health

man’s-heart-stopped-after-common-bacterium-caused-ultra-rare-infection

Man’s heart stopped after common bacterium caused ultra-rare infection

A 51-year-old man showed up at a hospital in Germany looking as though he was wasting away, with swelling and tenderness in his ankles and knees. Then, his heart stopped.

Doctors were able to resuscitate him. Then, they got to work trying to figure out what was wrong. The man told them that for three months he had been suffering from diarrhea, weight loss, joint pain, and fever. His case was reported in this week’s issue of the New England Journal of Medicine.

Blood tests didn’t detect any infection, but imaging of his heart told a different story. Doctors saw “vegetation” on both his aortic valve and mitral valve. Vegetations are clumps or masses that often build up from an infection, generally containing a bundle of proteins, platelets, and infecting germs stuck together. While they cause damage where they are, if they fully dislodge, they threaten to move to other parts of the body, such as the brain or lungs, and cause dangerous blockages. In the man’s case, the vegetation on his aortic valve appeared mobile.

The man was quickly sent to emergency surgery to replace his valves. Once removed, the diseased valves were sent for testing to see what was in those dangerous masses. The result likely came as a surprise to the doctors.

The man had in his heart Tropheryma whipplei, a very common environmental bacterium that dwells in soil. Only in exceedingly rare cases does it cause an infection—but when it does it’s a systemic, chronic, and sometimes life-threatening one called Whipple’s disease. The condition affects about one to three people in a million, most often middle-aged Caucasian men, like the patient in this case. Overall, 85 percent of Whipple’s disease cases are in men.

Curious condition

So, how can such a common germ also cause such a rare infection? Researchers think it’s due to genetic predisposition and a glitch in immune responses. Many people likely get infected with T. whipplei as kids, and have either an asymptomatic or limited gastrointestinal infection. They then develop protective immune responses. But in the few people who develop Whipple’s disease, this process seems to go awry. Researchers hypothesize that white blood cells called macrophages—which normally engulf and destroy invading pathogens—aren’t able to finish the job. They engulf T. whipplei, but don’t neutralize the germ. When this happens, the immune system doesn’t generate protective antibodies against the bacterium, and inflammation ratchets up. This, in turn, leads to the development of a systemic infection.

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RFK Jr. may be about to demolish preventive health panel, health groups fear

“Worrying”

With the latest cancellation, experts fear the USPSTF is next. “This is very worrying, because if past is prologue, it may suggest that they are preparing to eliminate or emasculate the committee,” Peter Lurie, executive director of the Center for Science in the Public Interest, told The New York Times.

Such concerns were first raised after a June 27 US Supreme Court ruling that upheld the provision in the Affordable Care Act that requires health plans to cover USPSTF A- and B-grade recommendations. The ruling preserved critical preventive care coverage but affirmed Kennedy’s authority to control the task force—such as replacing members and undoing recommendations.

In a letter to Congress this week, health and medical organizations urged lawmakers to protect the USPSTF from Kennedy, noting the Supreme Court ruling. In the wake of the ruling, they wrote, “It is critical that Congress protects the integrity of the USPSTF from intentional or unintentional political interference. The loss of trustworthiness in the rigorous and nonpartisan work of the Task Force would devastate patients, hospital systems, and payers as misinformation creates barriers to accessing lifesaving and cost effective care.”

The letter was led by nonprofit health professional organization AcademyHealth and signed by over 100 other organizations, including the American Medical Association, the American Academy of Pediatrics, and the American Public Health Association.

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Woman takes 10x dose of turmeric, gets hospitalized for liver damage

A 57-year-old woman spent six days in the hospital for severe liver damage after taking daily megadoses of the popular herbal supplement turmeric, which she had seen touted on social media, according to NBC News.

The woman, Katie Mohan, told the outlet that she had seen a doctor on Instagram suggesting it was useful against inflammation and joint pain. So, she began taking turmeric capsules at a dose of 2,250 mg per day. According to the World Health Organization, an acceptable daily dose is up to 3 mg per kilogram of weight per day—for a 150-pound (68 kg) adult, that would be about 204 mg per day. Mohan was taking more than 10 times that amount.

A few weeks later, she developed stomach pain, nausea, fatigue, and dark urine. “I just did not feel well generally,” she said.

After seeing a news report about the possibility of toxicity from turmeric, she connected her symptoms to the pills and went to urgent care. Blood tests revealed her liver enzyme levels were 60 times higher than the normal limit, suggesting liver damage. She was admitted to a local hospital and then transferred to NYU Langone in New York City. Her hepatologist there, Nikolaos Pyrsopoulos, said she was “one step before full liver damage, liver failure, requiring liver transplant.”

Rare toxicity

Generally, turmeric—a golden-colored staple of curries—is not harmful, particularly in foods. But, as herbal supplements have gained popularity and doses have gotten larger, doctors have reported a rise in liver injuries from the spice. In fact, while rare overall, turmeric appears to have become the most common herbal cause of liver injuries in the US.

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Weird chemical used in plastics has erupted as latest fentanyl adulterant

Urgent questions

And it wasn’t just found in a few samples at each location—in Los Angeles, for instance, it was present in 56 percent of drug samples in September, and 32 percent in Philadelphia. It also wasn’t just found in trace amounts. In a study of 98 samples of BTMPS-tainted fentanyl, 63 percent of samples contained more BTMPS than fentanyl. Fourteen samples had BTMPS levels that were 10 times higher than the fentanyl content.

While it’s unclear why BTMPS, of all chemicals, has shown up in illicit drugs, researchers have some ideas. For one, BTMPS could simply be a cheap bulking agent that allows makers to dilute fentanyl and maximize profits. The substantial amounts of BTMPS in some samples lend weight to this hypothesis. But another possibility is that makers are using the UV-protection feature that the light stabilizer provides to extend the shelf life of drugs.

It’s also possible it’s simply an accidental contaminant, but researchers suspect that, given the rapid and widespread emergence, its addition is deliberate and likely early in the production process.

How BTMPS affects users is another big question. Animal studies suggest that BTMPS can interact with cell receptors in the heart and nervous system. This raises the possibility of cardiotoxic effects, like low blood pressure and cardiovascular collapse, as well as neurological toxicity, such as muscle weakness or dysfunction of the autonomic nervous system, which controls things like heart rate and breathing.

Anecdotal clinical reports link use of BTMPS to blurred vision, pink eye, ringing in the ears, and nausea. There are also reports of skin irritation and burning after injection, and, after smoking, throat irritation, coughing, and coughing up blood.

Researchers say clinical research on the component is now urgently needed, as well as more surveillance.

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Mighty mitochondria: Cell powerhouses harnessed for healing


rescuing suboptimal organs

Researchers hope a new technique can treat a variety of damaged organs.

James McCully was in the lab extracting tiny structures called mitochondria from cells when researchers on his team rushed in. They’d been operating on a pig heart and couldn’t get it pumping normally again.

McCully studies heart damage prevention at Boston Children’s Hospital and Harvard Medical School and was keenly interested in mitochondria. These power-producing organelles are particularly important for organs like the heart that have high energy needs. McCully had been wondering whether transplanting healthy mitochondria into injured hearts might help restore their function.

The pig’s heart was graying rapidly, so McCully decided to try it. He loaded a syringe with the extracted mitochondria and injected them directly into the heart. Before his eyes, it began beating normally, returning to its rosy hue.

Since that day almost 20 years ago, McCully and other researchers have replicated that success in pigs and other animals. Human transplantations followed, in babies who suffered complications from heart surgery—sparking a new field of research using mitochondria transplantation to treat damaged organs and disease. In the last five years, a widening array of scientists have begun exploring mitochondria transplantation for heart damage after cardiac arrest, brain damage following stroke, and damage to organs destined for transplantation.

This graphic depicts the basic steps and results of mitochondrial transplantation. Scientists think that donor mitochondria fuse with the recipient cells’ mitochondrial networks. Then they work to shrink the size of the infarct (the area of tissue dying from lack of blood and oxygen), among other effects. Scientists have studied such transplants in kidneys, livers, muscle, brains, hearts, and lungs. Credit: Knowable Magazine

Mitochondria are best known for producing usable energy for cells. But they also send molecular signals that help to keep the body in equilibrium and manage its immune and stress responses. Some types of cells may naturally donate healthy mitochondria to other cells in need, such as brain cells after a stroke, in a process called mitochondria transfer. So the idea that clinicians could boost this process by transplanting mitochondria to reinvigorate injured tissue made sense to some scientists.

From studies in rabbits and rat heart cells, McCully’s group has reported that the plasma membranes of cells engulf the mitochondria and shuttle them inside, where they fuse with the cell’s internal mitochondria. There, they seem to cause molecular changes that help recover heart function: When comparing blood- and oxygen-deprived pig hearts treated with mitochondria to ones receiving placebos, McCully’s group saw differences in gene activity and proteins that indicated less cell death and less inflammation.

About 10 years ago, Sitaram Emani, a cardiac surgeon at Boston Children’s Hospital, reached out to McCully about his work with animal hearts. Emani had seen how some babies with heart defects couldn’t fully recover after heart surgery complications and wondered whether McCully’s mitochondria transplantation method could help them.

During surgery to repair heart defects, surgeons use a drug to stop the heart so they can operate. But if the heart is deprived of blood and oxygen for too long, mitochondria start to fail and cells start to die, in a condition called ischemia. When blood begins flowing again, instead of returning the heart to its normal state, it can damage and kill more cells, resulting in ischemia-reperfusion injury.

Since McCully’s eight years of studies in rabbits and pigs hadn’t revealed safety concerns with mitochondria transplantation, McCully and Emani thought it would be worth trying the procedure in babies unlikely to regain enough heart function to come off heart-lung support.

Parents of 10 patients agreed to the experimental procedure, which was approved by the institute’s review board. In a pilot that ran from 2015 to 2018, McCully extracted pencil-eraser-sized muscle samples from the incisions made for the heart surgery, used a filtration technique to isolate mitochondria and checked that they were functional. Then the team injected the organelles into the baby’s heart.

Eight of those 10 babies regained enough heart function to come off life support, compared to just four out of 14 similar cases from 2002 to 2018 that were used for historical comparison, the team reported in 2021. The treatment also shortened recovery time, which averaged two days in the mitochondrial transplant group compared with nine days in the historical control group. Two patients did not survive — in one case, the intervention came after the rest of the baby’s organs began failing, and in another, a lung issue developed four months later. The group has now performed this procedure on 17 babies.

The transplant procedure remains experimental and is not yet practical for wider clinical use, but McCully hopes that it can one day be used to treat kidney, lung, liver, and limb injuries from interrupted blood flow.

The results have inspired other clinicians whose patients suffer from similar ischemia-reperfusion injuries. One is ischemic stroke, in which clots prevent blood from reaching the brain. Doctors can dissolve or physically remove the clots, but they lack a way to protect the brain from reperfusion damage. “You see patients that lose their ability to walk or talk,” says Melanie Walker, an endovascular neurosurgeon at the University of Washington School of Medicine in Seattle. “You just want to do better and there’s just nothing out there.”

Walker came across McCully’s mitochondrial transplant studies 12 years ago and, in reading further, was especially struck by a report on mice from researchers at Massachusetts General Hospital and Harvard Medical School that showed the brain’s support and protection cells—the astrocytes—may transfer some of their mitochondria to stroke-damaged neurons to help them recover. Perhaps, she thought, mitochondria transplantation could help in human stroke cases too.

She spent years working with animal researchers to figure out how to safely deliver mitochondria to the brain. She tested the procedure’s safety in a clinical trial with just four people with ischemic stroke, using a catheter fed through an artery in the neck to manually remove the blockage causing the stroke, then pushing the catheter further along and releasing the mitochondria, which would travel up blood vessels to the brain.

The findings, published in 2024 in the Journal of Cerebral Blood Flow & Metabolism, show that the infused patients suffered no harm; the trial was not designed to test effectiveness. Walker’s group is now recruiting participants to further assess the intervention’s safety. The next step will be to determine whether the mitochondria are getting where they need to be, and functioning. “Until we can show that, I do not believe that we will be able to say that there’s a therapeutic benefit,” Walker says.

Researchers hope that organ donation might also gain from mitochondria transplants. Donor organs like kidneys suffer damage when they lack blood supply for too long, and transplant surgeons may reject kidneys with a higher risk of these injuries.

To test whether mitochondrial transplants can reinvigorate them, transplant surgeon-scientist Giuseppe Orlando of Wake Forest University School of Medicine in Winston-Salem and his colleagues injected mitochondria into four pig kidneys and a control substance into three pig kidneys. In 2023 in the Annals of Surgery, they reported fewer dying cells in the mitochondria-treated kidneys and far less damage. Molecular analyses also showed a boost in energy production.

It’s still early days, Orlando says, but he’s confident that mitochondria transplantation could become a valuable tool in rescuing suboptimal organs for donation.

The studies have garnered both excitement and skepticism. “It’s certainly a very interesting area,” says Koning Shen, a postdoctoral mitochondrial biologist at the University of California, Berkeley, and coauthor of an overview of the signaling roles of mitochondria in the 2022 Annual Review of Cell and Developmental Biology. She adds that scaling up extraction of mitochondria and learning how to store and preserve the isolated organelles are major technical hurdles to making such treatments a larger reality. “That would be amazing if people are getting to that stage,” she says.

“I think there are a lot of thoughtful people looking at this carefully, but I think the big question is, what’s the mechanism?” says Navdeep Chandel, a mitochondria researcher at Northwestern University in Chicago. He doubts that donor mitochondria fix or replace dysfunctional native organelles, but says it’s possible that mitochondria donation triggers stress and immune signals that indirectly benefit damaged tissue.

Whatever the mechanism, some animal studies do suggest that the mitochondria must be functional to impart their benefits. Lance Becker, chair of emergency medicine at Northwell Health in New York who studies the role of mitochondria in cardiac arrest, conducted a study comparing fresh mitochondria, mitochondria that had been frozen then thawed, and a placebo to treat rats following cardiac arrest. The 11 rats receiving fresh, functioning mitochondria had better brain function and a higher rate of survival three days later than the 11 rats receiving a placebo; the non-functional frozen-thawed mitochondria did not impart these benefits.

It will take more research into the mechanisms of mitochondrial therapy, improved mitochondria delivery techniques, larger trials and a body of reported successes before mitochondrial transplants can be FDA-approved and broadly used to treat ischemia-reperfusion injuries, researchers say. The ultimate goal would be to create a universal supply of stored mitochondria — a mitochondria bank, of sorts — that can be tapped for transplantation by a wide variety of health care providers.

“We’re so much at the beginning—we don’t know how it works,” says Becker. “But we know it’s doing something that is mighty darn interesting.”

This article originally appeared in Knowable Magazine, a nonprofit publication dedicated to making scientific knowledge accessible to all. Sign up for Knowable Magazine’s newsletter.

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Knowable Magazine explores the real-world significance of scholarly work through a journalistic lens.

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RFK Jr. barred registered Democrats from being vaccine advisors, lawsuit says

The lawsuit was filed by the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), the Infectious Diseases Society of America (IDSA), the Massachusetts Public Health Alliance, the Society for Maternal-Fetal Medicine, and a Jane Doe, who is a pregnant physician.

The group’s lawsuit aims to overturn Kennedy’s unilateral decision to drop the CDC’s recommendations that healthy children and pregnant people get COVID-19 vaccines. The medical groups argue that Kennedy’s decision—announced in a video on social media on May 27—violates the Administrative Procedure Act for being arbitrary and capricious.

Specifically, Kennedy made the decision unilaterally, without consulting the CDC or anyone on ACIP, entirely bypassing the decadeslong evidence-based process ACIP uses for developing vaccine recommendations that set standards and legal requirements around the country. Further, the changes are not supported by scientific evidence; in fact, the data is quite clear that pregnancy puts people at high risk of severe COVID-19, and vaccination protects against dire outcomes for pregnant people and newborns. Kennedy has not explained what prompted the decision and has not pointed to any new information or recommendations to support the move.

“Existential threat”

The medical groups say the decision has caused harms. Pregnant patients are being denied COVID-19 vaccines. Patients are confused about the changes, requiring clinicians to spend more time explaining the prior evidence-based recommendation. The conflict between Kennedy’s decision and the scientific evidence is damaging trust between some patients and doctors. It’s also making it difficult for doctors to stock and administer the vaccines and creating uncertainty among patients about how much they may have to pay for them.

In making the claims, the medical groups offer a sweeping review of all of the damaging decisions Kennedy has made since taking office—from canceling a flu shot awareness campaign, spreading misinformation about measles vaccines amid a record-breaking outbreak, and clawing back $11 billion in critical public health funds to wreaking havoc on ACIP.

The lead lawyer representing the groups, Richard Hughes IV, a partner at Epstein Becker Green, did not immediately respond to Ars’ request for comment.

But in a statement Monday, Hughes said that “this administration is an existential threat to vaccination in America, and those in charge are only just getting started. If left unchecked, Secretary Kennedy will accomplish his goal of ridding the United States of vaccines, which would unleash a wave of preventable harm on our nation’s children.”

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Man’s ghastly festering ulcer stumps doctors—until they cut out a wedge of flesh


The man made a full recovery, but this tale is not for the faint of heart.

If you were looking for some motivation to follow your doctor’s advice or remember to take your medicine, look no further than this grisly tale.

A 64-year-old man went to the emergency department of Brigham and Women’s Hospital in Boston with a painful festering ulcer spreading on his left, very swollen ankle. It was a gruesome sight; the open sore was about 8 by 5 centimeters (about 3 by 2 inches) and was rimmed by black, ashen, and dark purple tissue. Inside, it oozed with streaks and fringes of yellow pus around pink and red inflamed flesh. It was 2 cm deep (nearly an inch). And it smelled.

The man told doctors it had all started two years prior, when dark, itchy lesions appeared in the area on his ankle—the doctors noted that there were multiple patches of these lesions on both his legs. But about five months before his visit to the emergency department, one of the lesions on his left ankle had progressed to an ulcer. It was circular, red, tender, and deep. He sought treatment and was prescribed antibiotics, which he took. But they didn’t help.

You can view pictures of the ulcer and its progression here, but be warned, it is graphic. (Panel A shows the ulcer five months prior to the emergency department visit. Panel B shows the ulcer one month prior. Panel C shows the wound on the day of presentation at the emergency department. Panel D shows the area three months after hospital discharge.)

Gory riddle

The ulcer grew. In fact, it seemed as though his leg was caving in as the flesh around it began rotting away. A month before the emergency room visit, the ulcer was a gaping wound that was already turning gray and black at the edges. It was now well into the category of being a chronic ulcer.

In a Clinical Problem-Solving article published in the New England Journal of Medicine this week, doctors laid out what they did and thought as they worked to figure out what was causing the man’s horrid sore.

With the realm of possibilities large, they started with the man’s medical history. The man had immigrated to the US from Korea 20 years ago. He owned and worked at a laundromat, which involved standing for more than eight hours a day. He had a history of eczema on his legs, high cholesterol, high blood pressure, and Type 2 diabetes. For these, he was prescribed a statin for his cholesterol, two blood pressure medications (hydrochlorothiazide and losartan), and metformin for his diabetes. He told doctors he was not good at taking the regimen of medicine.

His diabetes was considered “poorly controlled.” A month prior, he had a glycated hemoglobin (A1C or HbA1C) test—which indicates a person’s average blood sugar level over the past two or three months. His result was 11 percent, while the normal range is between 4.2 and 5.6 percent.

His blood pressure, meanwhile, was 215/100 mm Hg at the emergency department. For reference, readings higher than 130/80 mm Hg on either number are considered the first stage of high blood pressure. Over the past three years, the man’s blood pressure had systolic readings (top number, pressure as heart beats) ranging from 160 to 230 mm Hg and diastolic readings (bottom number, pressure as heart relaxes) ranging from 95 to 120 mm Hg.

Clinical clues

Given the patient’s poorly controlled diabetes, a diabetic ulcer was initially suspected. But the patient didn’t have any typical signs of diabetic neuropathy that are linked to ulcers. These would include numbness, unusual sensations, or weakness. His responses on a sensory exam were all normal. Diabetic ulcers also typically form on the foot, not the lower leg.

X-rays of the ankle showed swelling in the soft tissue but without some signs of infection. The doctors wondered if the man had osteomyelitis, an infection in the bone, which can be a complication in people with diabetic ulcers. The large size and duration of the ulcer matched with a bone infection, as well as some elevated inflammatory markers he had on his blood tests.

To investigate the bone infection further, they admitted the man to the hospital and ordered magnetic resonance imaging (MRI). But the MRI showed only a soft-tissue defect and a normal bone, ruling out a bone infection. Another MRI was done with a contrast agent. That showed that the man’s large arteries were normal and there were no large blood clots deep in his veins—which is sometimes linked to prolonged standing, as the man did at his laundromat job.

As the doctors were still working to root out the cause, they had started him on a heavy-duty regimen of antibiotics. This was done with the assumption that on top of whatever caused the ulcer, there was now also a potentially aggressive secondary infection—one not knocked out by the previous round of antibiotics the man had been given.

With a bunch of diagnostic dead ends piling up, the doctors broadened their view of possibilities, newly considering cancers, rare inflammatory conditions, and less common conditions affecting small blood vessels (as the MRI has shown the larger vessels were normal). This led them to the possibility of a Martorell’s ulcer.

These ulcers, first described in 1945 by a Spanish doctor named Fernando Martorell, form when prolonged, uncontrolled high blood pressure causes the teeny arteries below the skin to stiffen and narrow, which blocks the blood supply, leading to tissue death and then ulcers. The ulcers in these cases tend to start as red blisters and evolve to frank ulcers. They are excruciatingly painful. And they tend to form on the lower legs, often over the Achilles’ tendon, though it’s unclear why this location is common.

What the doctor ordered

The doctors performed a punch biopsy of the man’s ulcer, but it was inconclusive—which is common with Martorell’s ulcers. The doctors turned to a “deep wedge biopsy” instead, which is exactly what it sounds like.

A pathology exam of the tissue slices from the wedge biopsy showed blood vessels that had thickened and narrowed. It also revealed extensive inflammation and necrosis. With the pathology results as well as the clinical presentation, the doctors diagnosed the man with a Martorell’s ulcer.

They also got back culture results from deep-tissue testing, finding that the man’s ulcer had also become infected with two common and opportunistic bacteria—Serratia marcescens and Enterococcus faecalis. Luckily, these are generally easy to treat, so the doctors scaled back his antibiotic regimen to target just those germs.

The man underwent three surgical procedures to clean out the dead tissue from the ulcer, then a skin graft to repair the damage. Ultimately, he made a full recovery. The doctors at first set him on an aggressive regimen to control his blood pressure, one that used four drugs instead of the two he was supposed to be taking. But the four-drug regimen caused his blood pressure to drop too low, and he was ultimately moved back to his original two-drug treatment.

The finding suggests that if he had just taken his original medications as prescribed, he would have kept his blood pressure in check and avoided the ulcer altogether.

In the end, “the good outcome in this patient with a Martorell’s ulcer underscores the importance of blood-pressure control in the management of this condition,” the doctors concluded.

Photo of Beth Mole

Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes.

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Medical groups warn Senate budget bill will create dystopian health care system

Medical organizations are blasting the Senate’s budget bill in the wake of its narrow passage Tuesday, warning of the dystopian health care system that will arise from the $1.1 trillion in cuts to Medicaid and other federal health programs if it is passed into law. The bill has moved back to the House for a vote on the Senate’s changes.

Over the weekend, an analysis from the Congressional Budget Office estimated that 11.8 million people would lose their health insurance over the next decade due to the cuts to Medicaid and other programs. Those cuts, which are deeper than the House’s version of the bill, were maintained in the Senate’s final version of the bill after amendments, with few concessions.

Organizations representing physicians, pediatricians, medical schools, and hospitals were quick to highlight the damage the proposal could cause.

The president of the American Academy of Pediatrics, Susan Kressly, released a stark statement saying the legislation “will harm the health of children, families, and communities.” The cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) will mean that “many children will not have healthy food to eat. When they are sick, they will not have health insurance to cover their medical bills—which means some children will simply forgo essential health care.” And the cuts are so deep that they will also have “devastating consequences that reach far beyond even those who rely on the program,” Kressly added.

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RFK Jr.’s health department calls Nature “junk science,” cancels subscriptions

The move comes after HHS Secretary and anti-vaccine activist Robert F. Kennedy Jr. said on a May 27 podcast that prestigious medical journals are “corrupt.”

“We’re probably going to stop publishing in the Lancet, New England Journal of Medicine, JAMA, and those other journals because they’re all corrupt,” he said. He accused the journals collectively of being a “vessel for pharmaceutical propaganda.” He went on to say that “unless these journals change dramatically,” the federal government would “stop NIH scientists from publishing there” and create “in-house” journals instead.

Kennedy’s criticism largely stems from his belief that modern medicine and mainstream science are part of a global conspiracy to generate pharmaceutical profits. Kennedy is a germ-theory denier who believes people can maintain their health not by relying on evidence-based medicine, such as vaccines, but by clean living and eating—a loose concept called “terrain theory.”

Access to top scientific and medical journals is essential for federal scientists to keep up to date with their fields and publicize high-impact results. One NIH employee added to Nature news that it “suppresses our scientific freedom, to pursue information where it is present.”

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Moderna says mRNA flu vaccine sailed through trial, beating standard shot

An mRNA-based seasonal flu vaccine from Moderna was 27 percent more effective at preventing influenza infections than a standard flu shot, the company announced this week.

Moderna noted that the new shot, dubbed mRNA-1010, hit the highest efficacy target that it set for the trial, which included nearly 41,000 people aged 50 and above. Participants were randomly assigned to receive either mRNA-1010 or a standard shot and were then followed for about six months during a flu season.

Compared to the standard shot, the mRNA vaccine had an overall vaccine efficacy that was 26.6 percent higher, and 27.4 percent higher in participants who were aged 65 years or older. Previous trial data showed that mRNA-1010 generated higher immune responses in participants than both regular standard flu shots and high-dose flu shots.

The company noted that the positive results for the new trial come in the wake of one of the worst flu seasons in years. During the 2024–2025 flu season, the Centers for Disease Control and Prevention estimates that 770,000 people in the US were hospitalized for the flu.

“Today’s strong Phase 3 efficacy results are a significant milestone in our effort to reduce the burden of influenza in older adults,” Moderna CEO Stéphane Bancel said in a statement. “The severity of this past flu season underscores the need for more effective vaccines. An mRNA-based flu vaccine has the potential advantage to more precisely match circulating strains, support rapid response in a future influenza pandemic, and pave the way for COVID-19 combination vaccines.”

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NIH budget cuts affect research funding beyond US borders


European leaders say they will fill the funding void. Is that realistic?

Credit: E+ via Getty Images

Rory de Vries, an associate professor of virology in the Netherlands, was lifting weights at the gym when he noticed a WhatsApp message from his research partners at Columbia University, telling him his research funding had been cancelled. The next day he received the official email: “Hi Rory, Columbia has received a termination notice for this contract, including all subcontracts,” it stated. “Unfortunately, we must advise you to immediately stop work and cease incurring charges on this subcontract.”

De Vries was disappointed, though not surprised—his team knew this might happen under the new Trump administration. His projects focused on immune responses and a new antiviral treatment for respiratory viruses like Covid-19. Animals had responded well in pre-clinical trials, and he was about to explore the next steps for applications in humans. But the news, which he received in March, left him with a cascade of questions: What would happen to the doctoral student he had just hired for his project, a top candidate plucked from a pool of some 300 aspiring scientists? How would his team comply with local Dutch law, which, unlike the US, forbids terminating a contract without cause or notice? And what did the future hold for his projects, two of which contained promising data for treating Covid-19 and other respiratory illnesses in humans?

It was all up in the air, leaving de Vries, who works at the Erasmus Medical Center in Rotterdam and whose research has appeared in top-tier publications scrambling for last-minute funding from the Dutch government or the European Union.

Of the 20 members in his group, he will soon run out of money to pay the salaries for four. As of June, he

estimated that his team has enough to keep going for about six months in its current form if it draws money from other funding sources.

But that still leaves funding uncertain in the long-term: “So, yeah, that’s a little bit of an emergency solution,” he said.

Cuts to science funding in the US have devastated American institutions, hitting cancer research and other vital fields, but they also affect a raft of international collaborations and scientists based abroad. In Canada, Australia, South Africa and elsewhere, projects receiving funds from the National Institutes of Health have been terminated or stalled due to recent budget cuts.

Researchers in Europe and the US have long collaborated to tackle tough scientific questions. Certain fields, like rare diseases, particularly benefit from international collaboration because it widens the pool of patients available to study. European leaders have said that they will step into the gap created by Trump’s NIH cuts to make Europe a magnet for science—and they have launched a special initiative to attract US scientists. But some researchers doubt that Europe alone can truly fill the void.

In many European countries, scientist salaries are modest and research funding has lagged behind inflation in recent years. In a May press release, a French scientists’ union described current pay as “scandalously low” and said research funding in France and Europe as a whole lags behind the US, South Korea, China, Taiwan, and Japan. Europe and its member states would need to increase research funding by up to 150 billion euros (roughly USD $173 billion) per year to properly support science, said Boris Gralak, general secretary of the French union, in an interview with Undark.

The shifts are not just about money, but the pattern of how international research unfolds, said Stefan Pfister, a pediatric cancer specialist in Germany who has also received NIH funds. The result, he said, is “this kind of capping and compromising well-established collaborations.”

Funding beyond US borders

For decades, international researchers have received a small slice of the National Institutes of Health budget. In 2024, out of an overall budget of $48 billion, the NIH dispensed $69 million to 125 projects across the European continent and $262 million in funding worldwide, according to the NIH award database.

The US and Europe “have collaborated in science for, you know, centuries at this point,” said Cole Donovan, associate director of science and technology ecosystem development at the Federation of American Scientists, noting that the relationship was formalized in 1997 in an agreement highlighting the two regions’ common interests.

And it has overall been beneficial, said Donovan, who worked in the State Department for a decade to help facilitate such collaborations. In some cases, European nations simply have capabilities that do not exist in the US, like the Czech Republic and Romania, he said, which have some of the most sophisticated laser facilities in the world.

“If you’re a researcher and you want to use those facilities,” he added, “you have to have a relationship with people in those countries.”

Certain fields, like rare diseases, particularly benefit from international collaboration because it widens the pool of patients available to study.

The shared nature of research is driven by personal connections and scientific interest, Donovan said: “The relationship in science and technology is organic.”

But with the recent cuts to NIH funding, the fate of those research projects—particularly on the health effects of climate change, transgender health, and Covid-19—has been thrown into question. On May 1, the NIH said it would not reissue foreign subawards, which fund researchers outside the US who work with American collaborators—or agree to US researchers asking to add a foreign colleague to a project. The funding structure lacked transparency and could harm national security, the NIH stated, though it noted that it would not “retroactively revise ongoing awards to remove foreign subawards at this time.” (The NIH would continue to support direct foreign awards, according to the statement.)

The cuts have hit European researchers like de Vries, whose institution, Erasmus MC, was a sub-awardee on three Columbia University grants to support his work. Two projects on Covid-19 transmission and treatment have ended abruptly, while another, on a potential treatment for measles, has been frozen, awaiting review at the end of May, though by late June he still had no news and said he assumed it would not be renewed.We’re trying to scrape together some money to do some two or three last experiments, so we at least can publish the work and that it’s in literature and anyone else can pick it up,” he said. “But yeah, the work has stopped.”

His Ph.D. students must now shift the focus of their theses; for some, that means pivoting after nearly three years of study.

De Vries’ team has applied for funds from the Dutch government, as well as sought industry funding, for a new project evaluating a vaccine for RSV—something he wouldn’t have done otherwise, he said, since industry funding can limit research questions. “Companies might not be interested in in-depth immunological questions, or a side-by-side comparison of their vaccine with the direct competition,” he wrote in an email.

International scientists who have received direct awards have so far been unaffected, but say they are still nervous about potential further cuts. Pfister, for example, is now leading a five-year project to develop treatments for childhood tumors; with the majority of funding coming from NIH and Cancer Research U.K., a British-based cancer charity, “not knowing what the solution will look like next year,” he said, “generates uncertainties.”

The jointly funded $25 million project—which scientists from nine institutions across five countries including the US are collaborating on—explores treatments for seven childhood cancers and offers a rare opportunity to make progress in tackling tumors in children, Pfister added, as treatments have lagged in the field due to the small market and the high costs of development. Tumors in children differ from those in adults and, until recently, were harder to target, said Pfister. But new discoveries have allowed researchers to target cancer more specifically in children, and global cooperation is central to that progress.

The US groups, which specialize in drug chemistry, develop lead compounds for potential drugs. Pfister’s team then carries out experiments on toxicity and effectiveness. The researchers hope to bring at least one treatment, into early-phase clinical trials.

Funding from NIH is confirmed for this financial year. Beyond that, the researchers are staying hopeful, Pfister said.

“It’s such an important opportunity for all of us to work together,” said Pfister, “that we don’t want to think about worst-case scenarios.”

Pfister told Undark that his team in Heidelberg, Germany, has assembled the world´s biggest store of pediatric cancer models; no similar stock currently exists in the US The work of the researchers is complementary, he stressed: “If significant parts would drop out, you cannot run the project anymore.”

Rare diseases benefit from international projects, he added. In these fields, “We don’t have the patient numbers, we don’t have the critical mass,” in one country alone, he said. In his field, researchers conduct early clinical trials in patients on both sides of the Atlantic. “That’s just not because we are crazy, but just because this the only way to physically conduct them.”

The US has spearheaded much drug development, he noted. “Obviously the US has been the powerhouse for biomedical research for the last 50 years, so it’s not surprising that some of the best people and the best groups are sitting there,” he said. A smaller US presence in the field would reduce the critical mass of people and resources available, which would be a disaster for patients, he said. “Any dreams of this all moving to Europe are illusions in my mind.”

While Europe has said it will step in to fill the gap, the amounts discussed were not enough, Gralak said. The amount of money available in Europe “is a very different order of magnitude,” Pfister said. It also won’t help their colleagues in the US, who European researchers need to thrive in order to maintain necessary collaborations, he said. “In the US, we are talking about dozens of billions of dollars less in research, and this cannot be compensated by any means, by the EU or any other funder.” Meanwhile, the French scientists’ union said the country has failed to meet funding promises made as long ago as 2010.

And although Europe receives a sliver of NIH funds, these cuts could have a real impact on public health. De Vries said that his measles treatment was at such an early stage that its potential benefits remained unproven, but if effective it could have been the only treatment of its kind at a time when cases are rising.

And he said the stalling of both his work and other research on Covid-19 leaves the world less prepared for a future pandemic. The antiviral drug he has developed had positive results in ferrets but needs further refinement to work in humans. If the drugs were available for people, “that would be great,” he said. “Then we could actually work on interrupting a pandemic early.”

New opportunities for Europe

The shift in US direction offers an opportunity for the EU, said Mike Galsworthy, a British scientist who campaigned to unite British and EU science in the wake of Brexit. The US will no longer be the default for ambitious researchers from across the world, he said: “It’s not just US scientists going to Canada and Europe. There’s also going to be the huge brain diversion.” he said. “If you are not a native English speaker and not White, you might be extra nervous about going to the States for work there right now,” he added.

And in recent weeks, European governments have courted fleeing scientists. In April, France launched a platform called Choose France for Science, which allows institutions to request funding for international researchers, and highlights an interest in health, climate science, and artificial intelligence, among other research areas Weeks later, the European Union announced a new program called Choose Europe for Science, aiming to make Europe a “magnet for researchers.” It includes a 500 million Euro (roughly USD $578 million) funding package for 2025-2027, new seven-year “super grants,” to attract the best researchers, and top-up funds that would help scientists from outside Europe settle into their new institution of choice.

The initial funding comes from money already allocated to Horizon Europe—the EU’s central research and innovation funding program. But some researchers are skeptical. The French union leader, Gralak, who is also a researcher in mathematical physics, described the programs as PR initiatives. He criticized European leaders for taking advantage of the problems in US science to attract talent to Europe, and said leaders should support science in Europe through proper and sufficient investment. The programs are “derisory and unrealistic,” he said.

“It’s not just US scientists going to Canada and Europe. There’s also going to be the huge brain diversion.”

Others agreed that Europe’s investment in science is inadequate. Bringing scientists to Europe would be “great for science and the talent, but that also means that will come from a line where there’s normally funding for European researchers,” said de Vries, the researcher from Rotterdam. As Mathilde Richard, a colleague of de Vries who works on viruses and has five active NIH grants, told Undark: “Why did I start to apply to NIH funds? And still, the most straightforward answer is that there isn’t enough in Europe.”

In the Netherlands, a rightwing government has said it will cut science funding by a billion euros over the next five years. And while the flagship program Horizon Europe encourages large-scale projects spanning multiple countries, scientists spend years putting together the major cross-country collaborations the system requires. Meanwhile, European Research Council grants are “extremely competitive and limited,” de Vries said.

Richard’s NIH grants pay for 65 percent of her salary and for 80 percent of her team, and she believes she’s the most dependent on US funds of anyone in her department at Erasmus Medical Center in Rotterdam. She applied because the NIH funding seemed more sustainable than local money, she said. In Europe, too often funding is short-term and has a time-consuming administrative burden, she said, which hinders researchers from developing long-term plans. “We have to battle so much to just do our work and find funds to just do our basic work,” she said. “I think we need to advocate for a better and more sustainable way of funding research.”

Scientists, too, are worried about what US cuts mean for global science, beyond the short-term. Paltry science funding could discourage a generation of talented people from entering the field, Pfister suggested: “In the end, the resources are not only monetary, but also the brain resources are reduced.”

Let’s not talk about it

A few months ago, Pfister attended a summit in Boston for Cancer Grand Challenges, a research initiative co-funded by the NIH’s National Cancer Institute and Cancer Research U.K. Nobody from the NIH came because they had no funding to travel. “So we are all sitting in Boston, and they are sitting like 200 miles away,” he said.

More concerning was the fact that those present seemed afraid to discuss why the NIH staff were absent, he said. “It was us Europeans to basically, kind of break the ice to, you know, at least talk about it.”

Pfister said that some European researchers are now hesitant about embarking on US collaborations, even if there is funding available. And some German scientists are taking steps to ensure that they are protected if a similar budget crackdown occurred in Germany, he said—devising independent review processes, separating research policy from funding, and developing funding models less dependent on government-only sources, he said. “I think the most scary part is that you know, this all happened in three months.”

Despite the worry and uncertainty, de Vries offered a hopeful view of the future. “We will not be defeated by NIH cuts,” he said. “I feel confident that Europe will organize itself.”

This article was originally published on Undark. Read the original article.

NIH budget cuts affect research funding beyond US borders Read More »

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SCOTUS upholds part of ACA that makes preventive care fully covered

The USPSTF is made up of 16 medical experts who carefully review scientific data and run models to assess what preventive health interventions are best, using a framework of recommendation gradings from A to F. Any recommendations graded A or B by the task force are required by the ACA to be covered by health plans at no cost to patients.

The US health department argued that the task force members are, in fact, appointed, and under control of the health secretary, a role currently filled by anti-vaccine advocate Robert F. Kennedy Jr.

Two lower courts in Texas sided with the Christian group, saying that the government violated the appointments clause.

But today, in a 6–3 ruling, the Supreme Court disagreed. Chief Justice John Roberts and Justices Amy Coney Barrett, Brett Kavanaugh, Elena Kagan, Ketanji Brown Jackson, and Sonia Sotomayor made up the majority.

Writing on their behalf, Kavanaugh explained: “Task Force members are supervised and directed by the Secretary, who in turn answers to the President, preserving the chain of command in Article II.”

While the ruling means that coverage of preventive health care is no longer under threat, the ruling clarifies that the health secretary has direct authority over the USPSTF. The clarification raises concern that the current secretary, Kennedy, could remove task force members and/or undo recommendations to suit his personal ideology, as he is now doing with the vaccine advisory board at the Centers for Disease Control and Prevention.

SCOTUS upholds part of ACA that makes preventive care fully covered Read More »