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air-quality-problems-spur-$200-million-in-funds-to-cut-pollution-at-ports

Air quality problems spur $200 million in funds to cut pollution at ports

carbon emissions, climate change, inflation reduction act, Policy, pollution, Science, syndication / /

Diesel equipment will be replaced with hydrogen- or electric-power gear.

Raquel Garcia has been fighting for years to clean up the air in her neighborhood southwest of downtown Detroit.

Living a little over a mile from the Ambassador Bridge, which thousands of freight trucks cross every day en route to the Port of Detroit, Garcia said she and her neighbors are frequently cleaning soot off their homes.

“You can literally write your name in it,” she said. “My house is completely covered.”

Her neighborhood is part of Wayne County, which is home to heavy industry, including steel plants and major car manufacturers, and suffers from some of the worst air quality in Michigan. In its 2024 State of the Air report, the American Lung Association named Wayne County one of the “worst places to live” in terms of annual exposure to fine particulate matter pollution, or PM2.5.

But Detroit, and several other Midwest cities with major shipping ports, could soon see their air quality improve as port authorities receive hundreds of millions of dollars to replace diesel equipment with cleaner technologies like solar power and electric vehicles.

Last week, the Biden administration announced $3 billion in new grants from the US Environmental Protection Agency’s Clean Ports program, which aims to slash carbon emissions and reduce air pollution at US shipping ports. More than $200 million of that funding will go to four Midwestern states that host ports along the Great Lakes: Michigan, Illinois, Ohio, and Indiana.

The money, which comes from the Inflation Reduction Act, will not only be used to replace diesel-powered equipment and vehicles, but also to install clean energy systems and charging stations, take inventory of annual port emissions, and set plans for reducing them. It will also fund a feasibility study for establishing a green hydrogen fuel hub along the Great Lakes.

The EPA estimates that those changes will, nationwide, reduce carbon pollution in the first 10 years by more than 3 million metric tons, roughly the equivalent of taking 600,000 gasoline-powered cars off the road. The agency also projects reduced emissions of nitrous oxide and PM2.5—both of which can cause serious, long-term health complications—by about 10,000 metric tons and about 180 metric tons, respectively, during that same time period.

“Our nation’s ports are critical to creating opportunity here in America, offering good-paying jobs, moving goods, and powering our economy,” EPA Administrator Michael Regan said in the agency’s press release announcing the funds. “Delivering cleaner technologies and resources to US ports will slash harmful air and climate pollution while protecting people who work in and live nearby ports communities.”

Garcia, who runs the community advocacy nonprofit Southwest Detroit Environmental Vision, said she’s “really excited” to see the Port of Detroit getting those funds, even though it’s just a small part of what’s needed to clean up the city’s air pollution.

“We care about the air,” she said. “There’s a lot of kids in the neighborhood where I live.”

Jumpstarting the transition to cleaner technology

Nationwide, port authorities in 27 states and territories tapped the Clean Ports funding, which they’ll use to buy more than 1,500 units of cargo-handling equipment, such as forklifts and cranes, 1,000 heavy-duty trucks, 10 locomotives, and 20 seafaring vessels, all of which will be powered by electricity or green hydrogen, which doesn’t emit CO2 when burned.

In the Midwest, the Illinois Environmental Protection Agency and the Cleveland-Cuyahoga County Port Authority in Ohio were awarded about $95 million each from the program, the Detroit-Wayne County Port Authority in Michigan was awarded $25 million, and the Ports of Indiana will receive $500,000.

Mark Schrupp, executive director of the Detroit-Wayne County Port Authority, said the funding for his agency will be used to help port operators at three terminals purchase new electric forklifts, cranes, and boat motors, among other zero-emission equipment. The money will also pay for a new solar array that will reduce energy consumption for port facilities, as well as 11 new electric vehicle charging stations.

“This money is helping those [port] businesses make the investment in this clean technology, which otherwise is sometimes five or six times the cost of a diesel-powered equipment,” he said, noting that the costs of clean technologies are expected to fall significantly in the coming years as manufacturers scale up production. “It also exposes them to the potential savings over time—full maintenance costs and other things that come from having the dirtier technology in place.”

Schrupp said that the new equipment will slash the Detroit-Wayne County Port Authority’s overall carbon emissions by more than 8,600 metric tons every year, roughly a 30 percent reduction.

Carly Beck, senior manager of planning, environment and information systems for the Cleveland-Cuyahoga County Port Authority, said its new equipment will reduce the Port of Cleveland’s annual carbon emissions by roughly 1,000 metric tons, or about 40 percent of the emissions tied to the port’s operations. The funding will also pay for two electric tug boats and the installation of solar panels and battery storage on the port’s largest warehouse, she added.

In 2022, Beck said, the Port of Cleveland took an emissions inventory, which found that cargo-handling equipment, building energy use, and idling ships were the port’s biggest sources of carbon emissions. Docked ships would run diesel generators for power as they unloaded, she said, but with the new infrastructure, the cargo-handling equipment and idling ships can draw power from a 2-megawatt solar power system with battery storage.

“We’re essentially creating a microgrid at the port,” she said.

Improving the air for disadvantaged communities

The Clean Ports funding will also be a boon for people like Garcia, who live near a US shipping port.

Shipping ports are notorious for their diesel pollution, which research has shown disproportionately affects poor communities of color. And most, if not all, of the census tracts surrounding the Midwest ports are deemed “disadvantaged communities” by the federal government. The EPA uses a number of factors, including income level and exposure to environmental harms, to determine whether a community is “disadvantaged.”

About 10,000 trucks pass through the Port of Detroit every day, Schrupp said, which helps to explain why residents of Southwest Detroit and the neighboring cities of Ecorse and River Rouge, which sit adjacent to Detroit ports, breathe the state’s dirtiest air.

“We have about 50,000 residents within a few miles of the port, so those communities will definitely benefit,” he said. “This is a very industrialized area.”

Burning diesel or any other fossil fuel produces nitrous oxide or PM2.5, and research has shown that prolonged exposure to high levels of those pollutants can lead to serious health complications, including lung disease and premature death. The Detroit-Wayne County Port Authority estimates that the new port equipment will cut nearly 9 metric tons of PM2.5 emissions and about 120 metric tons of nitrous oxide emissions each year.

Garcia said she’s also excited that some of the Detroit grants will be used to establish workforce training programs, which will show people how to use the new technologies and showcase career opportunities at the ports. Her area is gentrifying quickly, Garcia said, so it’s heartening to see the city and port authority taking steps to provide local employment opportunities.

Beck said that the Port of Cleveland is also surrounded by a lot of heavy industry and that the census tracts directly adjacent to the port are all deemed “disadvantaged” by federal standards.

“We’re trying to be good neighbors and play our part,” she said, “to make it a more pleasant environment.”

Kristoffer Tigue is a staff writer for Inside Climate News, covering climate issues in the Midwest. He previously wrote the twice-weekly newsletter Today’s Climate and helped lead ICN’s national coverage on environmental justice. His work has been published in Reuters, Scientific American, Mother Jones, HuffPost, and many more. Tigue holds a master’s degree in journalism from the Missouri School of Journalism.

This story originally appeared on Inside Climate News.

Photo of Inside Climate News

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tsmc-will-stop-making-7-nm-chips-for-chinese-customers

TSMC will stop making 7 nm chips for Chinese customers

china, lithography, Policy, syndication, Taiwan, Tech, TSMC / /

The company is understood to be particularly wary of being targeted as unreliable or uncooperative as Donald Trump is set to become the next US president.

This year, Trump accused Taiwan of “stealing” the US chip industry, and suggested TSMC could move its production back home after pocketing billions of dollars in subsidies from Washington for building fabrication plants in the US.

A person close to TSMC said its move was “not a show for Trump but definitely designed to underscore that we are the good guys and not acting against US interests.”

Being cut off from TSMC could hurt Chinese tech giants that have bet on making their most advanced AI chips in Taiwan. Search giant Baidu, in particular, is aiming to build a full stack of software and hardware to underpin its AI business.

Near the center of those efforts is its Kunlun series of AI chips. Its Kunlun II processor is made by TSMC on its 7-nanometer level of miniaturization, according to Bernstein Research.

“Kunlun chips are now especially well-suited for large model inference and will eventually be suitable for training,” Baidu founder Robin Li told a conference last year. Li added that the group had been effective in cutting costs by designing its own chips.

The people briefed on the situation said TSMC’s new rules were clear in targeting AI processors, but it was so far unclear how widely that would be applied to other chips. China has a number of leading start-ups designing AI chips for self-driving, including Hong Kong-listed Horizon Robotics and Black Sesame International Holding.

Executives and company materials at both groups have indicated their newest generation of chips would be made by TSMC on the 7-nanometer node.

The people close to TSMC said its new restrictions would not have a major impact on its revenue. TSMC’s October revenue increased 29.2 percent to NT$314 billion ($9.8 billion), a slight deceleration of growth compared with preceding months.

In a statement, TSMC said it was a “law-abiding company and we are committed to complying with all applicable rules and regulations, including applicable export controls.”

The news was first reported by Chinese media site ijiwei.com.

Nian Liu contributed reporting from Beijing.

© 2024 The Financial Times Ltd. All rights reserved. Not to be redistributed, copied, or modified in any way.

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Here are 3 science-backed strategies to rein in election anxiety

2024 election, anxieities, anxiety, health, Mental Health, Security, syndication / /

In this scenario, I encourage my patients to move past that initial thought of how awful it will be and instead consider exactly how they will respond to the inauguration, the next day, week, month, and so on.

Cognitive flexibility allows you to explore how you will cope, even in the face of a negative outcome, helping you feel a bit less out of control. If you’re experiencing a lot of anxiety about the election, try thinking through what you’d do if the undesirable candidate takes office—thoughts like “I’ll donate to causes that are important to me” and “I’ll attend protests.”

Choose your actions with intention

Another tool for managing your anxiety is to consider whether your behaviors are affecting how you feel.

Remember, for instance, the goal of 24-hour news networks is to increase ratings. It’s in their interest to keep you riveted to your screens by making it seem like important announcements are imminent. As a result, it may feel difficult to disconnect and take part in your usual self-care behavior.

Try telling yourself, “If something happens, someone will text me,” and go for a walk or, better yet, to bed. Keeping up with healthy habits can help reduce your vulnerability to uncontrolled anxiety.

Post-Election Day, you may continue to feel drawn to the news and motivated to show up—whether that means donating, volunteering, or protesting—for a variety of causes you think will be affected by the election results. Many people describe feeling guilty if they say no or disengage, leading them to overcommit and wind up overwhelmed.

If this sounds like you, try reminding yourself that taking a break from politics to cook, engage with your family or friends, get some work done, or go to the gym does not mean you don’t care. In fact, keeping up with the activities that fuel you will give you the energy to contribute to important causes more meaningfully.The Conversation

Shannon Sauer-Zavala, Associate Professor of Psychology & Licensed Clinical Psychologist, University of Kentucky. This article is republished from The Conversation under a Creative Commons license. Read the original article.

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US Space Force warns of “mind-boggling” build-up of Chinese capabilities

china, Space, syndication, US Space Force / /

Both Russia and China have tested satellites with capabilities that include grappling hooks to pull other satellites out of orbit and “kinetic kill vehicles” that can target satellites and long-range ballistic missiles in space.

In May, a senior US defense department official told a House Armed Services Committee hearing that Russia was developing an “indiscriminate” nuclear weapon designed to be sent into space, while in September, China made a third secretive test of an unmanned space plane that could be used to disrupt satellites.

The US is far ahead of its European allies in developing military space capabilities, but it wanted to “lay the foundations” for the continent’s space forces, Saltzman said. Last year UK Air Marshal Paul Godfrey was appointed to oversee allied partnerships with NATO with the US Space Force—one of the first times that a high-ranking allied pilot had joined the US military.

But Saltzman warned against a rush to build up space forces across the continent.

“It is resource-intensive to separate out and stand up a new service. Even … in America where we think we have more resources, we underestimated what it was going to take,” he said.

The US Space Force, which monitors more than 46,000 objects in orbit, has about 10,000 personnel but is the smallest department of the US military. Its officers are known as “guardians.”

The costs of building up space defense capabilities mean the US is heavily reliant on private companies, raising concerns about the power of billionaires in a sector where regulation remains minimal.

SpaceX, led by prominent Trump backer Elon Musk, is increasingly working with US military and intelligence through its Starshield arm, which is developing low Earth orbit satellites that track missiles and support intelligence gathering.

This month, SpaceX was awarded a $734 million contract to provide space launch services for US defense and intelligence agencies.

Despite concerns about Musk’s erratic behavior and reports that the billionaire has had regular contact with Russian President Vladimir Putin, Saltzman said he had no concerns about US government collaboration with SpaceX.

“I’m very comfortable that they’ll execute those [contracts] exactly the way they’re designed. All of the dealings I’ve had with SpaceX have been very professional,” he said.

Additional reporting by Kathrin Hille in Taipei.

© 2024 The Financial Times Ltd. All rights reserved. Not to be redistributed, copied, or modified in any way.

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a-new-dental-scam-is-to-pull-healthy-teeth-to-sell-you-expensive-fake-ones

A new dental scam is to pull healthy teeth to sell you expensive fake ones

dentistry, health, healthcare, implants, syndication / /

It turns out you may not have needed those implants after all.

Becky Carroll was missing a few teeth, others were stained or crooked. Ashamed, she smiled with lips pressed closed. Her dentist offered to fix most of her teeth with root canals and crowns, Carroll said, but she was wary of traveling a long road of dental work.

Then Carroll saw a TV commercial for another path: ClearChoice Dental Implant Centers. The company advertises that it can give patients “a new smile in as little as one day” by surgically replacing teeth instead of fixing them.

So Carroll saved and borrowed for the surgery, she said. In an interview and a lawsuit, Carroll said that at a ClearChoice clinic in New Jersey in 2021, she agreed to pay $31,000 to replace all her natural upper teeth with pearly white prosthetic ones. What came next, Carroll said, was “like a horror movie.”

Carroll alleged that her anesthesia wore off during implant surgery, so she became conscious as her teeth were removed and titanium screws were twisted into her jawbone. Afterward, Carroll’s prosthetic teeth were so misaligned that she was largely unable to chew for more than two years until she could afford corrective surgery at another clinic, according to a sworn deposition from her lawsuit.

ClearChoice has denied Carroll’s claims of malpractice and negligence in court filings and did not respond to requests for comment on the ongoing case.

“I thought implants would be easier, and all at once, so you didn’t have to keep going back to the dentist,” Carroll, 52, said in an interview. “But I should have asked more questions … like, Can they save these teeth?”

Dental implants have been used for more than half a century to surgically replace missing or damaged teeth with artificial duplicates, often with picture-perfect results. While implant dentistry was once the domain of a small group of highly trained dentists and specialists, tens of thousands of dental providers now offer the surgery and place millions of implants each year in the US.

Amid this booming industry, some implant experts worry that many dentists are losing sight of dentistry’s fundamental goal of preserving natural teeth and have become too willing to remove teeth to make room for expensive implants, according to a months-long investigation by KFF Health News and CBS News. In interviews, 10 experts said they had each given second opinions to multiple patients who had been recommended for mouths full of implants that the experts ultimately determined were not necessary. Separately, lawsuits filed across the country have alleged that implant patients like Carroll have experienced painful complications that have required corrective surgery, while other lawsuits alleged dentists at some implant clinics have persuaded, pressured, or forced patients to remove teeth unnecessarily.

The experts warn that implants, for a single tooth or an entire mouth, expose patients to costs and surgery complications, plus a new risk of future dental problems with fewer treatment options because their natural teeth are forever gone.

“There are many cases where teeth, they’re perfectly fine, and they’re being removed unnecessarily,” said William Giannobile, dean of the Harvard School of Dental Medicine. “I really hate to say it, but many of them are doing it because these procedures, from a monetary standpoint, they’re much more beneficial to the practitioner.”

Giannobile and nine other experts say they are combating a false public perception that implants are more durable and longer-lasting than natural teeth, which some believe stems in part from advertising on TV and social media. Implants require upkeep, and although they can’t get cavities, studies have shown that patients can be susceptible to infections in the gums and bone around their implants.

“Just because somebody can afford implants doesn’t necessarily mean that they’re a good candidate,” said George Mandelaris, a Chicago-area periodontist and member of the American Academy of Periodontology Board of Trustees. “When an implant has infection, or when an implant has bone loss, an implant dies a much quicker death than do teeth.”

In its simplest form, implant surgery involves extracting a single tooth and replacing it with a metal post that is screwed into the jaw and then affixed with a prosthetic tooth commonly made of porcelain, also known as a crown. Patients can also use “full-arch” or “All-on-4” implants to replace all their upper or lower teeth—or all their teeth.

For this story, KFF Health News and CBS News sought interviews with large dental chains whose clinics offer implant surgery—ClearChoice, Aspen Dental, Affordable Care, and Dental Care Alliance—each of which declined to be interviewed or did not respond to multiple requests for comment. The Association of Dental Support Organizations, which represents these companies and others like them, also declined an interview request.

ClearChoice, which specializes in full-arch implants, did not answer more than two dozen questions submitted in writing. In an emailed statement, the company said full-arch implants “have become a well-accepted standard of care for patients with severe tooth loss and teeth with poor prognosis.”

“The use of full-arch restorations reflects the evolution of modern dentistry, offering patients a solution that restores their ability to eat, speak, and live comfortably—far beyond what traditional dentures can provide,” the company said.

Carroll said she regrets not letting her dentist try to fix her teeth and rushing to ClearChoice for implants.

“Because it was a nightmare,” she said.

“They are not teeth”

Dental implant surgery can be a godsend for patients with unsalvageable teeth. Several experts said implants can be so transformative that their invention should have contended for a Nobel Prize. And yet, these experts still worry that implants are overused, because it is generally better for patients to have their natural teeth.

Paul Rosen, a Pennsylvania periodontist who said he has worked with implants for more than three decades, said many patients believe a “fallacy” that implants are “bulletproof.”

“You can’t just have an implant placed and go off riding into the sunset,” Rosen said. “In many instances, they need more care than teeth because they are not teeth.”

Generally, a single implant costs a few thousand dollars while full-arch implants cost tens of thousands. Neither procedure is well covered by dental insurance, so many clinics partner with credit companies that offer loans for implant surgeries. At ClearChoice, for example, loans can be as large as $65,000 paid off over 10 years, according to the company’s website.

Despite the price, implants are more popular than ever. Sales increased by more than 6 percent on average each year since 2010, culminating in more than 3.7 million implants sold in the US in 2022, according to a 2023 report produced by iData Research, a health care market research firm.

Some worry implant dentistry has gone too far. In 10 interviews, dentists and dental specialists with expertise in implants said they had witnessed the overuse of implants firsthand. Each expert said they’d examined multiple patients in recent years who were recommended for full-arch implants by other dentists despite their teeth being treatable with conventional dentistry.

Giannobile, the Harvard dean, said he had given second opinions to “dozens” of patients who were recommended for implants they did not need.

“I see many of these patients now that are coming in and saying, ‘I’ve been seen, and they are telling me to get my entire dentition—all of my teeth—extracted.’ And then I’ll take a look at them and say that we can preserve most of your teeth,” Giannobile said.

Tim Kosinski, who is a representative of the Academy of General Dentistry and said he has placed more than 19,000 implants, said he examines as many as five patients a month who have been recommended for full-arch implants that he deems unnecessary.

“There is a push in the profession to remove teeth that could be saved,” Kosinski said. “But the public isn’t aware.”

Luiz Gonzaga, a periodontist and prosthodontist at the University of Florida, said he, too, had turned away patients who wanted most or all their teeth extracted. Gonzaga said some had received implant recommendations that he considered “an atrocity.”

“You don’t go to the hospital and tell them ‘I broke my finger a couple of times. This is bothering me. Can you please cut my finger off?’ No one will do that,” Gonzaga said. “Why would I extract your tooth because you need a root canal?”

Jaime Lozada, director of an elite dental implant residency program at Loma Linda University, said he’d not only witnessed an increase in dentists extracting “perfectly healthy teeth” but also treated a rash of patients with mouths full of ill-fitting implants that had to be surgically replaced.

Lozada said in August that he’d treated seven such patients in just three months.

“When individuals just make a decision of extracting teeth to make it simple and make money quick, so to speak, that’s where I have a problem,” Lozada said. “And it happens quite often.”

When full-arch implants fail, patients sometimes don’t have enough jawbone left to anchor another set. These patients have little choice but to get implants that reach into cheekbones, said Sohail Saghezchi, an oral and maxillofacial surgeon at the University of California-San Francisco.

“It’s kind of like a last resort,” Saghezchi said. “If those fail, you don’t have anywhere else to go.”

“It was horrendous dentistry”

Most of the experts interviewed for this article said their rising alarm corresponded with big changes in the availability of dental implants. Implants are now offered by more than 70,000 dental providers nationwide, two-thirds of whom are general dentists, according to the iData Research report.

Dentists are not required to learn how to place implants in dental school, nor are they required to complete implant training before performing the surgery in nearly all states. This year, Oregon started requiring dentists to complete 56 hours of hands-on training before placing any implants. Stephen Prisby, executive director of the Oregon Board of Dentistry, said the requirement—the first and only of its kind in the US—was a response to dozens of investigations in the state into botched surgeries and other implant failures, split evenly between general dentists and specialists.

“I was frankly stunned at how bad some of these dentists were practicing,” Prisby said. “It was horrendous dentistry.”

Many dental clinics that offer implants have consolidated into chains owned by private equity firms that have bought out much of implant dentistry. In health care, private equity investment is sometimes criticized for overtreatment and prioritizing short-term profit over patients.

Private equity firms have spent about $5 billion in recent years to buy large dental chains that offer implants at hundreds of clinics owned by individual dentists and dental specialists. ClearChoice was bought for an estimated $1.1 billion in 2020 by Aspen Dental, which is owned by three private equity firms, according to PitchBook, a research firm focused on the private equity industry. Private equity firms also bought Affordable Care, whose largest clinic brand is Affordable Dentures & Implants, for an estimated $2.7 billion in 2021, according to PitchBook. And the private equity wing of the Abu Dhabi government bought Dental Care Alliance, which offers implants at many of its affiliated clinics, for an estimated $1 billion in 2022, according to PitchBook.

ClearChoice and Aspen Dental each said in email statements that the companies’ private equity owners “do not have influence or control over treatment recommendations.” Both companies said dentists or dental specialists make all clinical decisions.

Private equity deals involving dental practices increased ninefold from 2011 to 2021, according to an American Dental Association study published in August. The study also said investors showed an interest in oral surgery, possibly because of the “high prices” of implants.

“Some argue this is a negative thing,” said Marko Vujicic, vice president of the association’s Health Policy Institute, who co-authored the study. “On the other hand, some would argue that involvement of private equity and outside capital brings economies of scale, it brings efficiency.”

Edwin Zinman, a San Francisco dental malpractice attorney and former periodontist who has filed hundreds of dental lawsuits over four decades, said he believed many of the worst fears about private equity owners had already come true in implant dentistry.

“They’ve sold a lot of [implants], and some of it unnecessarily, and too often done negligently, without having the dentists who are doing it have the necessary training and experience,” Zinman said. “It’s for five simple letters: M-O-N-E-Y.”

Hundreds of implant clinics with no specialists

For this article, journalists from KFF Health News and CBS News analyzed the webpages for more than 1,000 clinics in the nation’s largest private equity-owned dental chains, all of which offer some implants. The analysis found that more than 70 percent of those clinics listed only general dentists on their websites and did not appear to employ the specialists—oral surgeons, periodontists, or prosthodontists—who traditionally have more training with implants.

Affordable Dentures & Implants listed specialists at fewer than 5 percent of its more than 400 clinics, according to the analysis. The rest were staffed by general dentists, most of whom did not list credentialing from implant training organizations, according to the analysis.

ClearChoice, on the other hand, employs at least one oral surgeon or prosthodontist at each of its more than 100 centers, according to the analysis. But its new parent company, Aspen Dental, which offers implants in many of its more than 1,100 clinics, does not list any specialists at many of those locations.

Not everyone is worried about private equity in implant dentistry. In interviews arranged by the American Academy of Implant Dentistry, which trains dentists to use implants, two other implant experts did not express concerns about private equity firms.

Brian Jackson, a former academy president and implant specialist in New York, said he believed dentists are too ethical and patients are too smart to be pressured by private equity owners “who will never see a patient.”

Jumoke Adedoyin, a chief clinical officer for Affordable Care, who has placed implants at an Affordable Dentures & Implants clinic in the Atlanta suburbs for 15 years, said she had never felt pressure from above to sell implants.

“I’ve actually felt more pressure sometimes from patients who have gone around and been told they need to take their teeth out,” she said. “They come in and, honestly, taking a look at them, maybe they don’t need to take all their teeth out.”

Still, lawsuits filed across the country have alleged that dentists at implant clinics have extracted patients’ teeth unnecessarily.

For example, in Texas, a patient alleged in a 2020 lawsuit that an Affordable Care dentist removed “every single tooth from her mouth when such was not necessary,” then stuffed her mouth with gauze and left her waiting in the lobby as he and his staff left for lunch. In Maryland, a patient alleged in a 2021 lawsuit that ClearChoice “convinced” her to extract “eight healthy upper teeth,” by “greatly downplay[ing] the risks.” In Florida, a patient alleged in a 2023 lawsuit that ClearChoice provided her with no other treatment options before extracting all her teeth, “which was totally unnecessary.”

ClearChoice and Affordable Care denied wrongdoing in their respective lawsuits, then privately settled out of court with each patient. ClearChoice and Affordable Care did not respond to requests for comment submitted to the companies or attorneys. Lawyers for all three plaintiffs declined to comment on these lawsuits or did not respond to requests for comment.

Fred Goldberg, a Maryland dental malpractice attorney who said he has represented at least six clients who sued ClearChoice, said each of his clients agreed to get implants after meeting with a salesperson—not a dentist.

“Every client I’ve had who has gone to ClearChoice has started off meeting a salesperson and actually signing up to get their financing through ClearChoice before they ever meet with a dentist,” Goldberg said. “You meet with a salesperson who sells you on what they like to present as the best choice, which is almost always that they’re going to take out all your natural teeth.”

Becky Carroll, the ClearChoice patient from New Jersey, told a similar story.

Carroll said in her lawsuit that she met first with a ClearChoice salesperson referred to as a “patient education consultant.” In an interview, Carroll said the salesperson encouraged her to borrow money from family members for the surgery and it was not until after she agreed to a loan and passed a credit check that a ClearChoice dentist peered into her mouth.

“It seems way backwards,” Carroll said. “They just want to know you’re approved before you get to talk to a dentist.”

CBS News producer Nicole Keller contributed to this report.

This story originally appeared on KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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A candy engineer explains the science behind the Snickers bar

Biology, candy, Food science, health, Science, syndication / /

It’s Halloween. You’ve just finished trick-or-treating and it’s time to assess the haul. You likely have a favorite, whether it’s chocolate bars, peanut butter cups, those gummy clusters with Nerds on them, or something else.

For some people, including me, one piece stands out—the Snickers bar, especially if it’s full-size. The combination of nougat, caramel, and peanuts coated in milk chocolate makes Snickers a popular candy treat.

As a food engineer studying candy and ice cream at the University of Wisconsin-Madison, I now look at candy in a whole different way than I did as a kid. Back then, it was all about shoveling it in as fast as I could.

Now, as a scientist who has made a career studying and writing books about confections, I have a very different take on candy. I have no trouble sacrificing a piece for the microscope or the texture analyzer to better understand how all the components add up. I don’t work for, own stock in, or receive funding from Mars Wrigley, the company that makes Snickers bars. But in my work, I do study the different components that make up lots of popular candy bars. Snickers has many of the most common elements you’ll find in your Halloween candy.

Let’s look at the elements of a Snickers bar as an example of candy science. As with almost everything, once you get into it, each component is more complex than you might think.

Snickers bars contain a layer of nougat, a layer of caramel mixed with peanuts, and a chocolate coating.

Credit: istarif/iStock via Getty Images

Snickers bars contain a layer of nougat, a layer of caramel mixed with peanuts, and a chocolate coating. Credit: istarif/iStock via Getty Images

Airy nougat

Let’s start with the nougat. The nougat in a Snickers bar is a slightly aerated candy with small sugar crystals distributed throughout.

One of the ingredients in the nougat is egg white, a protein that helps stabilize the air bubbles that provide a light texture. Often, nougats like this are made by whipping sugar and egg whites together. The egg whites coat the air bubbles created during whipping, which gives the nougat its aerated texture.

A boiled sugar syrup is then slowly mixed into the egg white sugar mixture, after which a melted fat is added. Since fat can cause air bubbles to collapse, this step has to be done last and very carefully.

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Are Boeing’s problems beyond fixable?

aviation, Boeing, Boeing 737 MAX, Policy, syndication / /

A new CEO promises a culture change as the aerospace titan is struggling hard.

A Boeing logo on the exterior of the company's headquarters.

Credit: Getty Images | Olivier Douliery

As Boeing’s latest chief executive, Kelly Ortberg’s job was never going to be easy. On Wednesday, it got harder still.

That morning, Ortberg had faced investors for the first time, telling them that ending a debilitating strike by Boeing’s largest union was the first step to stabilizing the plane maker’s business.

But as the day wore on, it became clear that nearly two-thirds of the union members who voted on the company’s latest contract offer had rejected it. The six-week strike goes on, costing Boeing an estimated $50 million a day, pushing back the day it can resume production of most aircraft and further stressing its supply chain.

The company that virtually created modern commercial aviation has spent the better part of five years in chaos, stemming from fatal crashes, a worldwide grounding, a guilty plea to a criminal charge, a pandemic that halted global air travel, a piece breaking off a plane in mid-flight and now a strike. Boeing’s finances look increasingly fragile and its reputation has been battered.

Bank of America analyst Ron Epstein says Boeing is a titan in a crisis largely of its own making, comparing it to the Hydra of Greek mythology: “For every problem that’s come to a head, then [been] severed, more problems sprout up.”

Resolving Boeing’s crisis is critical to the future of commercial air travel, as most commercial passenger aircraft are made by it or its European rival Airbus, which has little capacity for new customers until the 2030s.

Ortberg, a 64-year-old Midwesterner who took the top job three months ago, says his mission is “pretty straightforward—turn this big ship in the right direction and restore Boeing to the leadership position that we all know and want.”

Resolving the machinists’ strike is just the start of the challenges he faces. He needs to motivate the workforce, even as 33,000 are on strike and 17,000 face redundancy under a cost-cutting initiative.

He must persuade investors to support an equity raise in an industry where the returns could take years to materialize. He needs to fix Boeing’s quality control and manufacturing issues, and placate its increasingly frustrated customers, who have had to rejig their schedules and cut flights owing to delays in plane deliveries.

“I’ve never seen anything like it in our industry, to be honest. I’ve been around 30 years,” Carsten Spohr, chief executive of German flag carrier Lufthansa, said this month.

Eventually, Boeing needs to launch a new aircraft model to better compete with Airbus.

“If Kelly fixes this, he is a hero,” says Melius Research analyst Rob Spingarn. “But it’s very complex. There’s a lot of different things to fix.”

Ortberg started his career as a mechanical engineer and went on to run Rockwell Collins, an avionics supplier to Boeing, until it was sold to engineering conglomerate United Technologies in 2018.

His engineering background has been welcomed by many who regard previous executives’ emphasis on shareholder returns as the root cause of many of Boeing’s engineering and manufacturing problems.

Longtime employees often peg the shift in Boeing’s culture to its 1997 merger with rival McDonnell Douglas. Phil Condit and Harry Stonecipher, who ran Boeing in the late 1990s and early 2000s, were admirers of Jack Welch, the General Electric chief executive known for financial engineering and ruthless cost cuts.

Condit even moved Boeing’s headquarters from its manufacturing base in Seattle to Chicago in 2001, so the “corporate center” would no longer be “drawn into day-to-day business operations.”

Jim McNerney, another Welch acolyte, instituted a program to boost Boeing’s profits by squeezing its suppliers during his decade in charge. He remarked on a 2014 earnings call about employees “cowering” before him, a dark quip still cited a decade later to explain Boeing’s tense relationship with its workers.

Ken Ogren, a member of the International Association of Machinists and Aerospace Workers District 751, says managers at Boeing often felt pressured to move planes quickly through the factory.

“We’ve had a lot of bean counters come through, and I’m going to be in the majority with a lot of people who believe they’ve been tripping over dollars to save pennies,” he says.

Dennis Muilenburg headed the company in October 2018, when a new 737 Max crashed off the coast of Indonesia. Five months later, another Max crashed shortly after take-off in Ethiopia. In total, 346 people lost their lives.

Regulators worldwide grounded the plane—a cash cow and a vital product in Boeing’s competition with Airbus—for nearly two years. Investigations eventually showed a faulty sensor triggered an anti-stall system, repeatedly forcing the aircraft’s nose downward.

Boeing agreed in July to plead guilty to a criminal charge of fraud for misleading regulators about the plane’s design. Families of the crash victims are opposing the plea deal, which is before a federal judge for approval.

The manufacturer’s problems were compounded by COVID-19, which grounded aircraft worldwide and led many airlines to hold off placing new orders and pause deliveries of existing ones. Boeing’s debt ballooned as it issued $25 billion in bonds to see it through the crisis.

Regulators cleared the 737 Max to fly again, starting in November 2020. But hopes that Boeing was finally on top of its problems were shattered last January, when a door panel that was missing bolts blew off an Alaska Airlines jet at 16,000 feet.

While no one was injured, the incident triggered multiple investigations and an audit by the US Federal Aviation Administration, which found lapses in Boeing’s manufacturing and quality assurance processes and led to an uncomfortable appearance by then chief executive Dave Calhoun at a Senate subcommittee hearing.

The company also has struggled with its defense and space businesses. Fixed-price contracts on several military programs have resulted in losses and billions of dollars of one-off charges. Meanwhile, problems with its CST-100 Starliner spacecraft resulted in two astronauts being left on the International Space Station. SpaceX’s Crew Dragon vehicle will be used to return them to Earth early next year.

Boeing’s stumbles have resulted in loss of life, loss of prestige, and a net financial loss every year since 2019. On Wednesday, it reported a $6 billion loss between July and September, the second-worst quarterly result in its history.

One of Ortberg’s first big moves as chief executive was to move himself—from his Florida home to a house in Seattle. He told analysts that Boeing’s executives “need to be on the factory floors, in the back shops, and in our engineering labs” to be more in tune with the company’s products and workforce. Change in Boeing’s corporate culture must “be more than the poster on the wall,” he added.

His approach represents a shift from his predecessor Calhoun, who was criticized for spending more time in New Hampshire and South Carolina than in Boeing’s factories in Washington state.

Bill George, former chief executive at Medtronic and an executive fellow at Harvard Business School, says Ortberg is doing a “terrific job” so far, particularly for moving to the Pacific Northwest and pressuring other itinerant executives to follow.

“If you’re based in Florida, and you come occasionally, what do you really know about what’s going on in the business?” he says, adding that Boeing has “no business being in Arlington, Virginia,” where the company moved its headquarters in 2022.

Scott Kirby, chief executive at one of Boeing’s biggest customers, United Airlines, told his own investors this month that he was “encouraged” by Ortberg’s early moves, adding that the company suffered for decades from “a cultural challenge, where they focused on short-term profitability and the short-term stock price at the expense of what made Boeing great, which is building great products.”

“Kelly Ortberg is pivoting the company back to their roots,” he said. “All the employees of Boeing will rally around that.”

But Ogren of the machinists’ union cautions that previous commitments to culture change have been hollow. “You’ve got people at the top saying, ‘We’ve got to be safe, oh, and by the way, we need these planes out the door…’ They said the right thing. They didn’t emphasize it, and that’s not what they put pressure on the managers to achieve.”

When workers eventually return to work—Peter Arment, an analyst at Baird, expects the dispute to be resolved in November—Ortberg wants better execution, even if it means lower output. “It is so much more important we do this right than fast,” he said.

The company had planned to raise Max output from about 25 per month before the strike to 38 per month by the end of the year, a cap set by the FAA. It will not reach that goal and Spingarn, the Melius analyst, says the strike will probably delay any production increase by nine months to a year. Some workers would need retraining, Ortberg said, and the supply chain’s restart was likely to be “bumpy.” The manufacturer also has established a quality plan with the FAA that it must follow.

Boeing also needed to launch a new airplane “at the right time in the future,” Ortberg said. Epstein of BofA called this “one of the most important messages” from the new chief executive, likely “to reinvigorate the workforce and culture at Boeing.”

In the meantime, Boeing will continue to consume cash in 2025, having burnt through $10 billion so far this year, according to chief financial officer Brian West. Spingarn says that investors may be disappointed in the cash flow at first, but adds that “fixing airplanes isn’t one year, it’s three years.”

For all the challenges, Ortberg has the right personality to turn Boeing around, says Ken Herbert, an analyst at RBC Capital Markets.

“If he can’t do it, I don’t think anyone can.”

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40 years later, The Terminator still shapes our view of AI

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Countries, including the US, specify the need for human operators to “exercise appropriate levels of human judgment over the use of force” when operating autonomous weapon systems. In some instances, operators can visually verify targets before authorizing strikes and can “wave off” attacks if situations change.

AI is already being used to support military targeting. According to some, it’s even a responsible use of the technology since it could reduce collateral damage. This idea evokes Schwarzenegger’s role reversal as the benevolent “machine guardian” in the original film’s sequel, Terminator 2: Judgment Day.

However, AI could also undermine the role human drone operators play in challenging recommendations by machines. Some researchers think that humans have a tendency to trust whatever computers say.

“Loitering munitions”

Militaries engaged in conflicts are increasingly making use of small, cheap aerial drones that can detect and crash into targets. These “loitering munitions” (so named because they are designed to hover over a battlefield) feature varying degrees of autonomy.

As I’ve argued in research co-authored with security researcher Ingvild Bode, the dynamics of the Ukraine war and other recent conflicts in which these munitions have been widely used raises concerns about the quality of control exerted by human operators.

Ground-based military robots armed with weapons and designed for use on the battlefield might call to mind the relentless Terminators, and weaponized aerial drones may, in time, come to resemble the franchise’s airborne “hunter-killers.” But these technologies don’t hate us as Skynet does, and neither are they “super-intelligent.”

However, it’s crucially important that human operators continue to exercise agency and meaningful control over machine systems.

Arguably, The Terminator’s greatest legacy has been to distort how we collectively think and speak about AI. This matters now more than ever, because of how central these technologies have become to the strategic competition for global power and influence between the US, China, and Russia.

The entire international community, from superpowers such as China and the US to smaller countries, needs to find the political will to cooperate—and to manage the ethical and legal challenges posed by the military applications of AI during this time of geopolitical upheaval. How nations navigate these challenges will determine whether we can avoid the dystopian future so vividly imagined in The Terminator—even if we don’t see time-traveling cyborgs any time soon.The Conversation

Tom F.A Watts, Postdoctoral Fellow, Department of Politics, International Relations, and Philosophy, Royal Holloway University of London. This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Google, Microsoft, and Perplexity promote scientific racism in AI search results

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AI-powered search engines are surfacing deeply racist, debunked research.

Literal Nazis

LOS ANGELES, CA – APRIL 17: Members of the National Socialist Movement (NSM) salute during a rally on near City Hall on April 17, 2010 in Los Angeles, California. Credit: David McNew via Getty

AI-infused search engines from Google, Microsoft, and Perplexity have been surfacing deeply racist and widely debunked research promoting race science and the idea that white people are genetically superior to nonwhite people.

Patrik Hermansson, a researcher with UK-based anti-racism group Hope Not Hate, was in the middle of a monthslong investigation into the resurgent race science movement when he needed to find out more information about a debunked dataset that claims IQ scores can be used to prove the superiority of the white race.

He was investigating the Human Diversity Foundation, a race science company funded by Andrew Conru, the US tech billionaire who founded Adult Friend Finder. The group, founded in 2022, was the successor to the Pioneer Fund, a group founded by US Nazi sympathizers in 1937 with the aim of promoting “race betterment” and “race realism.”

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Hermansson logged in to Google and began looking up results for the IQs of different nations. When he typed in “Pakistan IQ,” rather than getting a typical list of links, Hermansson was presented with Google’s AI-powered Overviews tool, which, confusingly to him, was on by default. It gave him a definitive answer of 80.

When he typed in “Sierra Leone IQ,” Google’s AI tool was even more specific: 45.07. The result for “Kenya IQ” was equally exact: 75.2.

Hermansson immediately recognized the numbers being fed back to him. They were being taken directly from the very study he was trying to debunk, published by one of the leaders of the movement that he was working to expose.

The results Google was serving up came from a dataset published by Richard Lynn, a University of Ulster professor who died in 2023 and was president of the Pioneer Fund for two decades.

“His influence was massive. He was the superstar and the guiding light of that movement up until his death. Almost to the very end of his life, he was a core leader of it,” Hermansson says.

A WIRED investigation confirmed Hermanssons’s findings and discovered that other AI-infused search engines—Microsoft’s Copilot and Perplexity—are also referencing Lynn’s work when queried about IQ scores in various countries. While Lynn’s flawed research has long been used by far-right extremists, white supremacists, and proponents of eugenics as evidence that the white race is superior genetically and intellectually from nonwhite races, experts now worry that its promotion through AI could help radicalize others.

“Unquestioning use of these ‘statistics’ is deeply problematic,” Rebecca Sear, director of the Center for Culture and Evolution at Brunel University London, tells WIRED. “Use of these data therefore not only spreads disinformation but also helps the political project of scientific racism—the misuse of science to promote the idea that racial hierarchies and inequalities are natural and inevitable.”

To back up her claim, Sear pointed out that Lynn’s research was cited by the white supremacist who committed the mass shooting in Buffalo, New York, in 2022.

Google’s AI Overviews were launched earlier this year as part of the company’s effort to revamp its all-powerful search tool for an online world being reshaped by artificial intelligence. For some search queries, the tool, which is only available in certain countries right now, gives an AI-generated summary of its findings. The tool pulls the information from the Internet and gives users the answers to queries without needing to click on a link.

The AI Overview answer does not always immediately say where the information is coming from, but after complaints from people about how it showed no articles, Google now puts the title for one of the links to the right of the AI summary. AI Overviews have already run into a number of issues since launching in May, forcing Google to admit it had botched the heavily hyped rollout. AI Overviews is turned on by default for search results and can’t be removed without resorting to installing third-party extensions. (“I haven’t enabled it, but it was enabled,” Hermansson, the researcher, tells WIRED. “I don’t know how that happened.”)

In the case of the IQ results, Google referred to a variety of sources, including posts on X, Facebook, and a number of obscure listicle websites, including World Population Review. In nearly all of these cases, when you click through to the source, the trail leads back to Lynn’s infamous dataset. (In some cases, while the exact numbers Lynn published are referenced, the websites do not cite Lynn as the source.)

When querying Google’s Gemini AI chatbot directly using the same terms, it provided a much more nuanced response. “It’s important to approach discussions about national IQ scores with caution,” read text that the chatbot generated in response to the query “Pakistan IQ.” The text continued: “IQ tests are designed primarily for Western cultures and can be biased against individuals from different backgrounds.”

Google tells WIRED that its systems weren’t working as intended in this case and that it is looking at ways it can improve.

“We have guardrails and policies in place to protect against low quality responses, and when we find Overviews that don’t align with our policies, we quickly take action against them,” Ned Adriance, a Google spokesperson, tells WIRED. “These Overviews violated our policies and have been removed. Our goal is for AI Overviews to provide links to high quality content so that people can click through to learn more, but for some queries there may not be a lot of high quality web content available.”

While WIRED’s tests suggest AI Overviews have now been switched off for queries about national IQs, the results still amplify the incorrect figures from Lynn’s work in what’s called a “featured snippet,” which displays some of the text from a website before the link.

Google did not respond to a question about this update.

But it’s not just Google promoting these dangerous theories. When WIRED put the same query to other AI-powered online search services, we found similar results.

Perplexity, an AI search company that has been found to make things up out of thin air, responded to a query about “Pakistan IQ” by stating that “the average IQ in Pakistan has been reported to vary significantly depending on the source.”

It then lists a number of sources, including a Reddit thread that relied on Lynn’s research and the same World Population Review site that Google’s AI Overview referenced. When asked for Sierra Leone’s IQ, Perplexity directly cited Lynn’s figure: “Sierra Leone’s average IQ is reported to be 45.07, ranking it among the lowest globally.”

Perplexity did not respond to a request for comment.

Microsoft’s Copilot chatbot, which is integrated into its Bing search engine, generated confident text—“The average IQ in Pakistan is reported to be around 80”—citing a website called IQ International, which does not reference its sources. When asked for “Sierra Leone IQ,” Copilot’s response said it was 91. The source linked in the results was a website called Brainstats.com, which references Lynn’s work. Copilot also referenced Brainstats.com work when queried about IQ in Kenya.

“Copilot answers questions by distilling information from multiple web sources into a single response,” Caitlin Roulston, a Microsoft spokesperson, tells WIRED. “Copilot provides linked citations so the user can further explore and research as they would with traditional search.”

Google added that part of the problem it faces in generating AI Overviews is that, for some very specific queries, there’s an absence of high quality information on the web—and there’s little doubt that Lynn’s work is not of high quality.

“The science underlying Lynn’s database of ‘national IQs’ is of such poor quality that it is difficult to believe the database is anything but fraudulent,” Sear said. “Lynn has never described his methodology for selecting samples into the database; many nations have IQs estimated from absurdly small and unrepresentative samples.”

Sear points to Lynn’s estimation of the IQ of Angola being based on information from just 19 people and that of Eritrea being based on samples of children living in orphanages.

“The problem with it is that the data Lynn used to generate this dataset is just bullshit, and it’s bullshit in multiple dimensions,” Rutherford said, pointing out that the Somali figure in Lynn’s dataset is based on one sample of refugees aged between 8 and 18 who were tested in a Kenyan refugee camp. He adds that the Botswana score is based on a single sample of 104 Tswana-speaking high school students aged between 7 and 20 who were tested in English.

Critics of the use of national IQ tests to promote the idea of racial superiority point out not only that the quality of the samples being collected is weak, but also that the tests themselves are typically designed for Western audiences, and so are biased before they are even administered.

“There is evidence that Lynn systematically biased the database by preferentially including samples with low IQs, while excluding those with higher IQs for African nations,” Sear added, a conclusion backed up by a preprint study from 2020.

Lynn published various versions of his national IQ dataset over the course of decades, the most recent of which, called “The Intelligence of Nations,” was published in 2019. Over the years, Lynn’s flawed work has been used by far-right and racist groups as evidence to back up claims of white superiority. The data has also been turned into a color-coded map of the world, showing sub-Saharan African countries with purportedly low IQ colored red compared to the Western nations, which are colored blue.

“This is a data visualization that you see all over [X, formerly known as Twitter], all over social media—and if you spend a lot of time in racist hangouts on the web, you just see this as an argument by racists who say, ‘Look at the data. Look at the map,’” Rutherford says.

But the blame, Rutherford believes, does not lie with the AI systems alone, but also with a scientific community that has been uncritically citing Lynn’s work for years.

“It’s actually not surprising [that AI systems are quoting it] because Lynn’s work in IQ has been accepted pretty unquestioningly from a huge area of academia, and if you look at the number of times his national IQ databases have been cited in academic works, it’s in the hundreds,” Rutherford said. “So the fault isn’t with AI. The fault is with academia.”

This story originally appeared on wired.com

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Studies of migraine’s many triggers offer paths to new therapies

health, migraine, migraines, Science, syndication / /

One class of drugs has already found success in treating the painful, common attacks.

Displeased African American woman holding her head in pain.

For Cherise Irons, chocolate, red wine, and aged cheeses are dangerous. So are certain sounds, perfumes and other strong scents, cold weather, and thunderstorms. Stress and lack of sleep, too.

She suspects all of these things can trigger her migraine attacks, which manifest in a variety of ways: pounding pain in the back of her head, exquisite sensitivity to the slightest sound, even blackouts and partial paralysis.

Irons, 48, of Coral Springs, Florida, once worked as a school assistant principal. Now, she’s on disability due to her migraine. Irons has tried so many migraine medications she’s lost count—but none has helped for long. Even a few of the much-touted new drugs that have quelled episodes for many people with migraine have failed for Irons.

Though not all are as impaired as Irons, migraine is a surprisingly common problem, affecting 14 percent to 15 percent of people. Yet scientists and physicians remain largely in the dark about how triggers like Irons’ lead to attacks. They have made progress nonetheless: The latest drugs, inhibitors of a body signaling molecule called CGRP, have been a blessing for many. For others, not so much. And it’s not clear why.

The complexity of migraine probably has something to do with it. “It’s a very diverse condition,” says Debbie Hay, a pharmacologist at the University of Otago in Dunedin, New Zealand. “There’s still huge debate as to what the causes are, what the consequences are.”

That’s true despite decades of research and the remarkable ability of scientists to trigger migraine attacks in the lab: Giving CGRP intravenously to people who get migraines gives some of them attacks. So do nitric oxide, a natural body molecule that relaxes blood vessels, and another signaling molecule called PACAP. In mice, too, CGRP and PACAP molecules can bring on migraine-like effects.

All these molecules act as “on” switches for migraine attacks, which suggests that there must be “off” switches out there, too, says Amynah Pradhan, a neuroscientist at Washington University in St. Louis. Scientists have been actively seeking those “off” switches; the CGRP-blocking drugs were a major win in this line of research.

Despite the insights gleaned, migraine remains a tricky disease to understand and treat. For example, the steps between the molecular action of CGRP and a person experiencing a headache or other symptoms are still murky. But scientists have lots of other ideas for new drugs that might stave off migraine attacks, or stop ongoing ones.

“It’s important to have an expanded toolbox,” says Pradhan.

Deciphering migraine mechanisms

Migraine is the second most prevalent cause of disability in the world, affecting mainly women of childbearing age. A person may have one migraine attack per year, or several per week, or even ongoing symptoms.

Complicating the picture further, there’s not just one kind of migraine attack. Migraine can cause headache; nausea; sensitivity to light, sound or smell; or a panoply of other symptoms. Some people get visual auras; some don’t. Some women have migraine attacks associated with menstruation. Some people, particularly kids, have “abdominal migraine,” characterized not so much by headaches as by nausea, stomach pain, and vomiting.

Initially, the throbbing nature of the head pain led researchers to suspect that the root problem was expansion of the blood vessels within the membranes surrounding the brain, with these vessels pulsing in time with the heartbeat. But, as it turns out, the throbbing doesn’t really match up with heart rate.

Then researchers noticed that many signs that presage migraine attack, such as light sensitivity and appetite changes, are all regulated by the brain, particularly a region called the hypothalamus. The pendulum swung toward suspicion of a within-brain origin.

Today, scientists wonder if both in-brain and beyond-brain factors, including blood vessels releasing pain-causing molecules, play a role, as may other contributors such as immune cells.

What all these proposed mechanisms ultimately point to, though, is pain created not in the brain itself but in the meninges—a multilayered “plastic bag around your brain,” as described by Messoud Ashina, a neurologist at the University of Copenhagen and director of the Human Migraine Research Unit at Rigshospitalet Glostrup in Denmark. These membranes contain cerebrospinal fluid that cushions the brain and holds it in place. They also support blood vessels and nerves that feed into the brain. The brain itself cannot feel pain, but nerves in the meninges, especially the trigeminal nerve between the face and brain, can. If they’re activated, they send the brain a major “ouch” message.

Physicians and pharmacists already possess a number of anti-migraine tools — some to prevent future attacks, others to treat an attack once it’s started. Options to stop a current migraine attack in its tracks include over-the-counter painkillers, such as aspirin and ibuprofen, or prescription opioids. Triptans, developed specifically to counter migraine attacks once they’ve begun, are drugs that tighten up blood vessels via interactions with serotonin receptors.

However, scientists later recognized that constricting blood vessels is not the main way triptans relieve migraine; their action to quiet nerve signals or inflammation may be more relevant. Ditans, a newer class of migraine drugs, also act on serotonin receptors but affect only nerves, not blood vessels, and they still work.

For migraine attack prevention, pre-CGRP-era tools still in use today include antidepressants, blood pressure medications, epilepsy drugs, and injections of botulinum toxin that numb the pain-sensing nerves in the head and neck.

Most of these medicines, except triptans and ditans, weren’t designed specifically for migraine, and they often come with unpleasant side effects. It can take months for some preventive medicines to start working, and frequent use of triptans or painkillers can lead to another problem, the poorly understood “medication overuse headache.”

A powerful new player

The CGRP drugs provided a major expansion to the migraine pharmacopoeia, as they can both prevent attacks from happening and stop ones that have already started. They also mark the first time that clues from basic migraine research led to an “off” switch that prevents migraine attacks from even starting.

CGRP is a small snippet of protein made in various places in the body. A messenger molecule that normally clicks into another molecule, called a receptor, on a cell’s surface, CGRP can turn on activity in the receiving cell. It’s found in pain-sensing nerve fibers that run alongside meningeal blood vessels and in the trigeminal ganglia near the base of the skull where many nerves are rooted. The molecule is a powerful blood vessel dilator. It also acts on immune cells, nerve cells, and the nerve-supporting cells called glia.

All of these features—a location in the meningeal nerve fibers with several actions that might be linked to migraine, like expanding blood vessels—pointed to CGRP being a migraine “on” switch. Further research also showed that CGRP is often found at higher levels in the body fluids of people who get migraines.

In a small 2010 study, 12 out of 14 people with migraine did report a headache after receiving intravenous CGRP; four of them also experienced aura symptoms such as vision changes. Only two out of 11 people who don’t normally get migraine attacks also developed a headache after CGRP infusion.

CGRP also caused mice to be extra sensitive to light, suggesting it could have something to do with the light sensitivity in humans, too.

The steps between CGRP in the bloodstream or meninges as a trigger and migraine symptoms like light sensitivity aren’t fully understood, though scientists do have theories. Ashina is pursuing how CGRP, PACAP, and other substances might trigger migraine attacks. These molecules all stick to receptors on the surface of cells, such as the ones in blood vessel walls. That binding kicks off a series of events inside the cell that includes generation of a substance called cyclic AMP and, ultimately, opening of channels that let potassium ions out of the cell. All that external potassium causes blood vessels to dilate—but it might also trigger nearby pain-sensing nerves, such as the trigeminal cluster, Ashina hypothesizes.

It’s a neat story, but far from proven. “We still don’t really know what CGRP does in the context of migraine,” says Greg Dussor, a neuroscientist at the University of Texas at Dallas.

In one possible model for migraine, various molecules can activate blood vessel cells to release potassium, which activates nearby neurons that send a pain signal to the brain. Various strategies that seek to interfere with this pathway, including the anti-CGRP drugs, are of great interest to migraine researchers.

In one possible model for migraine, various molecules can activate blood vessel cells to release potassium, which activates nearby neurons that send a pain signal to the brain. Various strategies that seek to interfere with this pathway, including the anti-CGRP drugs, are of great interest to migraine researchers. Credit: Knowable Magazine

Uncertainty about CGRP’s precise role in migraine hasn’t stopped progress in the clinic: There are now eight different blockers of CGRP, or its receptor, approved by the US Food and Drug Administration for migraine treatment or prevention. The American Headache Society recently released a statement saying that CGRP drugs should be considered first-line treatments for migraine. Despite CGRP’s widespread presence across the body, blocking it results in few and generally mild side effects, such as constipation.

“It’s a good drug,” says Dan Levy, a neurophysiologist at Beth Israel Deaconess Medical Center in Boston who recently described the role of the meninges in migraine for the Annual Review of Neuroscience.

Questions remain, though. One is whether, and how well, CGRP blockers work in men. Since three to four times as many women as men have migraine, the medicines were mostly tested in women. A recent review found that while CGRP blockers seem to prevent future headaches in both sexes, they haven’t been shown to stop acute migraine attacks in men as currently prescribed. (Notably, men made up less than a fifth of those included in the studies as a whole, making it more difficult to detect any low-level effects.)

More data may settle the question. Hsiangkuo Yuan, neurologist and director of clinical research at Thomas Jefferson University’s headache center in Philadelphia, says he’s been tracking the effects of CGRP blockers in his patients and hasn’t seen much difference between the sexes so far in terms of CGRP-blocking antibodies, though there may be a difference in how people respond to small molecules that block CGRP.

Access to CGRP inhibitors has also become an issue. Many insurers won’t pay for the new drugs until patients have tried and failed with a couple of other treatments first — which can take several months. This led Irons, the Florida patient, to try multiple medications that didn’t help her before she tried several CGRP blockers. In her case, one CGRP drug didn’t work at all; others worked for a time. But eventually they all failed.

Searching for new “off” switches

Her case illustrates the need for still more options to prevent or treat migraine attacks, even as the CGRP success story showed there’s hope for new medicines.

“CGRP has really paved the way,” says Andrew Russo, a neuroscientist at the University of Iowa in Iowa City who described CGRP as a new migraine target for the Annual Review of Pharmacology and Toxicology in 2015. “It’s a very exciting time for the field.”

Physicians have a number of therapies that can treat migraine — from familiar painkillers such as acetaminophen to the newer ditans and CGRP blockers. Yet, many patients still struggle to find consistent symptom relief, motivating scientists to continue to search for new medications.

Physicians have a number of therapies that can treat migraine — from familiar painkillers such as acetaminophen to the newer ditans and CGRP blockers. Yet, many patients still struggle to find consistent symptom relief, motivating scientists to continue to search for new medications. Credit: Knowable Magazine

Russo and Hay, of New Zealand, are interested in building on CGRP action with a potential novel therapy. It turns out CGRP doesn’t hit just one receptor on the surface of cells, like a key that matches only one lock. In addition to the traditional CGRP receptor, it also binds and activates the AMY1 receptor—which itself can be activated by another molecule, amylin.

AMY1 receptors are found at key sites for migraine pain, such as the trigeminal nerves. In a small study, Russo and Hay found that injecting a synthetic version of amylin creates migraine-like attacks in about 40 percent of people with migraine. The researchers also discovered that in mice, activating AMY1 causes sensitivity to touch and light.

Again, that sounds like a migraine attack “on” switch, and Russo believes there’s a good chance that researchers can develop a drug that acts as an “off” switch.

Another promising “on” switch contender is PACAP. Like CGRP, it’s a small protein and signaling molecule. PACAP also appears in the trigeminal nerves that transmit migraine pain and seems to be elevated in some people experiencing a migraine attack. In rodents, PACAP causes expansion of blood vessels, inflammation in the nervous system, and hypersensitivity to touch and light. In a little over half of people with migraine, intravenous PACAP kicked off a fresh, migraine-like attack.

But, Russo says, “PACAP is more than just a CGRP wannabe.” It appears to work at least somewhat differently. In mice, antibodies that block PACAP do nothing against the light aversion activated by CGRP, and vice versa. That suggests that PACAP and CGRP could instigate two alternate pathways to a migraine attack, and some people might be prone to one or the other route. Thus, PACAP-blocking drugs might help people who don’t get relief from CGRP blockers.

Clinical research so far hints that anti-PACAP treatments indeed might help. In 2023, the Danish pharmaceutical company Lundbeck announced results of a trial in which they dosed 237 people with an antibody to PACAP. Those who received the highest dose had, on average, six fewer migraine days in the four weeks following the treatment than they did before receiving the medication, compared to a drop by only four days in people who received a placebo.

Then there’s Ashina’s work, which unites many of the “on”-switch clues to suggest that PACAP, CGRP and other molecules all act by triggering cyclic AMP, causing blood vessel cells to spew potassium. If that’s so, then drugs that act on cyclic AMP or potassium channels might serve as “on” or “off” switches for migraine attacks.

Ashina has tested that hypothesis with cilostazol, a blood vessel dilator used in people who have poor circulation in their legs. Cilostazol boosts production of cyclic AMP and, Ashina found, it caused attacks in a majority of people with migraine.

He also tried levcromakalim, another blood vessel opener that lowers blood pressure. It’s a potassium-channel opener, and this, too, caused migraine attacks for all 16 people in the study.

To Ashina, these experiments suggest that medicines that turn off migraine-inducing pathways at or before the point of potassium release could be of benefit. There might be side effects, such as changes in blood pressure, but Ashina notes there are potassium-channel subtypes that may be limited to blood vessels in the brain. Targeting those specific channels would be safer.

“I personally really like the potassium-channel track,” says Russo. “I think if we can find drugs targeting the ion channels, the potassium channels, that will be fruitful.”

Hopeful for opioids

Russo is also upbeat about work on a new kind of opioid. Traditional opioids, whether from poppies or pharmacies, work on a receptor called mu. Along with their remarkable pain-dulling abilities, they often create side effects including constipation and itching, plus euphoria and risk for addiction.

But there’s another class of opioid receptors, called delta receptors, that don’t cause euphoria, says Pradhan, who’s investigating them. When delta-targeting opioid molecules are offered to animals, the animals won’t self-administer the drugs as they do with mu-acting opioids such as morphine, suggesting that the drugs are less pleasurable and less likely to be habit-forming.

Delta receptors appear in parts of the nervous system linked to migraine, including the trigeminal ganglia. Pradhan has found that in mice, compounds acting on the delta opioid receptor seem to relieve hypersensitivity to touch, a marker for migraine-like symptoms, as well as brain activity associated with migraine aura.

Encouraged by early evidence that these receptors can be safely targeted in people, two companies—PharmNovo in Sweden and Pennsylvania-based Trevena—are pursuing alternative opioid treatments. Migraine is one potential use for such drugs.

Thus, the evolving story of migraine is one of many types of triggers, many types of attacks, many targets, and, with time, more potential treatments.

“I don’t think there’s one molecule that fits all,” says Levy. “Hopefully, in 10, 15 years, we’ll know, for a given person, what triggers it and what can target that.”

This story originally appeared in Knowable Magazine.

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

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Startup can identify deepfake video in real time

AI, Ai video, Deepfakes, Security, syndication, Zoom / /

Real-time deepfakes are no longer limited to billionaires, public figures, or those who have extensive online presences. Mittal’s research at NYU, with professors Chinmay Hegde and Nasir Memon, proposes a potential challenge-based approach to blocking AI bots from video calls, where participants would have to pass a kind of video CAPTCHA test before joining.

As Reality Defender works to improve the detection accuracy of its models, Colman says that access to more data is a critical challenge to overcome—a common refrain from the current batch of AI-focused startups. He’s hopeful more partnerships will fill in these gaps, and without specifics, hints at multiple new deals likely coming next year. After ElevenLabs was tied to a deepfake voice call of US president Joe Biden, the AI-audio startup struck a deal with Reality Defender to mitigate potential misuse.

What can you do right now to protect yourself from video call scams? Just like WIRED’s core advice about avoiding fraud from AI voice calls, not getting cocky about whether you can spot video deepfakes is critical to avoid being scammed. The technology in this space continues to evolve rapidly, and any telltale signs you rely on now to spot AI deepfakes may not be as dependable with the next upgrades to underlying models.

“We don’t ask my 80-year-old mother to flag ransomware in an email,” says Colman. “Because she’s not a computer science expert.” In the future, it’s possible real-time video authentication, if AI detection continues to improve and shows to be reliably accurate, will be as taken for granted as that malware scanner quietly humming along in the background of your email inbox.

This story originally appeared on wired.com.

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Sustainable building effort reaches new heights with wooden skyscrapers

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Wood offers architects an alternative to carbon-intensive steel and concrete.

At the University of Toronto, just across the street from the football stadium, workers are putting up a 14-story building with space for classrooms and faculty offices. What’s unusual is how they’re building it — by bolting together giant beams, columns, and panels made of manufactured slabs of wood.

As each wood element is delivered by flatbed, a tall crane lifts it into place and holds it in position while workers attach it with metal connectors. In its half-finished state, the building resembles flat-pack furniture in the process of being assembled.

The tower uses a new technology called mass timber. In this kind of construction, massive, manufactured wood elements that can extend more than half the length of a football field replace steel beams and concrete. Though still relatively uncommon, it is growing in popularity and beginning to pop up in skylines around the world.

A photo of a modern apartment interior with wooden beams, floor and ceiling. Windows overlook the surrounding neighborhood.

Mass timber can lend warmth and beauty to an interior. Pictured is a unit in the eight-story Carbon12 condominium in Portland, Oregon.

Mass timber can lend warmth and beauty to an interior. Pictured is a unit in the eight-story Carbon12 condominium in Portland, Oregon. Credit: KAISER + PATH

Today, the tallest mass timber building is the 25-story Ascent skyscraper in Milwaukee, completed in 2022. As of that year, there were 84 mass timber buildings eight stories or higher either built or under construction worldwide, with another 55 proposed. Seventy percent of the existing and future buildings were in Europe, about 20 percent in North America, and the rest in Australia and Asia, according to a report from the Council on Tall Buildings and Urban Habitat. When you include smaller buildings, at least 1,700 mass timber buildings had been constructed in the United States alone as of 2023.

Mass timber is an appealing alternative to energy-intensive concrete and steel, which together account for almost 15 percent of global carbon dioxide emissions. Though experts are still debating mass timber’s role in fighting climate change, many are betting it’s better for the environment than current approaches to construction. It relies on wood, after all, a renewable resource.

Mass timber also offers a different aesthetic that can make a building feel special. “People get sick and tired of steel and concrete,” says Ted Kesik, a building scientist at the University of Toronto’s Mass Timber Institute, which promotes mass timber research and development. With its warm, soothing appearance and natural variations, timber can be more visually pleasing. “People actually enjoy looking at wood.”

Same wood, stronger structure

Using wood for big buildings isn’t new, of course. Industrialization in the 18th and 19th centuries led to a demand for large factories and warehouses, which were often “brick and beam” construction—a frame of heavy wooden beams supporting exterior brick walls.

As buildings became ever taller, though, builders turned to concrete and steel for support. Wood construction became mostly limited to houses and other small buildings made from the standard-sized “dimensional” lumber you see stacked at Home Depot.

But about 30 years ago, builders in Germany and Austria began experimenting with techniques for making massive wood elements out of this readily available lumber. They used nails, dowels and glue to combine smaller pieces of wood into big, strong and solid masses that don’t require cutting down large old-growth trees.

Engineers including Julius Natterer, a German engineer based in Switzerland, pioneered new methods for building with the materials. And architects including Austria’s Hermann Kaufmann began gaining attention for mass timber projects, including the Ölzbündt apartments in Austria, completed in 1997, and Brock Commons, an 18-story student residence at the University of British Columbia, completed in 2017.

In principle, mass timber is like plywood but on a much larger scale: The smaller pieces are layered and glued together under pressure in large specialized presses. Today, beams up to 50 meters long, usually made of what’s called glue-laminated timber, or glulam, can replace steel elements. Panels up to 50 centimeters thick, typically cross-laminated timber, or CLT, replace concrete for walls and floors.

These wood composites can be surprisingly strong—stronger than steel by weight. But a mass timber element must be bulkier to achieve that same strength. As a building gets higher, the wooden supports must get thicker; at some point, they simply take up too much space. So for taller mass timber buildings, including the Ascent skyscraper, architects often turn to a combination of wood, steel and concrete.

Historically, one of the most obvious concerns with using mass timber for tall buildings was fire safety. Until recently, many building codes limited wood construction to low-rise buildings.

Though they don’t have to be completely fireproof, buildings need to resist collapse long enough to give firefighters a chance to bring the flames under control, and for occupants to get out. Materials used in conventional skyscrapers, for instance, are required to maintain their integrity in a fire for three hours or more.

To demonstrate mass timber’s fire resistance, engineers put the wood elements in gas-fired chambers and monitor their integrity. Other tests set fire to mock-ups of mass timber buildings and record the results.

These tests have gradually convinced regulators and customers that mass timber can resist burning long enough to be fire-safe. That’s partly because a layer of char tends to form early on the outside of the timber, insulating the interior from much of the fire’s heat.

Mass timber got a major stamp of approval in 2021, when the International Code Council changed the International Building Code, which serves as a model for jurisdictions around the world, to allow mass timber construction up to 18 stories tall. With this change, more and more localities are expected to update their codes to routinely allow tall mass timber buildings, rather than requiring them to get special approvals.

There are other challenges, though. “Moisture is the real problem, not fire,” says Steffen Lehmann, an architect and scholar of urban sustainability at the University of Nevada, Las Vegas.

All buildings must control moisture, but it’s absolutely crucial for mass timber. Wet wood is vulnerable to deterioration from fungus and insects like termites. Builders are careful to prevent the wood from getting wet during transportation and construction, and they deploy a comprehensive moisture management plan, including designing heat and ventilation systems to keep moisture from accumulating. For extra protection from insects, wood can be treated with chemical pesticides or surrounded by mesh or other physical barriers where it meets the ground.

Another problem is acoustics, since wood transmits sound so well. Designers use sound insulation materials, leave space between walls and install raised floors, among other methods.

Potential upsides of mass timber

Combating global warming means reducing greenhouse gas emissions from the building sector, which is responsible for 39 percent of emissions globally. Diana Ürge-Vorsatz, an environmental scientist at the Central European University in Vienna, says mass timber and other bio-based materials could be an important part of that effort.

In a 2020 paper in the Annual Review of Environment and Resources, she and colleagues cite an estimate from the lumber industry that the 18-story Brock Commons, in British Columbia, avoided the equivalent of 2,432 metric tons of CO2 emissions compared with a similar building of concrete and steel. Of those savings, 679 tons came from the fact that less greenhouse gas emissions are generated in the manufacture of wood versus concrete and steel. Another 1,753 metric tons of CO2 equivalent were locked away in the building’s wood.

“If you use bio-based material, we have a double win,” Ürge-Vorsatz says.

But a lot of the current enthusiasm over mass timber’s climate benefits is based on some big assumptions. The accounting often assumes, for instance, that any wood used in a mass timber building will be replaced by the growth of new trees, and that those new trees will take the same amount of CO2 out of the atmosphere across time. But if old-growth trees are replaced with new tree plantations, the new trees may never reach the same size as the original trees, some environmental groups argue. There are also concerns that increasing demand for wood could lead to more deforestation and less land for food production.

Studies also tend to assume that once the wood is in a building, the carbon is locked up for good. But not all the wood from a felled tree ends up in the finished product. Branches, roots and lumber mill waste may decompose or get burned. And when the building is torn down, if the wood ends up in a landfill, the carbon can find its way out in the form of methane and other emissions.

“A lot of architects are scratching their heads,” says Stephanie Carlisle, an architect and environmental researcher at the nonprofit Carbon Leadership Forum, wondering whether mass timber always has a net benefit. “Is that real?” She believes climate benefits do exist. But she says understanding the extent of those benefits will require more research.

In the meantime, mass timber is at the forefront of a whole different model of construction called integrated design. In traditional construction, an architect designs a building first and then multiple firms are hired to handle different parts of the construction, from laying the foundation, to building the frame, to installing the ventilation system, and so on.

In integrated design, says Kesik, the design phase is much more detailed and involves the various firms from the beginning. The way different components will fit and work together is figured out in advance. Exact sizes and shapes of elements are predetermined, and holes can even be pre-drilled for attachment points. That means many of the components can be manufactured off-site, often with advanced computer-controlled machinery.

A lot of architects like this because it gives them more control over the building elements. And because so much of the work is done in advance, the buildings tend to go up faster on-site — up to 40 percent faster than other buildings, Lehmann says.

Mass timber buildings tend to be manufactured more like automobiles, Kesik says, with all the separate pieces shipped to a final location for assembly. “When the mass timber building shows up on-site, it’s really just like an oversized piece of Ikea furniture,” he says. “Everything sort of goes together.”

This story originally appeared in Knowable Magazine.

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Sustainable building effort reaches new heights with wooden skyscrapers Read More »