9/season/1"><em>Life with Elizabeth</em></a> to <a href="https://tubitv.com/series/300009553/betty-white-s-off-their-rockers"><em>Betty White’s Off Their Rockers</em></a>, which ended in 2017. You can even find her animal talk show from the ’70s if you want to see Vincent Price’s pug, <a href="https://therokuchannel.roku.com/watch/04ba42a5ace754ceb4501397238e85a8">Puffalina Pansy Price</a>. But you won’t find <em>The Golden Girls</em>, which is probably what you wanted to see. That’s on Hulu. For now, anyway.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PWJU2O">
<em>A version of this story was also published in the Vox technology newsletter. </em><a href="https://www.vox.com/pages/newsletters"><em><strong>Sign up here</strong></em></a><em> so you don’t miss the next one!</em>
</p></li>
<li><strong>The cancer-reducing birth control method you might not have heard of</strong> -
<figure>
<img alt="Two women stand next to each other in a supportive embrace. One is looking through a telescope up at a constellation that makes up female reproductive organs. Fallopian tubes are visible at first, but slowly fade away. Then other stars in the sky flicker." src="https://cdn.vox-cdn.com/thumbor/fLE98KFimH8plhLccivdE6tHSHM=/0x0:1440x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72308285/R2_Salpingectomy.0.gif"/>
<figcaption>
Paige Vickers/Vox
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Salpingectomies, explained.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gG3L3u">
I started talking to my doctor about sterilization in the second trimester of my second pregnancy. I’d recently found out I’d need a C-section, thanks to a placental abnormality that made it unsafe for me to go into labor. I was mourning the birth experience I thought I’d get to have, and I felt, on some level, like a failure. Not having to worry about birth control anymore felt like a way to get something positive out of a situation I hadn’t chosen.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L2YzPd">
My husband and I also knew that, after our second son was born, we didn’t want more children. We only had the space — in our apartment, and also in our minds and lives — for two. I vaguely remembered that older relatives had gotten their “tubes tied” after a C-section, so I asked my obstetrician if that was still an option. She told me the preferred procedure these days is to remove the tubes entirely, an operation called a salpingectomy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ErpfJf">
I didn’t know it then, but this brief surgery — it adds about five minutes to a cesarean delivery — was about to have a big moment. In January, the Ovarian Cancer Research Alliance (OCRA) <a href="https://ocrahope.org/news/ovarian-cancer-screening-and-symptom-awareness-consensus-statement/">issued</a> a statement <a href="https://www.nytimes.com/2023/02/01/health/ovarian-cancer-fallopian-tubes.html">recommending</a> that all women consider salpingectomy if they’re having another abdominal surgery and don’t want to have future children. That’s because, in addition to providing permanent birth control, a salpingectomy also reduces the risk of ovarian cancer by <a href="https://journalofethics.ama-assn.org/article/fallopian-tube-ligation-or-salpingectomy-means-reducing-risk-ovarian-cancer/2015-09">up to 50<strong> </strong>percent</a>. “This is a very powerful opportunity for cancer prevention,” said Sarah DeFeo, the research alliance’s chief program officer.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OfP1AU">
Permanent, non-reversible contraception definitely isn’t for everyone. Sterilization in America retains a certain stigma, and doctors are sometimes unwilling to perform it, especially if a patient is young or doesn’t already have kids. The procedure also brings up equity issues, from the long history of American doctors forcibly sterilizing Black women and women with disabilities to the tendency to place the responsibility for birth control solely on women and their bodies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XlXk9D">
In the wake of the <a href="https://www.vox.com/2022/6/24/23181720/supreme-court-dobbs-jackson-womens-health-samuel-alito-roe-wade-abortion-marriage-contraception"><em>Dobbs</em></a> decision, however, interest in all forms of birth control is <a href="https://www.npr.org/sections/health-shots/2022/07/29/1113573995/more-people-are-opting-to-get-sterilized-and-some-are-being-turned-away">on the rise</a>. And experts say everyone with fallopian tubes should have the opportunity to consider a salpingectomy, even if they never take it.
</p>
<hr class="p-entry-hr" id="esJVah"/>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Cgr41X">
Tubal ligation as a method of permanent birth control has been around <a href="https://emedicine.medscape.com/article/266799-overview#a6">since the 1880s</a>. The expression “getting your tubes tied” is a misnomer; doctors don’t “tie” patients’ fallopian tubes, says Kavita Arora, a professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill and chair of the ethics committee of the American College of Obstetricians and Gynecologists. Instead, each tube can be closed off with a clip, band, or ring; it can be cauterized; or it can be cut. The goal is to interrupt the egg’s progress down a fallopian tube so that it can’t encounter sperm and be fertilized.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RSC7O1">
In a salpingectomy, rather than cutting or obstructing the tubes, doctors simply remove them. The procedure is <a href="https://emedicine.medscape.com/article/267384-overview">about as old as tubal ligation</a>, and has long been used as a treatment when a fallopian tube ruptures as a result of an ectopic pregnancy. Over the last decade, however, researchers have come to believe that many ovarian cancers start out in the fallopian tubes. Ovarian cancer is relatively uncommon, with <a href="https://www.cancer.org/cancer/types/ovarian-cancer/about/key-statistics.html">19,710 women</a> diagnosed in the US every year — for comparison, 264,000 women are diagnosed with breast cancer annually — but it is very deadly, <a href="https://www.nytimes.com/2023/02/01/health/ovarian-cancer-fallopian-tubes.html">accounting for more deaths</a> than any other cancer of the female reproductive organs. Screening and early detection, unfortunately, do not appear to help patients live longer. That fact has led researchers to look for ways of stopping the disease before it starts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TSr1qg">
Salpingectomy looks promising. <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788855">One 2022 study</a> found that removing the fallopian tubes was associated with significantly lower risk of ovarian cancer: Among 25,889 people who underwent a salpingectomy, none developed the disease during the nine-year study period. Since the procedure leaves the ovaries intact, it doesn’t cause menopause or change a patient’s menstrual cycle. Though the long-term effects are still being studied, “it’s generally considered to have very little impact on quality of life,” DeFeo said. While tubal ligations can <a href="https://www.uchealth.org/today/vasectomy-vs-tubal-ligation-understanding-permanent-birth-control-options/">sometimes</a> be reversed, removal of the tubes is not reversible. Patients can still become parents, however, by IVF, surrogacy, or adoption.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jjG4wi">
If it’s done on its own, salpingectomy can have a recovery period of <a href="https://www.uchealth.org/today/vasectomy-vs-tubal-ligation-understanding-permanent-birth-control-options/">about two weeks</a>. When done as part of another abdominal surgery, like a C-section, hysterectomy, or <a href="http://vox.com/the-highlight/22664601/fibroids-healing-womens-health-recovery">fibroid removal</a>, the procedure adds very little, if any, to the recovery time. That’s one reason the Ovarian Cancer Research Alliance <a href="https://ocrahope.org/news/ovarian-cancer-screening-and-symptom-awareness-consensus-statement/">recommended</a> that patients consider an “opportunistic salpingectomy,” or getting the procedure done when they’re already on the operating table for something else.
</p>
<hr class="p-entry-hr" id="OnzhSI"/>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gdJYrP">
I had never heard of a salpingectomy until my doctor mentioned it to me, even though I’ve been reporting on reproductive health for nearly 15 years. At first I was nervous: The idea of permanent birth control appealed to me, but I wasn’t sure if I wanted to lose parts of my body. I was worried that, on some level, I’d <a href="https://www.newyorker.com/culture/essay/the-unexpected-grief-of-a-hysterectomy">miss them</a>, or that I would come out of the procedure feeling somehow different or lesser. I tried to find personal stories of people who’d already been through the procedure, but because salpingectomies for birth control are relatively new, I didn’t find much.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NPFgbc">
For years, “women were really relying on their clinicians to recommend this, but didn’t have knowledge of it on their own,” DeFeo said. While doctors in major urban centers were often aware of the potential benefits of the procedure, that awareness didn’t always extend across the country, said OCRA CEO Audra Moran, or to other specialties outside of gynecology.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hz5Ytg">
It wasn’t until 2013<strong> </strong>that the Society of Gynecologic Oncology <a href="https://www.sgo.org/resources/sgo-clinical-practice-statement-salpingectomy-for-ovarian-cancer-prevention/">recommended</a> that doctors discuss the procedure with patients, and the American College of Obstetricians and Gynecologists <a href="https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/04/opportunistic-salpingectomy-as-a-strategy-for-epithelial-ovarian-cancer-prevention">did the same</a> in 2019. Today, most people who request a tubal ligation will probably be offered a salpingectomy, said Erin Medlin, a gynecologic oncologist at Colorado Permanente Medical Group. The health benefits are thought to be greater, though more conventional tubal ligation may also <a href="https://newsnetwork.mayoclinic.org/discussion/tubal-ligation-decreases-risk-of-developing-ovarian-cancer-2/">reduce ovarian cancer risk</a>. In cases where scar tissue or another problem makes the procedure difficult, a more conventional ligation can still be done instead, Medlin said, but generally, doctors today are more likely to perform salpingectomies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4uVq6N">
But most people still don’t know the procedure exists. In many ways, my generation of birthing people is the first to be offered opportunistic salpingectomy as an option. “Most women going into this surgery know what their mother had, which was some type of clip placed on their tube, or something of the like,” For people considering the surgery, there simply isn’t a wealth of generational experience to fall back on.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PJ1Nw1">
In addition to a lack of knowledge, patients can face another obstacle: doctors’ preconceptions around permanent methods of birth control. <a href="https://www.npr.org/sections/health-shots/2022/07/29/1113573995/more-people-are-opting-to-get-sterilized-and-some-are-being-turned-away">Patients have reported</a> being denied sterilization procedures if a doctor perceives them as too young, or if they have not yet had children. “Some of it is very paternalistic,” Arora said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ar6pCb">
On the other hand, some patients have historically been pressured or forced into sterilization. Between 1929 and 1974, for example, the state of North Carolina <a href="https://www.vox.com/policy-and-politics/23529685/healthcare-reparations-slavery-equity">forcibly sterilized</a> more than 7,600 people deemed to be “mentally defective;” the program specifically <a href="https://www.newsobserver.com/news/state/north-carolina/article244411987.html">targeted Black residents</a>. More than <a href="https://www.uvm.edu/~lkaelber/eugenics/">30 states</a> had compulsory sterilization laws on the books in the 20th century, and while many <a href="https://lawreview.syr.edu/could-forced-sterilization-still-be-legal-in-the-us/">have been repealed</a>, the practice isn’t necessarily a thing of the past. A <a href="https://revealnews.org/article/female-inmates-sterilized-in-california-prisons-without-approval/">2013 investigation</a> found that more than 100 incarcerated women in California had been sterilized without proper approval, and some reported being coerced.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Y5hXaN">
“The history of sterilization is intertwined with the history of eugenics,” said Krystale Littlejohn, a sociology professor at the University of Oregon who studies race, gender, and reproduction. Doctors shouldn’t talk to patients about salpingectomies or any sterilization procedure without being mindful of that history and the danger of repeating that coercion, even unintentionally, experts say. “It’s really important to think about the context in which people are encouraged to use particular methods or to pursue particular surgical options and to think about the deeper meanings that those options have for them,” Littlejohn said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8iosuv">
Getting a salpingectomy or any form of permanent birth control can also be difficult because a certain aura of shame still surrounds the idea. “There are so many parts of women’s health care that are stigmatized, that we don’t talk enough about, whether that’s cesarean deliveries or miscarriages or sterilization or Pap smears,” Medlin said. Even within the realm of reproductive health, sterilization can be tricky to bring up because it’s associated with not wanting children, an attitude that’s still <a href="https://www.10news.com/why-is-there-a-stigma-against-childless-women">viewed as suspect</a> by many Americans, even as <a href="https://www.pewresearch.org/short-reads/2021/11/19/growing-share-of-childless-adults-in-u-s-dont-expect-to-ever-have-children/">more and more people</a> are choosing to remain child-free. In my own life, I had a much easier time finding information and perspectives about reversible forms of contraception, like the pill or ring, than about a procedure that would be permanent. Even talking about the possibility felt a little taboo; I wondered if I should be embarrassed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VNehym">
Insurance can also be a hurdle. As a form of birth control, salpingectomy is covered by the <a href="https://www.vox.com/policy-and-politics/2017/10/6/16234238/trump-obamacare-birth-control">contraceptive mandate in the Affordable Care Act</a>, which requires employer-provided health plans to cover birth control without a copay. However, that mandate was <a href="https://www.vox.com/2020/7/8/21317323/supreme-court-obamacare-little-sisters-clarence-thomas-pennsylvania-birth-control">significantly weakened</a> by the Trump administration and has never covered people without employer-provided insurance. As of 2021, <a href="https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/#:~:text=The%20uninsured%20rate%20dropped%20in,to%202021%20(Figure%201).">10.2 percent of Americans</a> had no health insurance at all; without insurance, a salpingectomy can cost thousands of dollars.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xmXZz3">
Moreover, conversations around birth control in America, including sterilization, have typically placed the onus on women and people who can become pregnant. “There’s just this expectation that women should be responsible for preventing pregnancy,” Littlejohn said. That inequity often extends to sterilization. By the time they consider such a procedure, many women have already been shouldering for decades the responsibility of birth control. So “it can seem like a natural step for some of them” to be the one to undergo sterilization. Tubal sterilization procedures are <a href="https://pubmed.ncbi.nlm.nih.gov/22133657/">more common</a> than vasectomies, even though the latter is often less invasive.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RPUZ9M">
Sterilization in general has been <a href="https://www.npr.org/sections/health-shots/2022/07/29/1113573995/more-people-are-opting-to-get-sterilized-and-some-are-being-turned-away">getting more attention</a> since the <a href="https://www.vox.com/2022/6/24/23181720/supreme-court-dobbs-jackson-womens-health-samuel-alito-roe-wade-abortion-marriage-contraception"><em>Dobbs</em> decision</a> last summer resulted in <a href="https://www.guttmacher.org/state-policy/explore/state-policies-later-abortions">abortion bans in many states</a>. Procedures such as salpingectomy, however, will never be a substitute for abortion rights, Littlejohn said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ul9C7R">
“People need bodily autonomy,” she said. “<em>Dobbs</em> is an assault on their bodily and reproductive autonomy, and to suggest that they just get sterilized because they no longer have the option of getting an abortion is also encroaching on their reproductive autonomy.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YOYBr7">
At the same time, “clinicians should not impose paternalistic thresholds on whom they will and will not perform permanent contraception on,” Arora said. “The patient is the expert in their own lives.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YHKBmn">
When I started discussing sterilization with my doctor, I didn’t necessarily feel like an expert. What helped me decide and feel confident in my decision was talking to other people in my life. My husband and I talked about the pros and cons, but it was clear to both of us that the final vote should be mine; I had already been through a lot to build our family, and if I was going to undergo another medical procedure to finish building it, the decision would have to be mine alone. I also talked to my best friend, who helped me run through a list of all possible scenarios in which I might regret the decision. As we spoke, I began to lose my anxiety and feel, instead, a sense of self-determination.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I9eYs6">
Ultimately, I decided to get the surgery mostly because of its potential to reduce my cancer risk. There are other methods of birth control, but the idea of a surgery that could protect my future health, and that would be over in a few minutes with minimal side effects, was appealing to me. When the time came, I barely noticed the salpingectomy was happening — I was so focused on the baby who had just been lifted, wailing, from my body.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KvA7BR">
He’s about 8 months old now, and I’m glad I got the surgery when he was born. If it prevents me from getting ovarian cancer, I’ll never know it — that’s the nature of prevention. But it’s a choice the Ovarian Cancer Research Alliance wants more patients to have. “We’re not advocating for every single woman in America to have an opportunistic salpingectomy,” Moran said, “but just to talk about it and ask the questions.”
</p></li>
<li><strong>How some people get away with doing nothing at work</strong> -
<figure>
<img alt="A cartoon of a man with his feet on his desk, leaning back and tossing a pen." src="https://cdn.vox-cdn.com/thumbor/qC072MPgSLzfzS9r1lHLihLVIKA=/0x0:1885x1414/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72308204/GettyImages_658928966.0.jpg"/>
<figcaption>
Your suspicions are right: That one guy at work really doesn’t do anything. | A-R-T-U-R via Getty Images/iStockphoto
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
All hail the jobless employed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GHDXWm">
In theory, Nate works 40 hours a week in the operations department at a major fintech company. In reality, Nate works one hour a day at most. He moseys over to his computer whenever he gets an alert on his phone that he’s got a task to complete. Otherwise, he spends most of the day doing, basically, whatever he feels — he sleeps in, he watches TV, he does household chores. His only real restriction is that he can’t stray too far from home in the event he is needed for something.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rrrv7W">
“I don’t have a problem with being asked to do work; it’s just I’m not really being asked,” he says. Maybe he could take more initiative and try to take on more, but he gets good performance reviews and raises as it is, so he figures, why bother? Plus, it’s not like he can waltz up to his boss to announce there’s no real business reason for his existence. “How do I initiate that conversation that’s, ‘Hey, I haven’t been doing much of anything this whole time, I need more to do’? You don’t really want to draw attention to it,” says Nate, which is a pseudonym. Vox granted him anonymity to speak for this story for obvious reasons, as we did all of the workers interviewed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="H4bLa3">
Strongly suspecting that a certain person isn’t doing much, or not nearly enough to fill up what is ostensibly an eight-hour day, seems to be a near-universal work experience. Many people have also, at some point in time, been that less-than-occupied worker. Sometimes, it’s intentional. Other times, like in Nate’s case, that’s just how the corporate cards have been dealt.
</p>
<div class="c-float-right">
<div id="JZHJg5">
<div>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wdE67R">
These jobless employed are a persistent presence in the working world, their existence a bug that’s become a feature. There’s a percentage of every job that’s <a href="https://www.vox.com/2018/5/8/17308744/bullshit-jobs-book-david-graeber-occupy-wall-street-karl-marx">bullshit</a>, and in their case, that’s 90 percent, minimum.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Pv09Y2">
“It’s not good for the culture. It can engender huge resentment from the person’s colleagues, especially if they themselves are overworked, and you do see that combination a lot,” says Alison Green, a career columnist and expert who runs the website <a href="https://www.askamanager.org/">Ask a Manager</a>. “It also raises questions for people about whoever is supposed to be managing that person. Are they incompetent? Do they suck at managing?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="o1B54L">
Nate doesn’t think his boss or anyone is really aware of the problem — his company laid off hundreds of workers earlier this year, and he made it through. He shows up at office social events once a month to put in face-time and is generally well-liked. He’s read stories about companies tracking remote workers to make sure they’re actually working but feels pretty confident his company isn’t. “If we did,” he says, “I don’t think I’d be employed.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KKy599">
So for now, like many people, his jobless employment status continues. And he’s not alone.
</p>
<h3 id="WCCKxi">
Hanging out, 9 to 5
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zpwoHk">
Reporting for this story, I spoke with multiple people who are essentially funemployed, or at least one meaning of it, who sit around at work all day with very little to do. What was most surprising was that many did not exactly love the situation and felt somewhat conflicted.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zJ4Vhi">
Take Charlie, a data scientist at a financial company. For his first few years at the firm, he was pretty busy, but after his last promotion about five years ago, his workload has dwindled. He’s not super motivated to change the situation, though he worries this will ultimately be detrimental to his career. “I feel like I’m falling behind,” he says. “I definitely want to move to a different company, and I’m hopeful that when I do that, my work and my mindset will change.”
</p>
<div class="c-float-right">
<aside id="EbOYD3">
<q>“I almost wish that I could get laid off and have a generous severance package”</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="apTba7">
The Thursday and Friday prior, he worked from home and “literally did not do a second of work.” The following week, on a day he was working from the office, he read two chapters of his novel and took a small nap. The day we spoke, he took the call — which was about how he wasn’t working — from his office. “Whenever I work from home, it’s easier to go work from my couch or lay down or do whatever, go on my PC a little bit. Even in my office here, and actually today there are a bunch of people for some reason, but it’s normally pretty empty. It’s not like I have the peer pressure of people working around me,” he says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kwl1j3">
Charlie’s company cut workers this year, but he wasn’t really worried about it one way or the other. “I almost wish that I could get laid off and have a generous severance package,” he says. “That wouldn’t be the worst thing in the world.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pwf1bW">
One engineer told me he’s enjoying the freedom of having an incredibly light workload, but he knows it won’t go on forever. He also has to be intentional about keeping up his skill set so he doesn’t get too rusty. “I forget how to do stuff that I knew how to do,” he says. One government affairs representative says she completes the work for her eight-hour shift in two to three hours each day, which, again, is nice, but is also unsettling. “I get paid,” she says, “but I feel useless and like I could be doing more.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TM3pTn">
Green believes it’s not uncommon for people in these jobless employment situations to have complicated feelings about it. They feel guilty, or they get bored, or they’re paranoid they’ll get caught. “They worry that at some point someone’s going to notice,” she says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GljHwE">
To be sure, not everyone feels bad. Tom, who works in sales, appears to be a bit of an expert in getting paid for work he’s not doing. His boss at his last job forgot to inform HR that he’d quit, so he collected a paycheck from the company for a while before anyone figured it out. Now, at his new job, the company doesn’t even know where he’s based — he’s in the United Kingdom, they think he’s in Kentucky — and there’s minimal oversight. “I’m able to slip through the cracks most of the time,” he says. If someone asks what he did over the weekend, he’ll say he went to the Kentucky Derby or something, because he doesn’t want anyone getting suspicious.
</p>
<div class="c-float-right">
<aside id="WtDWjm">
<q>“I’ve tried at work before, and it just wasn’t worth it”</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2Lehfh">
He works commission and, suffice it to say, rarely meets or exceeds sales targets. So when he’s looking for <a href="https://www.vox.com/labor-jobs">jobs</a>, he adjusts accordingly. “I search for jobs with the highest and most generous base salary for obvious reasons,” he says. He’s not losing sleep over his ruse — he says his mental health is great. “I’ve tried at work before, and it just wasn’t worth it.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DWLt87">
From the outside, it can be a little hard to square how to feel about this. On the one hand, if someone’s getting a paycheck and doing very little, it’s sort of a good-for-them scenario. On the other hand, it can engender resentment, especially among their colleagues who aren’t so oblivious to what’s going on.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IpozXu">
“These people are often kind of gadflies, they’re hanging around the coffee machine, they’re stopping by people’s desks, and they become the subject of urban legends a little bit,” says Joseph Fuller, a professor of management practice at Harvard Business School. “It’s a phenomenon that’s been widely witnessed, let’s put it that way.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rI5vqc">
Pretty much everybody has at least one person at work where they look at them and think, “Seriously, what in the world does that guy even do? And how does no one notice???” It can be even more baffling when those people keep advancing, which they often do. Promoting the incompetent has been a thing for a long time.
</p>
<h3 id="MznXox">
Blame the boss
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Sd0d9O">
There are endless reasons why people at work wind up with little, if anything, to do. Maybe the project they were hired for is no longer a priority, or the tasks they were in charge of, by and large, are now being handled by technology. Maybe they never should have been hired in the first place, or they were brought on board too soon. Maybe they’re super fast at their jobs, or they’re really good at being secretly lazy, hiding in plain sight.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YPwPgS">
Whatever the context, the boss is often to blame. The biggest component of how this happens is poor management.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="k34jsL">
“You get managers who are either so disengaged that they truly are oblivious to the situation, they’re so disconnected from the work that they don’t have any sense of what the person is or isn’t doing or results they should be getting that they’re not getting,” Green says, “or you get a manager who does have a general sense of it that is so passive and nonconfrontational that they can’t bring themselves to do anything about it.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Qz5yXs">
It may be the case that someone’s manager is cut — part of why <a href="https://www.businessinsider.com/middle-managers-great-flattening-organization-meta-tech-layoffs-firing-2023-3">laying off middle managers</a> can be a problem — so they don’t have a real direct boss anymore who knows what they’re supposed to do. Perhaps their new boss is too swamped to pay attention, or they just don’t really care as long as the company’s making money. It might also be the case that their boss, new or old, isn’t doing much, either.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3fY5QI">
Bobby, an engineer at a tech company who’s been sitting on his hands for about a year, says his supervisor seems really busy with meetings, so he doesn’t think he has much time to notice beyond some vague conversations about “utilization” every once in a while. “I feel like his plate is full, unless he’s doing a similar trick where he has the appearance of motion,” he says. “I haven’t drilled into it, but it’s always in the back of my mind. Is he really working as hard as he says he is?”
</p>
<div class="c-float-right">
<aside id="Knjqn7">
<q>“It’s like being on vacation all the time”</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KxYBsE">
Bobby was brought on too soon — the division he was hired for wasn’t even remotely close to needing engineers to do actual work. So he spends his day doing research and development for his own tech projects. When he doesn’t feel like doing anything, he goes hiking or swimming or plays video games and watches movies. He gets to spend more time with his kids.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="n1ufn7">
“It’s like being on vacation all the time, with occasional scrambling to do a thing, then doing the thing for a couple of hours, then going back to the rest of my life,” he says. “Even though I feel guilty about it sometimes … it’s not really my job to tell a multinational company how to run a business or manage their employees.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8geGT6">
The experts concur. “At the end of the day, it’s the company’s responsibility, the leader’s responsibility, to manage their workforce and know who’s doing what and where and what’s the output,” says Bryan Creely, the <a href="https://www.alifeafterlayoff.com/">career coach</a> who coined the term “<a href="https://www.investopedia.com/what-is-quiet-quitting-6743910">quiet quitting</a>.”
</p>
<h3 id="P1ZVjt">
Change is hard, even when companies need to change
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5u299a">
As much as the private sector is supposed to be able to move fast and adjust, that’s just not the case. Change isn’t easy. Sometimes, a position just exists because it always has. Certain processes have certain roles in them, and nobody wants to take the time to scrutinize whether those roles are still needed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bwCpsx">
Fuller, the Harvard professor, offered up a hypothetical example. “There’s a checker to check checkers, and we don’t need that anymore, but there’s a position called ‘Check Checker,’ and we’ve always had one. It’s on the succession plan, it’s on the promotion path,” he says. “The process that person is in and the job they’re in is an artifact of the way the process was designed, the way the budget was set, the assumptions about how the process works as opposed to how it actually works.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fi6DpD">
A lot of white-collar work is related to risk aversion and having several eyes on decisions or processes, so there is some kind of built-in excess capacity by design. It’s a margin of safety, even though said margin can be excessive. Whether or not leaders know that, adjusting can be harder than leaving things as is.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a7SzEG">
“Managers may well realize they’re not using their staff well, but whether they do or they don’t, it just gets really hard to change those processes without somebody making that their priority,” says Carrie Bulger, a Quinnipiac University psychology professor who specializes in industrial-organizational psychology. “If it doesn’t feel like it’s broken, then no one’s going to make noise about fixing it.”
</p>
<h3 id="tjtNjh">
There’s no way to say, “Hey, I’m just chilling, or I think the guy over there is”
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="f9nTb6">
Remote work makes it easier to get away with not doing much because there’s no one looking over your shoulder to see what’s happening. It also makes it more palatable — you can find a lot more ways to entertain yourself during the day from your house than you can from your cubicle. Still, bosses should be able to tell the difference, wherever a worker is located. “If you have managers who know how to manage effectively … it shouldn’t be any easier for someone to slack off,” Green says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uMizg5">
Being in the office does not guarantee you’re working, either. People slacking off on the job long predates <a href="https://www.vox.com/remote-work">remote work</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sqPrWK">
Marty, a policy analyst at a federal agency, goes into the office every day, though he generally stays until about 2 pm — his boss doesn’t come in often, anyway. He uses his extra time to practice music and read. He and his colleagues, many of whom are also bored, will sometimes pick research papers to discuss to pass the time.
</p>
<div class="c-float-right">
<aside id="IfJCRs">
<q>“What’s ironic is that I’m seen as the high performer on the team”</q>
</aside>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ypFXOo">
He’s not concerned someone will notice what he’s up to because he can just close his office door. Plus, he’s got a mouse jiggler. “What’s ironic is that I’m seen as the high performer on the team, and I’m also confused,” he says. “I think it’s because they’re also just making up stuff to do as well.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Vxqmwe">
To the extent that this is an issue that needs fixing — which is debatable — there aren’t any easy answers. Experts say it is generally a bad idea to rat out a colleague who’s not doing work unless it’s really impacting you, and it can be a very bad idea to rat out yourself. You can try, but it’s tough.
</p>
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“If you go in and say, ‘Hey, I’m underutilized right now,’ you’re basically putting a target on your back,” Creely says. “It sounds good on paper — you get paid to do nothing — but especially if you’re not well-connected, eventually that’s going to come to an end.”
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Tom has no plans to alert his employer to his circumstances, nor is he super concerned about what his habit of picking up workless jobs will mean for his career. People would be surprised to see how easy it is to get positive references from other departments when it’s time to move on to the next job, and he really doesn’t think anyone has picked up on what’s going on. “I don’t think I’ve ever really occupied one minute of somebody’s headspace,” he says. “As long as you’re nice and polite and can manage to forward the right things to the right people.”
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Tried off-roading? Now, learn about BAJA SAE, a competitive automobile sport in Chennai</strong> - What is it like to sit in a buggy and compete in BAJA? A sport for engineering students, that binds the worlds of scholarship, man and machine</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IPL 2023 | Pre-season camp key to our success: CSK’s Ruturaj Gaikwad</strong> - Four-time champions Chennai Super Kings put themselves in line for a fifth IPL title triumph after they stormed into the final with a 15-run victory over holders Gujarat Titans in the Qualifier 1</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Morning Digest | Update NPR to enumerate self during next Census; CSK beats GT by 15 runs, qualifies for IPL final, and more</strong> - Here’s a select list of stories to read before you start your day</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>IPL 2023 | I have 8-9 months to decide: Dhoni on retirement after CSK reaches 10th final</strong> - With speculation rife that 2023 could be a swansong IPL season for M.S. Dhoni, the CSK captain said he will decide before the next auction</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Kevin Pietersen suggests Kohli must move to Delhi Capitals</strong> - Kevin Pietersen has suggested that Virat Kohli change his IPL franchise and move to Delhi Capitals, a day after Royal Challengers Bangalore endured yet another premature exit in the cash-rich league</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Smart meter row: KSEB told to freeze tender for procurement</strong> - Power department issued the single-line directive following strong intervention of employees’ organisations of the KSEB that objected to the TOTEX mode recommended for the meter rollout</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Panneerselvam seeks compensation for farmers in Tiruppur district</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Andhra Pradesh: Markfed intervenes to stabilise the price of maize</strong> - Since May 5, the A.P. Markfed has procured more than 25,000 tonnes of the produce through 1,548 Rythu Bharosa Kendras as its price fell below the MSP of ₹1,962 per quntial</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>CBI slams Telangana HC’s “contradictory” order on bail</strong> - CBI tells SC that Telangana HC order to cancel and then grant bail to Gangi Reddy, main accused in the murder of Y.S. Vivekananda Reddy, is like a Frankenstein, an “eighth marvel” in bail jurisprudence</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Civil services exam results: Stalin praises successful candidates</strong> -</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Tariq Ramadan: Islam scholar cleared of Swiss rape charges</strong> - The renowned scholar is cleared of rape and sexual coercion by a court in Switzerland.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>German climate activists raided for forming ‘criminal group’</strong> - German police launch raids in seven states against a group involved in controversial stunts.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine war: US distances itself from Belgorod incursion into Russia</strong> - Washington says it does not encourage strikes in Russia, after a border attack.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>France bans short-haul flights to cut carbon emissions</strong> - All domestic air routes are stopped where the same journey could be made by train in under 2.5 hours.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Vinicius Jr: Valencia fined and sanctioned with partial stadium closure for five matches</strong> - Valencia are sanctioned with a partial stadium closure for five matches and fined following the racist abuse of Real Madrid forward Vinicius Jr.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Dealmaster: Save on Lenovo’s latest ThinkPad X1 Gen 11 laptop, and more</strong> - Memorial Day sales include savings on laptops, smart home accessories, and grills. - <a href="https://arstechnica.com/?p=1941281">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Your fave illustration of Franklin’s kite experiment is likely riddled with errors</strong> - Most date from 19th century and were heavily influenced by Joseph Priestley’s 1767 account. - <a href="https://arstechnica.com/?p=1941212">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Widespread FBI abuse of foreign spy law sets off “alarm bells,” tech group says</strong> - Section 702 debate rages after another FISA Court opinion is unclassified. - <a href="https://arstechnica.com/?p=1941492">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Netflix crackdown on account sharing hits US with $8 fee for each extra user</strong> - “Your Netflix account is for you and the people you live with,” email tells users. - <a href="https://arstechnica.com/?p=1941574">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Fake Pentagon “explosion” photo sows confusion on Twitter</strong> - Incident shows weakness of Twitter’s verification system, speed of misinformation. - <a href="https://arstechnica.com/?p=1941475">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A feminist told me about the “Dwayne Johnson Rule.” The rule, as she explained it..</strong> - <!-- SC_OFF --></p>
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was that in order to determine if a particular comment was appropriate to say to a woman, first ask yourself, ‘Would I be comfortable saying this to Dwayne Johnson?’ If not, don’t say it.
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I thought this sounded like a good rule. So I told her:
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Your chest is fucking epic.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/HelpingHandsUs"> /u/HelpingHandsUs </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13q0xf7/a_feminist_told_me_about_the_dwayne_johnson_rule/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13q0xf7/a_feminist_told_me_about_the_dwayne_johnson_rule/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I joined a local scat group on Facebook recently who said they were having a meet up</strong> - <!-- SC_OFF --></p>
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Once I showed up and saw what they were doing to each other, I realized my mistake and skiddy-be-bop-a-do’d out of there as fast as I could.
</p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/jskoker"> /u/jskoker </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13qffsi/i_joined_a_local_scat_group_on_facebook_recently/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13qffsi/i_joined_a_local_scat_group_on_facebook_recently/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Teacher wants to do a little Quiz with her Students.</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Teacher:“Guess what this is, which animal has a Beak and Feathers?”
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Random Student:“A Duck!”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Teacher:“Thats right, but it could also be a Goose. Next question, which animal has Claws and Fur?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Random Student:“A Dog!”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Teacher:“Thats right, but it could also be a Cat.”
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A Boy steps infront of the Teacher:“Now i have a question for you.”
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Teacher:“Sure go ahead.”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Boy:“Whats this?? First its Long, Hard and Dry, then you stick it into something warm and soft, after some penetration its soft, short and wet?”
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The Teacher immediatly slaps the Boys face.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The Boy smiling says:“Thats right, but it could have been a Chewing Gum!”
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Wolfguard087"> /u/Wolfguard087 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13q3mas/a_teacher_wants_to_do_a_little_quiz_with_her/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13q3mas/a_teacher_wants_to_do_a_little_quiz_with_her/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>What gets burning hot right before it freezes?</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A laptop.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/reduxde"> /u/reduxde </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13pzky8/what_gets_burning_hot_right_before_it_freezes/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13pzky8/what_gets_burning_hot_right_before_it_freezes/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Hell no.</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A man dies and is sent to hell. He meets the devil who offers him three choices of punishment for the sins that he had committed. The devil tells the man, “There are three torture rooms, of which you will pick one and go in to replace the person who is being punished in that room. The choice is yours.” The man walks to room one and sees another man in a pit of fire being stabbed by pitchforks. “No way in hell am I going in this room” he thought and proceeded to room two where he sees another man, bound and gagged, being whipped with a acid laced spiked chain. “Holy shit” the man says and he continues on to room three. Upon arriving at room three he noticed a man receiving a blowjob from the sexiest, most beautiful woman he had ever seen, and without hesitation he tells the devil, “I choose this room.” The devil replied, “Very well” and walks up to the woman and says to her, “You’re free to go, your replacement’s here.”
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/kickypie"> /u/kickypie </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/13q2h16/hell_no/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/13q2h16/hell_no/">[comments]</a></span></p></li>
</ul>
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