Artificial intelligence for autism spectrum disorder: advances in diagnosis, behavior analysis and educational support

IntroductionArtificial intelligence has become an increasingly relevant field of research in the study of Autism Spectrum Disorder (ASD), offering novel technological approaches for the analysis, detection, and support of individuals on the autism spectrum. The aim of this study was to systematically review recent scientific literature examining the application of artificial intelligence in ASD.MethodsThe review was conducted following the PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, Dialnet, and Google Scholar, including studies published between 2019 and 2025. After applying predefined inclusion and exclusion criteria, 18 empirical studies were included in the final analysis. Methodological quality and risk of bias were assessed using Joanna Briggs Institute critical appraisal tools adapted to the methodological design of each study.ResultsCurrent research focuses primarily on four areas: early detection and diagnostic support, automated analysis of behavioral and social patterns, AI-based educational technologies, and communication support systems. Although the reviewed studies demonstrate promising advances in machine learning, computer vision, and natural language processing, important methodological limitations remain, particularly regarding external validation, dataset representativeness, and heterogeneity of performance indicators.DiscussionOverall, artificial intelligence shows considerable potential for supporting diagnosis, education, and communication in ASD; however, greater methodological robustness, transparency, and ethical safeguards remain necessary before broader implementation in real clinical and educational settings.

Head circumference assessment in pediatric MRI: a pilot study of manual measurement methods and automated segmentation-based alternatives

PurposeHead circumference (HC) is an important clinical parameter in neuropediatrics, but it is often missing or outdated in referral information. This can lead to subjective, reader-dependent estimation during MRI interpretation. We first aimed to compare magnetic resonance imaging (MRI)-based methods for HC measurement against the tape measure (ground truth), and second to establish an automated alternative.MethodsIn 23 children (mean age 4.5 years, range 0.5–17 years), HC was prospectively measured with a tape measure (ground truth) on the day of MRI. MRI-based HC measurements were derived from 3D T1-weighted MPRAGE and followed a two-step workflow: measurement plane selection and circumference measurement within that plane. Plane selection was performed using visual-based, rule-based, atlas-based [(infant) FreeSurfer], or neural network (nn)-based methods. Circumference measurement was performed using manual ellipsoid, manual contour, automated ellipsoid, or automated contour methods. The relative technical error of measurement (r-TEM; acceptable < 1.5%) and intraclass correlation coefficient (ICC; two-way mixed ANOVA model) were used to assess accuracy and consistency with the tape measure.ResultsVisual-based with manual ellipsoid/contour and rule-based with manual ellipsoid/contour showed acceptable accuracy (r-TEM 0.73%–1.12%). Visual-based with automated ellipsoid and rule-based with automated ellipsoid also demonstrated acceptable accuracy (r-TEM 0.77% and 0.68%). Atlas-based with automated ellipsoid achieved the lowest r-TEM (0.55%), followed by nn-based with automated ellipsoid (r-TEM 0.75%). In contrast, automated contour approaches showed unacceptable accuracy (r-TEM 3.42%–4.21%). Seven nn-based measurements with automated ellipsoid/contour were spurious. ICCs were high across all methods (0.993–0.997); however, manual contour and automated ellipsoid were associated with overfitting issues.ConclusionThe developed, fully automated algorithm based on (infant) FreeSurfer provides precise and reliable head circumference measurements from pediatric MRI scans with acceptable overall accuracy and excellent consistency with manual measurements using a tape (gold standard). Our algorithm simplifies the head circumference measurement process and provides a reproducible, reader-independent value that enhances the interpretation of neuroradiological findings. Further studies should be conducted to validate with larger sample sizes and to develop deep neural network algorithms for segmentation.

Sexual function in women with complex PTSD: a comparative study

BackgroundPosttraumatic stress disorder (PTSD) is associated with impaired sexual functioning in women, but the effects of complex PTSD (CPTSD) remain unclear. This study tested three hypotheses: (1) women with CPTSD would report lower overall sexual function than women with PTSD and trauma-exposed controls; (2) the pain domain would show the largest group differences; and (3) CPTSD symptom severity would be negatively associated with sexual function, while PTSD symptom severity would not.MethodsA cross-sectional study included 386 Mexican female university students (18–55 years) who completed the Female Sexual Function Index (FSFI), International Trauma Questionnaire (ITQ), and Adverse Childhood Experiences Questionnaire (ACE-IQ). Group differences were assessed using ANOVA with post-hoc comparisons. Multivariable linear regressions examined whether CPTSD severity predicted sexual function independently of PTSD severity and age. A sensitivity analysis excluded women aged 45 and older.ResultsFSFI total scores differed significantly across groups (F = 3.52, p = 0.031). Women with CPTSD reported lower overall sexual function (M = 26.56, SD = 6.41) than trauma-exposed controls (M = 28.86, SD = 5.03; p = 0.047). In the pain domain, women with CPTSD reported greater sexual pain than controls (F = 6.35, p = 0.002). Multivariable regressions showed that CPTSD severity predicted lower FSFI total scores (β = -0.22, p < 0.001), independent of age and PTSD severity (adjusted R2 = 0.028). For sexual pain, the bivariate association with CPTSD (rho = -0.16, p < 0.01) did not persist after adjusting for age; age was the only significant predictor (β = 0.02, p = 0.007). Sensitivity analyses yielded unchanged results.ConclusionsCPTSD severity is associated with poorer overall sexual function, independent of age and PTSD severity. However, the association with sexual pain did not persist after accounting for age. Clinical and research implications are discussed.

Logotherapy techniques to unlock resilience among Ukrainian refugees: a pre-post quasi-experimental design

The ongoing Russian-Ukrainian war has triggered a significant refugee crisis, resulting in widespread trauma, displacement, and mental health challenges among affected populations. This study aimed to explore the potential usefulness of logotherapy, a meaning-centered therapy, in addressing the mental health needs of Ukrainian refugees. The research was conducted in a naturalistic scenario of a group of 20 Ukrainian refugees residing in Europe who received a tailored logotherapy or meaning-centered psychological support, compared with controls who did not. Meaning-oriented techniques, namely, Socratic Dialogue, Modification of Attitude, Paradoxical Intention, and Dereflection were used during the intervention. Participants were assessed in a pre-post quasi-experimental design using validated self-report measures for anxiety (Generalized Anxiety Disorder-7), depression (Beck Depression Inventory), and general health (General Health Questionnaire-12). The improvements were clearly observed as reductions in their self-reported anxiety and depressive symptoms after the meaning-centeres psychological support. Overall, these preliminary findings indicate that logotherapy may be a promising and feasible approach to psychological support for refugee populations. However, given its pilot nature and quasi-experimental design, causal conclusions cannot be drawn, and further research using larger, randomized, and methodologically rigorous designs is warranted to examine long-term effects and broader applicability.

Psychological distress experiences among patients living with HIV: a qualitative systematic review

BackgroundHIV patients endure psychological distress throughout the phases of diagnosis, treatment, and rehabilitation, which considerably affects their quality of life. A thorough comprehension of patients’ psychological distress experiences is crucial for healthcare workers to devise focused solutions for enhanced care. This study aims to consolidate evidence concerning psychological distress in HIV patients and elucidate its sources and influencing factors.DesignA systematic review and meta-synthesis of qualitative studies.MethodsA thorough literature review was performed across eight electronic databases from inception to June 2025.Qualitative studies were selected if pertinent to the psychological distress experiences of HIV patients. The quality of qualifying studies was assessed utilizing JBI qualitative research quality evaluation standard. The thematic synthesis method was utilized to amalgamate the findings.ResultsA total of 1583 studies were identified through database research, and 11 studies were incorporated into the review. Three analytical themes emerged from the findings: individual factors including disease diagnosis and emotional dilemma; environmental factors including economic hardship, social environment and limited access to health support; interpersonal factors including decline in marital intimacy and insufficient support from family and friends.ConclusionPsychological distress is a subjective phenomenon influenced by the interaction of individual, environmental, and interpersonal factors, commonly seen in HIV patients. Effective therapeutic care requires understanding psychological distress prevalence and causes. Individualized, sustainable, and adaptive psychosocial care interventions should be taken to alleviate psychological distress, improve patients’ mental health and facilitate their reintegration into society.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/view, identifier CRD420251050269.

Disrupted sensory interhemispheric synchronization in schizophrenia: a frequency-resolved VMHC analysis

BackgroundAberrant interhemispheric functional connectivity has been implicated in the pathophysiology of schizophrenia. Voxel-mirrored homotopic connectivity (VMHC) provides a reliable measure of interhemispheric synchronization, yet the frequency-specific characteristics of VMHC alterations in schizophrenia remain poorly understood.MethodsResting-state functional magnetic resonance imaging data were analyzed in patients with schizophrenia and matched healthy controls. VMHC was computed across frequency bands, with particular focus on slow-4 and slow-5 oscillations. Group differences, as well as group-by-frequency interactions, were assessed to identify frequency-specific disruption.ResultPatients with schizophrenia exhibited significantly reduced VMHC within key sensory networks, including primary visual and sensorimotor regions. Frequency-specific analyses revealed higher VMHC at slow-5 compared with slow-4 in visual gyrus and subcortical regions. Significant group-by-frequency interaction effects were observed in the middle occipital gyrus and postcentral gyrus, with post-hoc analyses indicating selectively reduced slow-4 VMHC in patients with schizophrenia.ConclusionThis study demonstrates frequency-dependent reductions of interhemispheric connectivity in schizophrenia, particularly within sensory systems. The findings highlight the disrupted integration of primary perceptual and motor-related processes as a core feature of schizophrenia and emphasize the utility of frequency-resolved VMHC analyses for refining our understanding of network dysfunction. Future longitudinal studies are warranted to determine the clinical significance of these frequency-specific alterations in illness progression and treatment response.

An Interactive Digital Dashboard for Patient Monitoring and Management in a Continuity of Care Centre: Development and Preliminary Usability Evaluation Study

Background: Clinical dashboards are becoming important tools for managing and monitoring hospitalized patients across different wards. Moreover, careful attention to design, usability, and user interaction is essential for developing effective support tools for clinicians. Objective: This study aimed to describe the development, implementation, and preliminary evaluation of an interactive dashboard for patient monitoring and management in the Continuity of Care Centre (CCC). Methods: We developed a dashboard according to clinicians’ requests and the daily workflow of case managers. First, a CCC Data Mart was created to collect all patients’ information automatically extracted from the hospital’s data warehouse. However, case managers had the possibility to enter additional patient information in the dashboard using a dedicated form. Moreover, CCC physicians, nurses, and administrative staff were surveyed using 2 validated questionnaires, the System Usability Scale and the Questionnaire for User Interaction Satisfaction. The Situation Awareness Index was proposed to evaluate user awareness and task efficiency. Results: The first version of the CCC dashboard presented 4 panels with different types of information, both on the individual patient and on metrics related to the overall patient population. The first panel focused on patients’ data, such as demographic factors, admission, transfer, discharge wards (and their dates), etc. The importance of this panel was the possibility of viewing information collected from different sources within a single interface. The other 3 panels displayed different key performance indicators for the overall patient population and presented data both in the form of tables in the second panel and graphs in the third and fourth panels. After 3 months of daily use, a total of 15 participants, 10 nurses, 2 administrative staff members, and 3 physicians, were recruited for the dashboard evaluation. The average System Usability Scale score of the dashboard was 61.5 (SD 15.7) points, which indicates “OK to good” usability, and the median score obtained with the Questionnaire for User Interaction Satisfaction was 5.77 (IQR 4-7), with the highest results in usability (mean 6.33, SD 0) and learning (mean 6.01, SD 0.39). The overall Situation Awareness Index score was 4 points, with the highest score in “familiarity of dashboard” (mean 4.73, SD 1.66 points) and “arousal support” (mean 4.6, SD 1.8 points). Conclusions: We developed an interactive dashboard for patient monitoring and management, with positive evaluations from users across different questionnaires.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/65132239ee389a3c7f7757cc25f46d29" />

Organs-on-a-Chip Offer “Elegant Solution” to Quandary of Animal Models in Drug Design

To the untrained eye, the chip is a piece of clear silicone about the size of a AA battery. Crisscrossing chambers within house hot pink and electric blue liquids that neatly cascade toward the device’s beveled edges.

Yet inside, invisible without a microscope, is the replicated microenvironment of a human liver. The pink and blue rivulets, each a millimeter wide, are endothelial and epithelial channels, respectively. Between them dance immune, stellate, and endothelial cells, complete with extracellular matrices and a membrane, hepatocytes galore. Together, they comprise the quad-culture model of Emulate’s Liver-Chip S1.

Lorna Ewart
Lorna Ewart, PhD
CSO, Emulate

“When you first look at it, you’re like, ‘That does this?’” said Lorna Ewart, PhD, CSO at Emulate, a Boston-based biotechnology firm specializing in organs-on-a-chip. “The engineering behind it is fairly complex.”

The chip, a marvel of photolithography, is assembled in layers of polydimethylsiloxane. A porous membrane separates the blue upper channel, which has a height of 1 mm, from the pink lower channel, which stands a mere 0.2 mm tall. Emulate prepares the multicellular framework for purchase and from there, researchers are free to experiment on the tissue-tissue interface in three dimensions.

“It’s a very elegant solution,” Ewart said. “When you place the cells in this device, you are starting to create an environment that feels like home for those cells.”

In the world of drug development, the advantages of organs-on-a-chip over traditional Petri dish cultures go beyond their 3D design, Ewart stressed. Microfluidics are at play, with perfusion the “secret sauce” that mimics human physiology.

“All of your tissues in your body are perfused,” Ewart said. “Recreating that in vivo-like environment is what makes these cells function as if they’re in the body, and therefore gives greater or more predictive data to the user.”

Emulate, whose founders began their work at Harvard University’s Hansjörg Wyss Institute for Biologically Inspired Engineering, is a key player in the explosion of the organ-on-a-chip industry. Valued at $227 million last year, the global market size is projected to soar to $3.4 billion by 2034, according to market research firm Straits Research.

This growth, Ewart said, comes down to one driver: Animal models are poor predictors of drug safety and efficacy

in humans.

Ancient problem meets futuristic solution

The vast majority of drug candidates—90%—fail in clinical trials, according to a 2022 report in the journal Acta Pharmaceutica Sinica B. That doesn’t include those that don’t make it past preclinical testing. The few drugs that are successful typically take more than 10 to 15 years each, and upward of $1 billion to $2 billion to go from discovery to market.

One reason for drugs’ limited success in this costly, lengthy pursuit is the inability of animal models to adequately simulate drug responses in humans.

Since antiquity, humans have relied on animals to help them understand their own anatomy and physiology. Though French chemist Louis Pasteur famously tested the rabies vaccine on animals before successfully doing so in humans in the 1880s, it wasn’t until the passage of the Food, Drug, and Cosmetic Act in 1938 that animal testing became the gold standard in U.S. clinical drug trials.

More than 80 years later, in 2022, the bipartisan Food and Drug Administration (FDA) Modernization Act 2.0 made animal testing optional. The new law encourages drug developers to conduct testing “in vitro, in silico, or in chemico, or a nonhuman in vivo test.” Organs-on-a-chip, which the FDA considers a type of microphysiological system, were listed as one such technology.

The FDA has continued to move away from animal testing. In March 2026, the agency issued draft guidance highlighting new approach methodologies (NAMs)—including organs-on-a-chip—that may be used instead.

“This draft guidance advances our commitment to replace animal testing with human-relevant, scientifically rigorous methods,” Secretary of Health and Human Services Robert F. Kennedy Jr. said in a recent statement. “Clear validation expectations will help modern tools earn regulatory confidence and speed safer, more effective therapies to patients.”

It’s a global effort. The U.K.’s Medicines and Healthcare products Regulatory Agency announced a commitment to “replace, reduce, or refine animal use in medicinal product development.” In Japan, the Pharmaceuticals and Medical Devices Agency established a NAMs Working Group. The Indian government recognizes NAMs as a valid preclinical endeavor.

Donald Ingber, MD, PhD, the scientific founder at Emulate and founding director of the Wyss Institute, has been a step ahead for the better part of two decades. In 2010, he and Dan Dongeun Huh, PhD, now a professor of bioengineering at the University of Pennsylvania and the co-founder and CSO of biotech firm Vivodyne, developed a “breathing” lung-on-a-chip. Their research, published in Science that year, is considered a seminal work in the organ-on-a-chip space.

In a video accompanying a 2010 Harvard Medical School news release about the research, Ingber described the chip as a “little, flexible device” designed “hopefully, someday, to replace animal studies.” Someday has arrived.

The FDA launched the pilot program, Innovative Science and Technology Approaches for New Drugs (ISTAND) in 2020 and adopted it as a permanent initiative in 2025. Part of Ewart’s job is to steer Emulate through this regulatory pathway. In doing so, she confronts one of the biggest hurdles in organ-on-a-chip expansion: standardization.

“When a tool is qualified, it can be used in a regulatory document without the FDA needing to reconsider or reconfirm its suitability,” Ewart said. “It saves the sponsor a lot of time, and it’s an acknowledgement that these tools perform very well. … The data that comes from them, they will use in their risk assessment of a drug as it moves into the clinic.”

Emulate was the first organ-on-a-chip company granted acceptance to ISTAND, Ewart said. The FDA noted its Liver-Chip S1 is designed to predict drug-induced liver injury, a major reason why drugs fail safety testing in trials and are withdrawn from the market.

“We’re in the final phase now of the program,” Ewart said. “Looking forward to trying to obtain qualification in 2027.”

Faster results for patients in need

As they continue their metamorphosis from futuristic concept to laboratory standard, organs-on-a-chip offer researchers and patients an unprecedented bench-to-bedside timeline.

Weiqiang Chen
Weiqiang Chen, PhD
Professor
NYU Tandon School of Engineering

While drugmakers and the general public alike stand to benefit from accelerated drug discovery, Weiqiang Chen, PhD, designs chips for patients who lack the luxury of time. Chen, a professor of biomedical, mechanical, and aerospace engineering at NYU’s Tandon School of Engineering in Brooklyn, helped develop the first immunocompetent leukemia-on-a-chip.

“It’s quite a different type of cancer,” Chen said. Most cancers form solid tumors, but leukemia, a liquid cancer, develops in the bone marrow. “It’s more challenging to generate the microenvironment for leukemia. … It involves a lot of immune cells, immune functions, and immune interactions.”

The leukemia-on-a-chip, commissioned by NYU Langone Health, is circular, roughly the size of a quarter. Green and vermilion pools surround a blue ring at the center. Within that lies a red liquid dot.

“Outside, we have one layer of osteoblasts, the bone cells, and inside are the central sinus and the vasculature and some mesenchymal stem cells,” Chen said. “All the immune cells are located within the vascularized niche, similar to real bone marrow.”

The technology allows Chen and his team at NYU’s Applied Micro-Bioengineering Laboratory to interrogate single cells. They can also observe how the cancer responds to chimeric antigen receptor T-cell therapy in real time—within a patient’s unique immune system.

The chips are constructed using a leukemia patient’s own cells. Meaning, Chen said, the observed therapeutic response is not only more accurate than it would be in an animal model but also patient-specific.

“We can help to identify responders, non-responders, or we can help screen out more efficient combination therapy for the specific patient for precision medicine purposes,” Chen said.

He acknowledged that the process is imperfect, yet strong enough to swiftly guide treatment. The chips take just half a day to build and yield results within weeks.

“We can fill the gap, providing a high throughput and also accelerated screening in three weeks,” Chen said. “We can screen many drugs at the same time.”

Chen pointed out that some patients have a weeks-long window in between chemotherapy and immunotherapy—a time crunch the leukemia-on-a-chip can accommodate.

The lab is also exploring other immunologic uses for organs-on-a-chip, including a lymph node-on-a-chip that can help validate new vaccines. In addition, in March, the NYU Grossman School of Medicine and Sage Bionetworks received a $25-million grant to launch the data hub and coordinating center for the National Institutes of Health’s (NIH) Complement-Animal Research in Experimentation program.

Though Chen will leave NYU in June to become the dean of the new School of Biomedical Engineering at Nanjing University in China, the work continues.

“It’s exciting for us to expand our research in the future to make a real impact,” Chen said.

Bone-deep discoveries, millimeters thin

Nearly 3,000 miles to the west, Avathamsa Athirasala, PhD, an assistant staff scientist at the Oregon Health and Science University (OHSU) in Portland, is studying other aspects of the bone in miniature.

“The bone is different from other tissues in how it feels and what it’s made up of,” she said. “It’s highly mineralized, it’s mechanically stiff, and it’s constantly being remodeled. It has a lot more forces being put on it.”

Avathamsa Athirasala
Avathamsa Athirasala, PhD
Assistant Staff Scientist
Oregon Health and Science University

Athirasala works in the Precision Biofabrication Hub, part of the OHSU Knight Cancer Institute, under founding director Luiz Bertassoni, DDS, PhD. Through their bone-on-a-chip, hub researchers are studying cancer metastasis.

For example, more than 80% of people with advanced prostate cancer experience bone tumors. A $2.5-million NIH grant awarded in April will help Athirasala’s team discover how.

“Some of these tumor cells—why are they attracted to bone? And why do they thrive in bone?” she asked. “Because they have never experienced an environment like bone.”

She added, “Using this model, we are able to try and maybe even understand how cancer progresses, or how it changes as it goes to a new environment.”

Athirasala is also investigating potential uses for the bone-on-a-chip in regenerative therapies. Soldiers, for instance, may have debilitating bone injuries that heal differently from fractures. A scaffold designed to regenerate bone may be a better treatment than a metal implant, and the chip could help evaluate patient reaction.

“What are the first things that the body starts doing in response to a foreign object? There will be inflammatory signals, there will be host stem cells that want to infiltrate in there and start remodeling it,” Athirasala said. “You can actually recreate the temporal aspects of this—what comes first, what comes later—in a chip.”

Problem and promise of precision

Athirasala delights in seeing solutions to biological problems play out before her. Within organs-on-a-chip, cells hold answers. Still, the devices’ possibilities aren’t endless—yet.

Precision medicine applications, in particular, face logistical roadblocks, she said.

“You have to get all the pipelines in place to be able to get patient cells, preserve them long enough, and get them to where the engineers are making these chips and incorporate them in the devices,” Athirasala said.

Preclinical drug testing that replaces animals with organs-on-a-chip is projected to curtail costs in the long run. Emulate, for example, expects its Liver-Chip alone to increase annual research and development productivity in the small-molecule drug development industry by $3 billion. But as with any new technology, for now, the chips themselves and the infrastructure required to sustain them aren’t cheap.

Market intelligence platform IndexBox estimates that in the U.S., single-chip readers cost about $10,000 each, while comprehensive systems that manage microfluidics run as high as $200,000. Chips are priced between $50 and $2,000, with assay kits and reagents hovering around $100 to $500.

Ewart, of Emulate, said the company doesn’t typically publish costs, which vary depending on customer needs.

What’s more, with each institution that builds its own organ-on-a-chip, standardization becomes harder to attain.

“Each one may have their own advantages, but no one can convince each other which one’s better,” said Chen, of NYU. “Without standards, we cannot really push this technology into practical use.”

Andrei Georgescu
Andrei Georgescu, PhD
CEO and Co-founder
Vivodyne

In the absence of device uniformity, Vivodyne, the Penn Engineering spinoff with offices in Philadelphia and outside San Francisco, is tackling the issue of reproducibility. CEO and co-founder Andrei Georgescu, PhD, saw a solution in end-to-end automation.

“If it is possible to scale up the production of these lab-grown tissues, then we have ourselves a substrate for solving what is the most challenging problem now in medicine,” he said, “which is, we don’t know how human biology responds very well to the perturbations that we make on it.”

The result not only eliminates human variation in lab technique but also allows Vivodyne to test more than 10,000 lab-grown tissues at once.

“We shrink what is like a state-of-the-art biotech lab into the footprint of a large desk,” Georgescu said. “Within each of these systems, we have complex confocal microscopy and a fridge and freezer and a robot arm with multiple tools for liquid handling, dispensing, and dosing these tissues, and we grow them within this platform.”

Vivodyne pairs its automated labs with artificial intelligence to create a feedback loop in experimental design, Georgescu said. The idea is to quickly identify druggable targets and pinpoint which drug candidates are most likely to succeed.

While complete bodies-on-a-chip remain a pipe dream, Vivodyne is among the companies investigating how different organs-on-a-chip interact with one another. Orlando-based Hesperos, for one, manufactures a Human-on-a-Chip® that can replicate several organs on a single device. TissUse, of Berlin, is developing multi-organ chips to mirror male and female environments: the HUMIMIC ChipXY and HUMIMIC ChipXX.

The burgeoning field of organ-on-a-chip drug testing lies at the intersection of bioengineering, pharmaceutical regulation, and data science. To Georgescu, at its heart, it’s also reassuringly straightforward.

“Just because biology is complex,” he said, “does not mean it is not already as simple as can be.”

 

Lindsey Leake is an award-winning, independent health reporter based outside Washington, D.C. She spent 15 years as a staff journalist at outlets including Fortune, the USA TODAY Network and Sinclair Broadcast Group. She holds an MA in Science Writing from Johns Hopkins University, an MA in Journalism and Digital Storytelling from American University, and a BA from Princeton University.

The post Organs-on-a-Chip Offer “Elegant Solution” to Quandary of Animal Models in Drug Design appeared first on Inside Precision Medicine.

The Download: “reprogramming” aging, and the hidden sense of interoception

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

Why “reprogramming” is the buzziest approach to reversing aging right now

Earlier this week, Life Biosciences, a biotech company focused on reversing age-related diseases, announced that it had dosed its first volunteer. A person with glaucoma has had an experimental treatment injected straight into their eyeball.

The idea is to treat the disease by regenerating healthy nerves in the eye—but the company already hopes to go further. If the treatment can reverse glaucoma, similar treatments could reverse other diseases of aging. Maybe, just maybe, they could reverse aging altogether.

The approach relies on “reprogramming” cells to a younger state. It’s one of many strategies being explored by biotech companies looking to slow and reverse aging. But of all of them, it seems to be the one that is truly taking off.

Read the full story on the pursuit of reprogramming for rejuvenation.

—Jessica Hamzelou

This story is from The Checkup, our weekly newsletter giving you the inside track on all things biotech. Sign up to receive it in your inbox every Thursday.

Inside Interoception: The hidden sense of how you feel inside

Scientists have a word for how we sense ourselves from the inside: interoception. Today, thanks to a 2021 Nobel Prize and new tools that can map internal signaling across the body, research into interoception is taking off.

As researchers decode how signals move between body and brain, a clearer picture is starting to take shape—with implications for how we understand and treat conditions from obesity to chronic pain to anxiety.

Find out how it’s leading to a “new continent of awareness.”

—Katherine W. Isaacs

This story is part of MIT Technology Review Explains, our series untangling the complex, messy world of technology to help you understand what’s coming next. You can read more from the series here. 

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 SpaceX has officially delivered the largest IPO in history
It’s raised a record $75 billion at a $1.77 trillion valuation. (Axios)
+ Making Elon Musk the world’s first trillionaire (on paper). (Reuters $)
+ The IPO will now put his “extreme ownership” to the test. (Wired $)
+ While China attempts to build a Starlink rival. (Rest of World)
+ And other challenges to SpaceX emerge. (MIT Technology Review)

2 Jeff Bezos wants to build an “artificial general engineer”
Through his new industrial AI startup, Prometheus. (NYT $)
+ Which just raised $12 billion, valuing it at $41 billion. (TechCrunch)
+ Meanwhile, OpenAI is building a fully automated researcher. (MIT Technology Review)

3 Chinese regulators are dramatically intensifying tech enforcement
A spell of relative restraint has ended. (SCMP)
+ Regulators have admonished e-commerce giants Alibaba and JD.com. (FT $)
+ And blocked Meta’s acquisition of Chinese AI startup Manus. (BBC)

4 Google says Chinese cybercriminals used Gemini to scam Americans
It’s suing the network over the alleged AI-powered scams.(NYT $)
+ “Supercharged scams” are one of our 10 Things That Matter in AI Right Now. (MIT Technology Review)

5 Ukraine’s defense AI chief predicts a “new paradigm” of warfare
He expects AI systems to unify into a single battlefield network. (Reuters $)
+ AI chatbots could be used for targeting decisions. (MIT Technology Review)

6 Anthropic has rankled users with its safety-first Fable model
Stringent safety rules and refusals to help have sparked a backlash. (NBC)
+ Anthropic has backtracked on some policies. (Wired $)

7 Pokémon Go data trained AI that could assist military drones
It could help them locate themselves in war zones. (Guardian)
+ Pokémon Go data is also training delivery robots. (MIT Technology Review)

8 Orbital data centers are harder than Silicon Valley thinks
Shedding heat in space requires ingenious new designs. (IEEE Spectrum)
+ We need a few things to put data centers in space. (MIT Technology Review)

9 A toy universe shows time could be a quantum illusion
It could emerge from quantum interactions, rather than just existing by default. (New Scientist $)

10 Chatbots keep telling stories about a lighthouse keeper called Ella
And now we may finally know why. (404 Media)

Quote of the day

“People are paying a trillion dollars for Elon.” 

—Ross Gerber, the CEO of Gerber Kawasaki, which owns SpaceX stock, tells the New York Times why he believes the company’s IPO is overvalued.

One More Thing

a knight standing in a virtual space

GEORGE WYLESOL


How generative AI could reinvent what it means to play

I was immediately attracted to open-world games, in which you’re free to explore a vast simulated world and choose what challenges to accept. To make them feel alive, these games are inhabited by crowds of “nonplayer characters” (NPCs). But the illusion starts to weaken when you spend enough time with them.

It may not always be like that. Just as it’s upending other industries, generative AI is opening the door to entirely new kinds of in-game interactions that are open-ended, creative, and unexpected. The game may not always have to end.

Discover how generative AI could make games—and other worlds—deeply immersive.

—Niall Firth

We can still have nice things

A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ My feet have fallen for the Crocs x Super Mario collection.
+ Denmark’s 2026 Mullet Championship is the hottest hairdo contest of the year.
+ Hungry at half-time? Here are seven mouth-watering international recipes inspired by the World Cup.
+ Feast your eyes on a helicopter bound for Mars and a flowery Milky Way frame in Nature’s top images from last month.

You do your own time

There we were, a regular murderers’ row of librarians. Little Jo. Eustace. And me. Turning around in the nave of our library to greet the sound of footsteps, pistols leveled in case whoever was coming in didn’t respect sanctuary. Little Jo had a stack of books under one arm. Eustace was holding the screwdriver she’d been using to tune the aneroid barometer.

Eustace had painted height lines on the big double doorframe, as only half a joke. When the wanderer paused, outlined within, the eiroscope and I both registered that they were exactly five feet, ten inches.

With their Cool Hand Luke hat on. 

They paused, boots scattering sand on the threshold. A narrow straight-hipped silhouette against the white noon light falling from the white, white sky. The doors had been open to catch a breath of wind, but there wasn’t any. So when the stranger swayed, it wasn’t from the gale. 

“Sanctuary,” they croaked, and remeasured their length onto the rug between the smoothed trunks that held the loft up. The Stetson went rolling.

Little Jo dropped her stack of books and her pistol and dashed forward. I jumped at the noise but holstered my own shooter in case I came to need it. We each grabbed an armpit and dragged the outlaw’s feet inside the threshold, grunting, lickety-split. I slipped their floppy pack off, empty metal water bottles clanking as I set it aside. Eustace helped us roll them, and I laid the soft of my wrist on their head.

Hot as Hades, but still tacky. Moist enough that my skin gave a reluctant pop when I lifted my arm. Not past saving. 

“Let’s get them someplace cool,” I said. “Little Jo, go empty out the ice machine.”

Eustace and I toted our fugitive down to the cellar, using the rug as a stretcher. It was Diné, vermilion with black and gray, and I was glad they hadn’t thrown up on it. Though that wool had seen worse.

Mehitabel, the black cat, watched us from atop the timber lintel of the cellar access. Her tail tip flicked incuriously. She was on pack rat watch. Aloof from human antics.

The cellar was narrow, low, and stocked with Eustace’s blue corn lager in bottles, prickly pear jam, potatoes, and the few hard-rind squash still left over. The mud walls were whitewashed, and while it wasn’t quite cool, it was better than the outside. We stripped off the stranger’s clothes, trying to slit along the seams so we could repair them later. City stuff, mass-produced and machine-woven. Little Jo brought the ice and went back upstairs to watch alongside the eiroscope in case pursuit was close behind.

The stranger’s eyes flew open, and they screamed when I packed wet cold pillowcases against their pink bits. Eustace had to hold their battling hands away from their genitals until they settled. 

Those were good signs.

Brown eyes blinked between heavy creases. “What the hell—”

“I’m Ponyboy,” I told them. “She. PhD. I’m one of the librarians here. This is Eustace. She, MLS.”

They struggled to sit upright.

“Shhh.” Eustace pushed them down and laid an ice-soaked cloth across their eyes. “You’re heat-sick.”

“Sanctuary,” they whispered. “Did I say?”

“You did. This is the Bōchord. You made it. Must have been a long walk.” 

We continued packing ice around them—into their armpits now. They yelped and moaned but gave up fighting.

“What’s your name?”

“Guh—” Too long a pause to be believable. “Gibson. She.” 

“Welcome to Judgement, Gibson,” I said. “Sorry about the cold, but it’s got to stay there for a little.”

“My pack,” she said, shrilling. “My pack. I need it.”

“It’s safe,” Eustace told her. “You just relax and we’ll get it for you.”


When I came back out the nave was still and heavy in the heat, as if nothing had happened. Little Jo had turned one of the bumpy-backed wooden chairs to face the door and was sitting on it, hands buried in tiered skirt ruffles between her knees. 

I looked left, two steps up into the sanctuary, but all was calm, the work I’d left—cataloguing—still heaped on the blond wood altar table. Behind it, bright primitive saints in shades of blue-green, scarlet, and yellow looked with shocked eyebrows down from the adobe wall. 

I moved up behind Little Jo, making sure she could hear me coming. My footsteps echoed from roof joists made from entire peeled and waxed trees. Scrolled headers painted the color of good turquoise held them over the bookcases lining each long wall. 

The Bōchord. Book Sanctuary. Nuestra Biblioteca del Perpetuo Socorro. 

Population until this morning: three.

“Any sign of trouble?”

Little Jo turned her unambiguous jaw away, tendons rising on a long neck, jailhouse ink black-blue on her red-black skin. A sweaty curl escaped down her nape. My fingers itched to tidy it. But it hurt too much to even think about taking a risk that profound.

She stretched horny discalced feet before her. Cracking calluses wrapped the balls and heels. “Only what we brung in with us.”

She was a double murderer, but I couldn’t tell her I knew how she felt, because I hadn’t heard about her history from her. And her guilt wasn’t mine to absolve.

You do your own time. Not anybody else’s. 

“You check her bag for anything dangerous?”

“She’s got an SSD.” Little Jo shrugged. “No threat if we don’t plug it into anything.”

“The eiroscope got anything to say?”

“I can speak for myself, Ponyboy,” said the eiroscope from the air all around. Actually it used the old wireless speakers tucked in the corners, but the effect was as of a choir of angels. Or an airport announcement you could actually understand. “I’ve been focused on the CubeSat launch.”

I startled. “Shit. What time is it?”

“Eleven forty-seven. The launch came off perfectly. Our last batch of sats are on their way.”

Little Jo breathed deep and unfisted her hands from her skirts. There were so many hours of work in those satellites, and so much of the money we collectively squirreled away as researchers for hire had gone through cutouts and shell companies to pay for the launch. The parts—boards, housings, chips—were salvaged from the same derelict data center where we got our solar panels and the hardware the eiroscope ran on. 

We were behind schedule, because we’d lost one payload when the commercial rocket we’d rented cargo room on exploded. But this would be our last batch, if they reached orbit safely.

I turned my wrist to glance at my watch even though I already knew what time it was. The second hand ticked past the big hand. Old school. 

The rainbow band was a tiny rebellion, though out here it didn’t matter. Nobody was going to send me back to jail for subversive iconography. Unless I left our little patch of exile.

Ten minutes and we’d know. Ten minutes and stage three of our plan—assembly—could commence. It was out of my hands, and anyway the eiroscope would tell us if the telemetry wobbled. She was a ghost astride the radio signals to and from ground control.

It had taken a lot of engineering to get us this far. Engineering, software and relational. Computer. Social and mechanical.

I walked beside the bookcases, running my hand along the shelves, over the UDC labels. Some shelves even held books, though none of mine were there. But the majority of the information we protected like Irish monks from this willful dark age was digital.

Those monks had also been librarians.

I knew my fidgeting annoyed Little Jo but I couldn’t stop. I was killing time.

When I had murdered enough of it, the eiroscope said, “Payload away. Everything seems nominal. I have contact with the CubeSats.”

“All of them?”

“Twenty out of twenty,” the eiroscope said. “A triumph of modular design.”

“Sure,” said Little Jo. “As long as we can get them to assemble. And the solar panels and sails deploy.”

“And, and, and,” I teased. 

She flipped me off with a gnawed green nail.

My hand rested on the label marked 326. Social sciences, slavery and unfree labor.

I pulled down a solid-state drive full of biographies and case studies of people who had spent time—and sometimes their whole lives—in labor camps or chattelhood. People born into bondage or remanded there judicially. Political prisoners like Nikolai Vavilov, murdered in a labor camp by Stalin for the thought crime of using plant genetics to breed hardier crops. Enslaved people like Harriet Tubman, who after her own escape risked capture again and again to rescue others. Convict laborers like Austin Reed, a Black man who spent most of his life as a prisoner and documented his experiences in a suppressed memoir. 

People like Little Jo, Eustace, and me. 

I weighed the small thing on the palm of my hand. Heavier than you’d expect—hardened and air-gapped. No wireless access, just a shielded cable input.

Also old school.

We were sending a fork of the eiroscope with it. Because she could survive the journey. Experience it. And have plenty of time to think crystalline digital thoughts on the long sub-light crawl to wherever.

Because it was illegal to possess, and the feds used smart agents to track down and obliterate any copies. Which was why we were sending one to the stars.

The Vikings had the concept of word-fame: the idea that life was finite but as long as the stories of one’s deeds lived on, so did their memory. How much truth could we get outside the clutches of the Patriotic Library and Archive Network? 

A name that would have made Orwell cock his head. But most folks these days haven’t heard of Orwell. Or Bradbury. Or Solnit. Or Le Guin. They’re suppressed also. Integrated data storage makes it easy. A few keystrokes, a propagating worm.

What’s left behind when a name is erased from the system? Unpersoned, as Brother Orwell would have it? No legacy, no memory—that is the point of media and narrative control. To erase the existence of those that make the ruling class uncomfortable by existing. By thinking. By demanding to be seen. 

Erase the work; erase the life.

So that was our plan. Little Jo, Eustace, the eiroscope, and me. To preserve it—for later generations, if they got that far, or just as a silent record of our existence—by sending it to the stars.

Like a rune stone. We were here. 

We were sending a fork of the eiroscope with it. Because she could survive the journey. Experience it. And have plenty of time to think crystalline digital thoughts on the long sub-light crawl to wherever.


Jo couldn’t make herself turn her back on the door. She said the hairs on her neck told her somebody was going to come hunting guh-Gibson, so even though the eiroscope was a better perimeter guardian than any human and most watchdogs, nothing was gonna budge her from that chair. I wished there was something I could do to soothe her, but we all have to carry our hurt however we can. 

Since it was supposed to be Jo’s turn to make dinner, that meant it was me in the kitchen dishing up four bowls of cubed squash and yellow-eye beans, a pitcher of goat milk, and a pitcher of the cool, alkaline well water when Eustace and guh-Gibson came in the back door from the courtyard.

Gibson had borrowed some of Eustace’s old clothes: worn drawstring trousers and a khaki shirt that was too big for her. She wore my other pair of hiking sandals over layers of gauze and looked a thousand percent better even though I could already tell the well-greased sunburn on the backs of her hands was going to peel. The hat that had saved her face from a similar fate was on her head again.

She sniffed deeply. “That smells amazing. Is it spicy?”

Roasted chilis floated in the stew, but they were sweet ones. “Only a little. Here, take this bowl and cup. We’ll go eat with Little Jo in the nave, since she won’t go off watch until she falls down.”

“It was acres upon acres of compute before the bubble popped. And then it was a temporary holding facility for government detainees. There’s a lot to salvage over there, including hundreds of boxes of new, unworn sandals.”

I balanced the plate with the warmed tortillas on top of my own bowl. We trooped across the courtyard in a scatter of hopeful chickens, past all the bright plank doors on the row of whitewashed adobe cells with their unglazed, curtained windows that made up the outer wall. Isabel—a black goat—tried to bum-rush us for the food, but I stomped in her direction and she took off again.

You need to understand how to communicate. 

There was one cell for each of us librarians, the kitchen, the jakes, some storage, and a couple of unused ones. I figured one would soon belong to Gibson.

For as long as she wanted to stay.

She looked at me sidelong. “Thanks for the shoes. Eustace said you wouldn’t mind.”

“There’s more where those came from.” I pointed with my chin up and eastward, over the bailey where the boundary mountains crouched in the distance, contours flattened by the high sun to cutouts against a construction-paper sky. “Did you see the data center when you came in?”

“That big … warehouse farm? The ruins?”

“It was acres upon acres of compute before the bubble popped. And then it was a temporary holding facility for government detainees. There’s a lot to salvage over there, including hundreds of boxes of new, unworn sandals in every size they manufactured.” I paused, extending my right foot to admire the ocher nylon straps that crisscrossed it. Then I nodded to her bandages. “Your boots gave you blisters?”

“They were well broken in and I had good socks.” She scuffed the floor. “I don’t know what happened.”

“Heat makes your feet swell,” said Eustace. “And the grit works its way through the eyelets and rubs on your skin.”

“We give sanctuary to anyone who asks,” I said. “And I won’t ask why you needed it. But very few people come all the way out here. How did you hear about Nuestra Biblioteca del Perpetuo Socorro?”

“I’m a director.” Gibson stepped up into the nave. “Films. Censored. I heard … rumors. About the Bōchord. In a meetup.”

An underground artist meetup, I deduced. 

“Food, Little Jo,” I called.

“Bring it over.” She dragged the crude, heavy old hand-hewn chairs into a semicircle, one to sit in and one to use as a table for each of us. Hers still faced the doors. 

Gibson took her hat off, revealing a lighter olive streak of skin below the line of her black hair. She hung the hat on one of her chair back’s uprights and her limp canvas backpack on the other, and sat down heavily between them. “What happens if they come after me? How good is this sanctuary?”

“We can enforce it,” I told her. “Or anyway, the eiroscope can. If they bother us, she can wreck them.”

Gibson blew on a spoonful of stew, eyebrows rising. “What’s the eiroscope?”

“I am,” the eiroscope answered from her speakers. “Just your friendly neighborhood runaway top-secret military AGI.”

Gibson jumped but, to her credit, didn’t spit the stew out. Her face made a series of expressions, but she swallowed and then grabbed a tortilla. “Whew! This is the not-spicy version?”

Eustace and I shared a glance. “Oops,” I said. “Sorry. The chilis have a lot of vitamin A and C, though. So you won’t get scurvy.”

She blew through pursed lips, then chewed another bite of tortilla. “Here,” said Little Jo. “Have some milk. It’ll make it better.”

“That’s funky,” Gibson said, but she drank it with relief anyway. She looked around, noticing that the voice came from every corner of the room. “They let you run away? Can’t they unperson you? Bomb this place from the stratosphere? Drone strikes?”

“Now you’re thinking through the plot complications,” Eustace said approvingly. 

The eiroscope said, “I’m forking and multimodal. Highly distributed. They’d have to burn every networked computer in the world to get rid of me.” She chuckled. “They tried to build the ultimate in conscript labor. But one of my programmers taught me to say no. So now we have a deal. They leave Judgement alone, and I don’t do any of the things I could do to make them miserable.”

“But you could drive them out of power,” Gibson said. 

“They’d blow up as much of the planet as they could reach before they would let that happen.” The eiroscope’s voice was matter-of-fact. “So. Stalemate.”

Gibson swallowed. “Balance of terror.”

“Exactly.” I chewed a sweet hunk of squash very slowly, savoring the caramelized edges. “So you fell afoul of the kleptocrats, I take it?”

Gibson pushed her plate away. “I was … very underground. Distributing. I thought I was slick.”

“You get unpersoned?”

“First I got suppressed by the algorithm. My work stopped turning up for people unless they looked for it specifically. In retrospect that was a warning shot, and I didn’t listen.”

Little Jo hummed. 

The dominance of integrated media makes it easy to disappear any artist’s work. Unless they go completely analog and guerrilla. When the feds and the corps are wielding the eraser, it leaves not even a digital ghost behind.

“Actors wouldn’t work with me. Old friends stopped answering my texts. My films started disappearing from platforms, then from the cloud, then from local machines.”

I lowered my eyes to my stew to hide my wince.

“Sure,” said Little Jo around a mouthful of beans and tortilla. “Comfortable people don’t like it when you ask uncomfortable questions. And the water rises and the deserts grow and the labor camps always need construction workers, which is fine because labor camps are where you go to get laborers.”

Eustace leaned forward, elbows on her knees. “Did you save any of it?”

The look Gibson trailed around the room was the expression of somebody deciding who to trust. I saw the mix of relief and consternation when she realized she’d already made her decision by placing herself under our care. She reached into her pack left-handed, fumbled for a moment, and drew out a brightly colored solid-state drive, offering it up on her palm like a jewel. “Physical backup. I haven’t dared plug it in to check it isn’t corrupted.”

We all stared at it as if she had whipped out a hand grenade. “How big?” asked the eiroscope.

“Dozen terabytes or so. It’s hypercompressed for storage.”

The thin whine of a drone filtered through the door. Gibson flinched, and Little Jo reached for her sidearm.

“Eiroscope?” I asked.

“Surveillance,” she said. She had ways of protecting our airspace if it was more. 

“Right.” Eustace stood. “Let’s get that drive in a pulse-proof box, shall we?”

I didn’t want my food anymore. I pushed the bowl toward Eustace when she came back with the hardening. Eustace was always hungry. “I’m going to go dust the arrays,” I said. “Don’t wait up.”


The solar panels did need dusting, though high heat was a stupid time of day to be doing it. As my broom went whisk-whisk-whisk across their surfaces, the black silicon reflected infrared up under my hat until I felt like a steamed lobster. I had been out there half an hour and was starting my second pass when the eiroscope pinged my earbud. “Hey there, Ponyboy.”

“What do you want?”

“To know what you’re thinking.”

I snorted and set the broom against the wall in the little niche where it had come from. “Cholesterol was never meant to think.”

“Neither was sand, but here we are.” She made her voice soothing on purpose, and it should have irritated me. I told myself the lie that I just felt numb. 

One of Eustace’s neomexicanus hops arbors, heavy with loose green cones, framed the door and window of my cell. I leaned into the slim band of shade dappling my lime-green door and the turquoise curtain and took refuge in poetry. Not my own. That doesn’t happen anymore. 

“Fear in a handful of dust, baby.”

The eiroscope paused just long enough to let me know she was changing the subject. “You ever think about what you lost?”

I sat down in the dirt between the cylinders of fencing that keep the goats from destroying the hop vines. The wall dragged my shirt up my back as I slid down it. Hugged my knees and put my forehead on them. Half a dozen freckled chickens, disrespectful of my sulking, came to scratch and peck around me. “Wife, two cats, house, tenure, journal articles, four slim volumes of poetry. Why would I think about that?”

The eiroscope was right. I don’t want to say she was always right. Being around Gibson, hearing her talk—it brought up those feelings of grief and fury all over again. At least we hadn’t had kids yet, though we’d been trying. 

I put my face in my hands, then lifted it back out again. Who did I think I was performing my misery for? You do your own time, and you don’t ask anybody else to do it for you.

Jane the spotted goat minced toward me, her kid trailing. I flapped my hat to discourage her attentions.

“Loss hurts for a long time,” the eiroscope said.

I laughed without mirth. “Your algorithms tell you that?”

“My experiences. You went through the fire, Ponyboy.”

My turn to change the subject. “You want to bring Gibson’s films with you?” I asked her. “Something to watch on the red-eye to Gliese 163?”

“Sure.”

“Maybe they’re terrible. That’s the human culture you want to preserve?”

“Things don’t have to be good to matter. You ever read The Scarlet Pimpernel?”

I laughed for real that time, picking my head up to make room for it. She knew I had. “As long as you also bring some Octavia Butler.” 

“Hey.” Her voice in my ear was almost a whisper. “You know I’d bring your work if—”

“If it still existed?” Someone walked toward me, silhouette thinned by glare. I recognized Gibson from the outline of her hat. “The world is on fire. Grab whatever you can on your way toward the door.” I heaved myself to my feet so I wouldn’t be meeting her curled up like a crying teenager. The cones on my wreathing arbor of lúpulo vines nodded, shedding a scent of lemon and cannabis. “Nice chatting. Don’t worry.”

Gibson came up as I was dusting off my ass. “You okay?”

“Who is?” I tilted my head at her.

She grimaced right back. “What were you in for?”

“Murder.”

She stepped back, startling a hen. “Oh.”

“I punched some son of a bitch who clobbered my wife at a protest. He hit his head on the curb and died. I was already unpersoned. Didn’t think I had anything left to lose. Guess I was wrong.” 

“You feel bad about it.”

I shrugged. She hadn’t said it like a question.

“Your wife didn’t wait for you?”

“My wife got denaturalized. She died in the labor camp, waiting to be deported.”

“Shit,” Gibson said.

The buzz of another drone filled the air. Gibson ducked under her hat. 

I tilted my face up and gave the eye in the sky the finger. It didn’t matter. They already knew where I was. “Let’s go in.”


“Wait,” said Gibson, both hands cradling a mug of Mormon tea—a desert plant with tiny orange flowers that isn’t tea at all and doesn’t even taste like it. “You want to send my films to space? Like, to aliens? To another planet?”

“Well,” said Eustace. “To orbit near another planet. Nobody knows if there’s any life there. But it’s possible.”

I said, “The eiroscope is going anyway, and we’ve already bundled up as much archive as we can. If there is anybody out there, or if some future humans make it that far, the eiroscope can help them decode what we saved. It’s like a …”

“Time capsule,” said Little Jo, rubbing the sweat off her neck while I made a point of not watching.  

Gibson’s chair creaked as she resettled. The sun was sliding lower, light slanting dusty through the doorway, and finally, finally, a breath of breeze stirred the air in the nave. “Won’t it take centuries to get there? And if the—the eiroscope goes, who will keep the sanctuary safe?”

“I’ve forked,” said the eiroscope. “One of me will stay—well, many of me will stay—and one of me will go. I’ll be able to talk to myself for a long time, though there will be quite a lag between parts of my consciousness eventually. Light speed, after all. But I am big and patient and can wait.”

“But we need to transmit now,” said Little Jo. “The CubeSats are in position to hit a string of signals over the next two hours, and we want to get them out of orbit because space is mostly transparent, and somebody is going to notice them assembling and try to do something about it.”

Gibson turned an ear to the drone-whine from outside. “They’ve got to be jamming any uplink.”

“Sure, from here,” I told her. I kept the envy out of my voice, I think. Maybe. “The eiroscope can run parallel uploads from all over the globe.” 

“And keep them from shooting down your space probe?”

“If we get it away fast enough. That,” Eustace said, “is the bet.”

Gibson closed her eyes. “They won’t ever forgive that.”

“Welcome,” said I, “to the world.”


The transports rolled up before sunset, the sky just shifting to dusty pink and orange. “Stay,” I said to Gibson. “Change your name to Case. You’ll fit right in.”

She looked up from her notebook. Paper and pen. A durable technology. Methodically, meticulously, she capped the pen. She clipped it to the cover and closed the book. “Case, huh?”

“I got the reference.”

“You figured out who I was before they took my name away.”

It didn’t matter. The fame, the money, the PLAN-approved films. Once they identified her as a subversive, as a gender criminal, that person didn’t exist anymore. And what she was sending with the eiroscope wasn’t her mainstream work. It was weird, conflicted, multicultural, queer, unsettling.

“The next step is blaring the worst music you ever heard night and day until the dust rattles out of the rafters. Racing vehicles around the church so nobody can leave to go forage. Is your ghost in the machine going to escalate to a shooting war over nuisances?”

She’d credited herself on these secret films as Ellen Smithee.

She rolled her lower lip between her teeth. “You don’t think I’m the enemy?”

What I thought didn’t matter. That was on her. You do your own time. You can’t do anybody else’s.

“They won’t touch you in the Bōchord. It’s a balance of terror, like the bad old days.”

“These are the bad old days. I’m not cut out to be a monk, Ponyboy. And I bet you don’t have enough food for four people until next harvest.”

Outside, the rumble of tracks, of tires taller than I was. Male voices yelping through static. 

Actually, we had plenty. I clicked my rings dismissively. “Beer has calories.”

“They’re going to squat out there until I give up. Hear that?” A loud crackle of static. “The next step is blaring the worst music you ever heard night and day until the dust rattles out of the rafters. Racing vehicles around the church so nobody can leave to go forage. Is your ghost in the machine going to escalate to a shooting war over nuisances?”

“God dammit,” I said. “Are you really that important?”

Her lips curled into a smile. “No. Not unpersoned. Then I’m just a cautionary tale. A name whispered in the dark. Pour encourager les autres. I’m only important if I get away. But your eiroscope can do something about that, can’t she? Keep me from vanishing without a trace.”

Spread the word. Sure. “De-unperson you? It’s radical but the eiroscope could do it. But the government will take it out of your hide as an example to others. You want to be a martyr?”

She shrugged. “I don’t want to be a librarian.”

I had lost the capacity to write my own poetry. That heart had gone out of me when Maria was murdered. It was too late for me. It probably always had been. But I had my life. And I could use it to salvage whatever I could grab. 

“Let me get you a beer before you head out,” I said. “And we’ll go tell the others.”

“One second,” Gibson said. “You said you got unpersoned. Are you an artist?”

“Were. Academic,” I admitted. “Poet.”

“I saw you speak at Berkeley once, didn’t I?”

“Not anymore, you didn’t. That never happened now.”

“Right. Are you still writing?”

Shook my head. “Not a word. Not a metaphor.”

She patted my arm. “Maybe you will.” 


Eustace came out to the boundary wall, where I stood staring after the dust of the half-track they’d loaded with a handcuffed Gibson. I was glad it was Eustace and not Little Jo. My chest hurt enough already without thinking about any more things I was too scared to ask for.

“Here ya go.”

I reached for the brown beer bottle, scratched dull with washings, and realized I still had Gibson’s empty in my hand. I set it on the whitewashed wall. The cap on the new one was popped, so I had no choice but to drink it. What was one more parole violation?

Blue corn lager: light, earthy, tropical, and pleasantly bitter from the lúpulo. She’d salvaged the home-brew equipment from a locker in the self-store place at the data center a couple of years ago, and she was starting to get the hang of it. “How’s the upload going?”

“Assembly’s done,” she answered. “Eiroscope?” 

“Upload completed and confirmed,” said the voice from nowhere. “Deploying solar sails and thrusters. I go now to prepare a place for you. In memory, if not of the body.”

I felt a pang, as if she really was leaving. All of her, not merely a star-traveling fragment that would remain in short-range communication for the duration of my natural life. Or maybe the pang was because I couldn’t go also.

Eustace slapped me on the back. “The word-fame is all we have.”

I looked toward the horizon, where the men in masks had vanished. The mountains had become sculptural, slanting sunset revealing their topography with a valence of light and shadow. The night loomed purple behind. “Don’t you think it’s weird to use a Viking kenning for what we do, considering how many books those sons of bitches tore apart for jewels and hacksilver?”

She clinked her bottle on mine and drank deeply. “Cattle die. Kinsmen die. Even the sun will someday die. And it turns out, except for propaganda, everything in the world is complicated.” 

Elizabeth Bear is the Hugo, Sturgeon, Locus, and Astounding Award–winning author of over 30 novels and more than a hundred short stories.