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Kalamazoo residents submit signatures to put Healthcare Action Plan on November ballot
Kalamazoo residents submitted enough signatures to the Kalamazoo City Clerk Wednesday morning to put an initiative on the November ballot for a local healthcare
With DeGette’s loss, Raul Ruiz eyes her job on a powerful health panel - Live Updates
The Energy and Commerce Health Subcommittee has jurisdiction over HHS, Obamacare, Medicare and Medicaid.
With DeGette’s loss, Raul Ruiz eyes her job on a powerful health panel - Live Updates
The Energy and Commerce Health Subcommittee has jurisdiction over HHS, Obamacare, Medicare and Medicaid.
Federal Reserve Chair Warsh emphasizes political independence, signals focus on inflation
In remarks at a central bank conference in Sintra, Portugal, Warsh said that if businesses or households thought the Fed would accept inflation above 2%, “I guess they'd be disappointed. We're going to deliver price stability.”
The Case for Performance-First Management
What began as a crisis-driven response to the Covid pandemic laid the foundation for today’s dominant management paradigm: people-first management. But today’s business demands a different approach, as performance and productivity have replaced engagement and retention atop the CEO agenda. Performance-first management represents a gentle shift toward an approach where managers empower their teams to deliver high-impact results within a complex and evolving reality. It keeps people at the center, but reorients the manager’s role around enabling performance, not just supporting satisfaction. Gartner research shows that managers who shift toward a performance-first approach are up to 21% more likely to deliver the business results that are expected of them. And employees who say that their managers are performance-first report higher overall satisfaction with their employee experience.
Sony will cease production of discs for new PlayStation games in 2028
New games sold for PlayStation consoles will only be available digitally and won’t be sold on discs effective January 2028, Sony has announced. The move applies to all PlayStation games released from that point on, including those made by Sony and those released by third parties. The PlayStation group calls the change “a natural direction for Sony Interactive Entertainment to adapt to consumer trends as the general preference for digital media significantly outpaces physical discs,” according to a PlayStation blog post reviewed by Game File in advance of its publication. As movies, TV and music have shifted from physical media to an age of downloads and streaming, Sony’s move could speed the demise of physical media in a gaming. The industry has offered consumers games via cartridges, cassettes, floppy discs, CDs, DVDs and Blu-Rays across a 50-year stretch. Sony has been reporting to investors in recent years that PlayStation games have been increasingly purchased as downloads, not as discs. The most recent figures show nearly four in five purchases of full games for PlayStation 4 and PlayStation 5 were purchased digitally in the past year. Stats like that may cause today’s news to carry an air of the inevitable. But Sony’s declaration for 2028 is still likely to produce a shock, as the biggest gaming platform on the planet that uses game discs leaves them behind. Discs going away, but the fate of game boxes is unknown Sony is committing to still selling games in physical retailers even after they drop discs in 2028. Just how those games will be sold—in boxes with codes inside, as cards marked with digital redemption codes—is unclear. Digital games will also continue to be sold in the online PlayStation Store. New games released for PlayStation consoles prior to January 2028 will be unaffected by the policy change, Sony says. That means the PS5 games of 2027, be they a new Madden, a new God of War, a new Call of Duty, a new Sly Cooper (one can dream?), would still potentially be offered on disc. PlayStation 6 implications Sony’s timeline for a transition to a no-disc era will also spin up more speculation about the timing and configuration of Sony’s next-generation console, the probable PlayStation 6. “This pretty much guarantees that PS6 won’t arrive until 2028 at the earliest,” Piers Harding-Rolls, senior games research analyst at Ampere Analysis tells Game File. Harding-Rolls also concludes from today’s news that “the base version of a PS6 will not include a physical media drive,” as Sony looks to keep costs down on the device. Sony itself is saying nothing about the PS6 today: not its timing, nor how it might or might not support internal or external disc drives in order to run disc-based PS4 and PS5 games, should the console be backwards compatible. The many signs this was coming Industry support for games being released on physical media has been waning. As has consumer interest in them. PC games effectively went all-digital years ago, thanks to the popularity of playing games through Steam and other digital storefronts. The Covid-19 pandemic and the lockdowns that kept much of the global population home helped shift shopping patterns toward downloads. Sony’s own data shows PlayStation game downloads being an uncommon consumer choice a decade ago and now becoming the norm. On consoles, physical media has been in such decline that Sony and Microsoft both launched their current gen Xbox Series and PS5 consoles in 2020 with cheaper versions that lacked disc drives. In early 2024, Phil Spencer, then head of Xbox, told me that ““[w]e ship games physically and digitally, and we’re really just following what the customers are doing.” He added that the game industry had become an outlier in still supporting disc-based entertainment, even as movies and TV have bailed on discs in favor of downloads and steaming: “Gaming consoles themselves have kind of become the last consumer electronic device that has a drive. And this is a real issue, just in terms of the number of manufacturers that are actually building drives and the cost associated with those. And when you think about cogs that we’re going to go put in a console—and as you have fewer suppliers and fewer buyers—the cost of the drive does have an impact.” Last year, the Nintendo’s Switch 2, which uses cartridges rather than discs, introduced the concept of game-key cards, which are physical media that contain no game, just a prompt for a download. Even disc-based games aren’t what they once were, now frequently containing just stubs of games rather than the whole thing. The website Does It Play has tested over 3000 games and found that, for example, that the disc version of this year’s hit 007: First Light, only contained the game’s first mission, with the rest needing to be downloaded. Beyond all that, last week brought the news that Grand Theft Auto VI, likely the biggest game launch this decade, will debut for PS5 and Xbox Series without a disc-based version. Today’s big news comes to you for free. Game File is a reader-supported publication. To receive new posts and ensure more of my work is possible, please consider becoming a free or paid subscriber. Subscribe Discs helped define PlayStation However the trends in entertainment may be going, it is still remarkable to see PlayStation ditch discs given their importance in PlayStation history: In the late 1990s, the first PlayStation’s support for games on relatively cheap CD-ROMs instead of traditional game cartridges allowed the upstart console to outmaneuver cartridge-based systems from Nintendo and Sega, as it drove down game prices down in the process. (The cheaper disc format even prompted Final Fantasy VII maker Square to taunt Nintendo in a magazine ad, saying that if the game was “available on cartridge, it’d retail for around $1200.”) PlayStation devices often doubled as machines for watching movies and TV on the latest disc-based formats. In the late 2000s, for example, Sony’s pricy PS3 gained traction as a go-to device for playing then-novel Blu-Ray discs. In 2013, Sony effectively roasted the digital game-sharing restrictions proposed by rival Microsoft for its upcoming Xbox One console by showing how games could be shared for the then-upcoming PS4. In a 21-second clip that has over 20 million views on YouTube, one PlayStation executive simply handed a game box—presumably with disc inside—to another, who said “thanks.” Sony’s possible motivations The PlayStation announcement today cites “consumer preferences” and a shift away from discs among “the broader entertainment industry,” but does not delve into the decision-making process that brought Sony to this point. Sony is not discussing the economics of this move (I asked!), but there are a number of potential factors: Abandoning discs will spare Sony the cost of manufacturing and shipping them, which analysts and industry veterans I spoke to said could account for $1 or so of a game’s retail price. For first-party games, that’s direct savings for Sony, though the amount is limited by the winnowing percentage of people who were even buying the disc-based versions. For third-party games, Sony could pass the savings on to partners or just retain the better profit margin for themselves. As the 2024 comments from Phil Spencer alluded to, leaving discs behind could mean leaving disc-drives behind, allowing Sony to produce consoles more cheaply. Switching to digital-only for games could diminish the risks of copies of new games leaking. It would also seemingly make second-hand sales of used games impossible, pushing more people to buy their own copies of games. These economic benefits for Sony could be boons for the games industry overall, Ampere analyst Piers Harding-Rolls tells Game File. Among other things, it could free publishers and retailers from having to worry about securing an inventory of game discs when trying to sell games, he noted. “If there is a way to streamline the business of games retail, I generally think it’s a good thing for the industry as it removes unnecessary costs,” Harding-Rolls said. “This will help offset pressure on margins from other directions – development and staffing costs for example.” Should the industry shift from game boxes that contain discs to smaller, cheaper game cards, Harding-Rolls said, that reduces pressure on publishers and retailers. “The advantage of everything going digital for the industry is that sales can be tracked much more easily and there is less commercial risk for publishers wanting to continue selling via retail,” he said. The shift to no discs will also likely impact game development timelines, as developers will no longer face the same urgency to have a build ready to submit to PlayStation for the production of a disc, as industry experts noted around GTA VI’s no-disc news last week. Instead, projects may gain weeks of development time, in the event delivery deadlines for platform approval move closer to release date. Preservationists’ likely worries While millions of gamers have shifted to digital, there are still people who associate game discs—and only game discs—with actual ownership of PlayStation games. That portion of the gaming community spoke up last week about wanting to buy a version of GTA VI that they could hold in their hands, could lend to a friend and could potentially pop into a well-preserved PS5 console three decades from now and still see it run. Such gamers didn’t want to worry that they’d merely purchased a digital copy that could lose access to the game if, say, the company behind the game someday turns of the servers that transmit downloadable copies. Digital copies of games are inherently less long-lasting, because consumers aren’t actually buying a game (on a disc), just buying access to the game. The fine print in online gaming shops notes this, as does a recent law that went on the books in California in 2025. That lasw requires game publishers doing business in the state to refrain from words like “sell” when offering digital copies of games, unless they explicitly tell consumers that what’s being sold isn’t the game itself but a potentially revocable license to access it. A Sony spokesperson noted to Game File that “[w]ith all digital content, including games, movies, and music, players are purchasing a personal license for non-commercial use.” Regarding the fears of PlayStation games being lost to time in an all-digital era, the rep also noted that Sony remains “committed to delivering experiences from past generations to the new platforms our players are using.” They noted that PlayStation has used emulation and remasters to keep offering its classic games to modern gamers. It’s true that many consumers have become accustomed to not having physical copies of new music albums or movies, but the relative precariousness of digital copies of games is in fact being highlighted today by…. Sony’s other big announcement: the upcoming closure of the PS3 and PS Vita online stores Sony said today that it will be closing the online marketplaces for its PlayStation 3 console and PS Vita handheld in most countries in July 2027 (sooner elsewhere: August 2026 for the PS3 store Mexico, Honduras and Nicaragua; late 2026 for PS3 in other Latin American countries and the Middle East). “We know this news may be disappointing to PS3 and PS Vita players who hold a special place in their hearts for this generation of gaming,” Sony said in its announcement, saying the move “was not an easy decision for us to make.” Sony said that PS3 and Vita marketplaces “are no longer able” to support modern commerce systems, prompting a “need” to close the shops and focus on more modern PlayStation platform stores. The news may spark some deja vu. Sony announced back in March 2021 that it planned to take the PS3, Vita and PlayStation Portable marketplaces offline that summer. The move would have caused some 2,000 digital-only games to become unavailable for new purchasers, according to a VGC analysis at the time. Fans complained loudly. By April 2021, Sony walked back the PS3 and Vita shop closures, with then PlayStation boss Jim Ryan saying “it’s clear that we made the wrong decision here.” This time around, Sony is giving a longer notice period in most regions. The closure of those stores is still likely to cut off access to new purchases of digital-only PS3 and Vita games. The current PlayStation 5 marketplace sells PS5 and PS4 games, as well as a selection of PS1 and PS2 games. It does not sell PS3 games, because games for that platform can’t run on the system (some are offered via a PlayStation Plus streaming option). Vita games also aren’t sold via PS5. Sony says digitally purchased PS3 and Vita games will be downloadable after the stores’ shutdowns “for the foreseeable future.” Sony’s move contrasts with Microsoft’s Xbox platform, which continues to sell and support games from all four Xbox console generations. But it puts it in line with Nintendo, which disabled purchases in the marketplace for its Wii console (a contemporary of the PS3) in 2019. Nintendo discontinued purchases in the online shop for its 3DS portable (a contemporary of the Vita) in 2023. The big questions about Sony’s 2028 post-disc era Will Microsoft follow suit, ending support for new disc-based games on Xbox platforms and therefore all game consoles, too? Whether Microsoft does or not, will third-parties that can no longer release games on discs for PlayStation, simply ditch the disc options across the board? Given the GTA VI no-disc experiment launching this November, will more game publishers decide to forgo disc-based offerings even in 2027? How will no-disc PS5/6 games be packaged and sold in brick-and-mortar retail stores? What becomes of game sharing in an all-digital era? Will Sony modify its current set-up, which currently allows some sharing of digital games across a pair of consoles, to allow more casual lending? (See for example, Nintendo’s year-old system of letting players lend a digital game to another player in a “family group” for up to 14 days.) Will there be a version of a PS6 with a disc drive? Or will a drive be offered as an add-on? And how will gamers who want to retain access to PS4/PS5 disc-based games react to whichever configurations Sony chooses to offer? What will the final disc-based PlayStation game be?
Dave Roberts reaches 1,000 wins in Dodgers win over A's
SACRAMENTO — Milestones have become commonplace during this era of Dodgers baseball, but Tuesday night delivered one that placed Dave Roberts in a class of his own.
Supreme Court upholds transgender sports bans: What to know and what’s next
The Supreme Court on Tuesday upheld state bans on transgender students playing on girls sports teams, delivering another blockbuster setback to trans youth and their families in a decision that is likely to sustain similar laws in about half of the nation.
Supreme Court upholds transgender sports bans: What to know and what’s next
The Supreme Court on Tuesday upheld state bans on transgender students playing on girls sports teams, delivering another blockbuster setback to trans youth and their families in a decision that is likely to sustain similar laws in about half of the nation.
Trump nominates acting Labor Secretary Keith Sonderling to permanent role
President Donald Trump nominated acting Labor Secretary Keith Sonderling to keep the role permanently. Trump made the announcement on Truth Social, touting his experience during his first and second terms in the Labor Department. “Throughout his career, Keith has proven his dedication to delivering strong results for the Hardworking People of our Country, and I […]
Supreme Court strikes down Watergate-era limits on campaign funds for political parties
The Supreme Court ruled again that campaign funding is free speech protected by the 1st Amendment.
I Tried Sony's $260 Wearable AC. Here's Why I Turned Around Before Leaving the Block
Sony's Reon Pocket Pro Plus delivered on its promise of keeping me cool—but one major flaw made wearing it in public surprisingly difficult.
PENN Entertainment Sheds Indiana Bid to Boost Income Tax Base
Penn Entertainment Inc. convinced the Indiana Supreme Court to allow the casino operator to exclude unapportioned wagering taxes it paid to other states from its in-state income tax base.
Milwaukee Brewers' Joey Ortiz Delivers Heroics in Late Innings
Facing roster pressure after a top prospect's arrival, the infielder silenced critics with a clutch eighth-inning blast to secure a vital victory and solidify his place with the Milwaukee Brewers.
Reaching communities close to hostilities in Ukraine
Primary health care teams in Ukraine are reaching 121 locations within 60 km from active hostilities. This is part of the largest primary health care intervention in frontline areas in the country. European Union (EU)-supported teams are delivering essential services to people trapped by constant shelling and severe security constraints in 7 regions where no pharmacies operate, no health facilities function and evacuation remains impossible for residents.
Inside the SpaceX trading frenzy
SpaceX was expected to be one of the hottest stocks on Wall Street this year – and it has quickly delivered on that promise, shattering trading volume records while companies race to launch new products tied to the stock.
Scientists cured sickle cell. Then their next challenge began.
Gene editing has delivered remarkable results against sickle cell disease. Now researchers are working to make these personalized treatments faster, cheaper, and available to far more patients.
Alt-rock band Drip Edges hits the stage at Gabe’s
Drip Edges, led by Jeremy Scott, delivers powerful alt-rock influenced by power pop bands like Sugar and the Smithereens, showcasing catchy, dynamic tracks that highlight the lead singer’s dedication to
[8-K] ALLIANCE ENTERTAINMENT HOLDING CORP Reports Material Event
Alliance Entertainment Holding Corporation reports that majority stockholders delivered a written consent on June 24, 2026 approving a major charter change.
"It's not gonna be good:' Local business braces for Parkway East closure
Dave Guerin, a Swissvale business owner, shared his concerns about the upcoming 25-day Parkway East closure, citing challenges for deliveries and suppliers navigating detours.
A Longstanding Theory of Childbirth Is a Myth
Delivering a human baby is not uniquely difficult.
Healthcare AI's next big leap: Removing friction from clinical workflows
Rather than just adding more applications, one CMIO says, organizations should focus on using automation and intelligence to eliminate unnecessary steps, reduce clinician burden and streamline care delivery.
Google Pixel phones may soon let you ‘shuffle’ your favorite wallpapers
According to new findings under the hood of Google’s software, future Pixel updates may deliver support for a “shuffle” option...
Austin Home Theater Helps Central Texas Homeowners Reimagine Entertainment With Custom Home Theater Design
Locally owned integrator combines decades of experience with personalized design to deliver cinema-quality systems across the Austin area
Science and Technology Must Deliver for the Public
The United States has never lacked for scientific ambition. What we need now is a renewed civic commitment to ensuring that talent is harnessed for the benefit of all people. Science can work for everyone. Join us as we build a broader coalition committed to that vision.
Remembering Joe Delaney, 43 years after he died
24-year-old running back gave his life to try to save three children.
Dario Announces Strategic Collaboration with Beluga Health to Deliver Provider-Backed, Integrated Care at Scale
/PRNewswire/ -- DarioHealth Corp. (NASDAQ: DRIO) (the "Company", "DarioHealth" or "Dario"), a leader in AI-powered digital health solutions, today announced it...
Dario Announces Strategic Collaboration with Beluga Health to Deliver Provider-Backed, Integrated Care at Scale
/PRNewswire/ -- DarioHealth Corp. (NASDAQ: DRIO) (the "Company", "DarioHealth" or "Dario"), a leader in AI-powered digital health solutions, today announced it...
PPDS Brings 'Limitless' TV Entertainment To Historic 5 Star Bellevue Syrene Hotel With Philips MediaSuite
PPDS, the exclusive global provider of Philips Professional Displays, has announced that its Philips MediaSuite TV range has been chosen to deliver seamless access to a virtually limitless world of | Delivering modern luxuries to the 18th century hotel in Sorrento, Philips MediaSuite TVs with cast built in are now bringing seamless access to millions of movies, TV shows, games, and streaming apps to guests at one of Italy's most prestigious and exquisite hospitality destinations.
ACE WFM Strengthens Workforce System Delivery Approach for Australian Organisations
Melbourne, AUSTRALIA, June 29, 2026 (GLOBE NEWSWIRE) -- ACE WFM, a workforce management consulting provider, has outlined its structured approac...
Millions take omega-3 fish oil for brain health but a new study found no benefit
Fish oil supplements successfully delivered omega-3s to the brain, but a two-year study found no meaningful benefits for memory, cognition, or Alzheimer’s-related brain changes. The results challenge the idea that fish oil pills can help prevent Alzheimer’s and shift attention toward overall diet and lifestyle instead.
Millions take omega-3 fish oil for brain health but a new study found no benefit
Fish oil supplements successfully delivered omega-3s to the brain, but a two-year study found no meaningful benefits for memory, cognition, or Alzheimer’s-related brain changes. The results challenge the idea that fish oil pills can help prevent Alzheimer’s and shift attention toward overall diet and lifestyle instead.
Meaningful Outcomes Determine the Winners of the Health AI Race
Global investment in healthcare AI exceeded $18 billion in 2025, yet health systems still lack a shared understanding of the outcomes that investment should deliver. This paper argues that success in the health AI race will be determined not by technological sophistication but by which systems first identify and pursue the outcomes that matter most to patients, professionals and health systems. Without a shared language for defining and measuring what healthcare AI should deliver, systems risk optimizing for what is easiest to count rather than what matters most. This paper provides a framework for ensuring AI investment translates into real value for healthcare systems and the populations they serve.
49ers Insider Delivers Commanders Blunt Reality on Brandon Aiyuk
The Washington Commanders are a side character in the rift between Brandon Aiyuk and the San Francisco 49ers. In recent days, Aiyuk has made it clear that he wants to play for the Commanders.Before the remarks from Aiyuk, there was only reporting of Washington’s interest in the 49ers’ wideout. Nonetheless, that’s slightly changed with the […] The post 49ers Insider Delivers Commanders Blunt Reality on Brandon Aiyuk appeared first on HEAVY.
Health insurers are looking for MAHA wins
The companies are offering benefits aimed at appealing to Robert F. Kennedy Jr. and his Make America Healthy Again movement.
Efzimfotase alfa demonstrated improvements in bone health in treatment-naïve pediatric patients with hypophosphatasia achieving median difference of 1.67 vs placebo in RGI-C Score at week 25 in MULBERRY Phase III trial
Positive results from the MULBERRY Phase III trial showed that efzimfotase alfa (ALXN1850), an investigational enzyme replacement therapy, demonstrated a statistically significant and clinically meaningful improvement in bone health in children (2 to
Toronto Blue Jays Infielder Delivers Simple Message to Fans
Ernie Clement was named an All-Star Game starter earlier this week.
From global politics to legendary performances: 110 years of Western Herald
June 28, 2026 marks the 110th birthday of Western Herald, celebrating over a century of journalism and dedication to delivering news to campus.
Belkin launches new 14-in-1 Thunderbolt 5 dock with 140W charging and triple 4K display support
Belkin has launched a 14-in-1 Thunderbolt 5 Dock in China priced at 2,299 yuan (approximately $338). The Belkin dock ships with a 180W adapter and 1m cable and delivers 140W USB Power Delivery over a single Thunderbolt 5 connection, with bandwidth scaling from 80Gbps to 120Gbps for high-resolution display use. Belkin briefly listed the dock on its global website at $350 before removing the page, hinting at a global launch.
Texas A&M’s Marcel Reed impresses in Air‑It‑Out exhibition
Marcel Reed delivered one of the top highlights at the Manning Passing Academy, dropping a perfect deep ball during the Air‑It‑Out exhibition.
Why soccer is life - Live Updates
“Sport is never just about sport. It is about storytelling and national storytelling,” says acclaimed playwright.
The weekend of Andy Burnham’s life - Live Updates
If England wins the World Cup, one pollster says the new prime minister should call a snap election.
HISTORY IN THE MAKING: A RECORD-BREAKING OPENING DAY AT THE PAN AMERICAN ATHLETICS CHAMPIONSHIP MEDELLÍN 2026
The Pan American Athletics Championship delivered everything the Americas had been waiting […]
Which coach helped Dianna Russini get out of a ticket?
The recent New York Times article regarding former New York Times reporter Dianna Russini answered some lingering questions.
New vitamin B12 therapy shows promise against deadly brain cancer
Researchers have identified a vitamin B12–based compound that can cross the blood-brain barrier and home in on glioblastoma tumors. In animal studies, the compound accumulated preferentially in tumor tissue and delivered sustained nitric oxide directly to cancer cells. It also worked synergistically with existing glioblastoma treatments, significantly enhancing their tumor-fighting effects.
Walker Buehler delivers statement win for the Padres over Dodgers
The Sporting Tribune's Fernando Ramirez writes about Walker Buehler throwing a solid game against his former team.
Twin Cities Pride organizers expect festival to deliver big boost to businesses
Trump-backed Letlow faces Fleming in Louisiana GOP Senate runoff
President Donald Trump’s choice for U.S. Senate in Louisiana is seeking to secure the GOP nomination and deliver another win for the president in his effort to replace Republicans who crossed him
Why Belgium’s prime minister isn’t cheering on the Red Devils - Live Updates
The World Cup isn’t easy for Bart De Wever.
Seattle World Cup match brings fans, Pride weekend, and global politics together
The World Cup’s stop in Seattle has already delivered packed streets, record-setting business days and a surge of international energy around Lumen Field.
Healthcare AI Leaders Are Rapidly Trying To Outmaneuver Skyrocketing Memory And GPU Costs
Compute power has become one of the most crucial components of the healthcare delivery cycle.
The 5-Question Org Chart Audit I Run Before Scaling AI Across a Business
AI success depends less on the technology and more on the organization behind it. These five questions help leaders identify the structural barriers that prevent AI from delivering real business impact.
Hisense U7SG 4K TV: Modern Entertainment for the New Age
The Hisense U7SG 4K TV delivers stunning MiniLED visuals, 165Hz gaming performance, and Dolby Vision IQ for an immersive entertainment experience.
New feed trailer expands feed delivery opportunities
Delivery of bulk feed produced at the Iowa State University Kent Feed Mill and Grain Science Complex to Iowa State’s animal science farms is now possible, thanks to a new high-tech feed trailer.
Morocco jails 29, including politicians and sports figures, in drug trial
Casablanca court delivers landmark verdict in 'Escobar of the Sahara' case: up to 12 years for top figures.
ECU Health announces 2026 Board Quality Leadership Award winners
ECU Health Board Quality Leadership Award winners were recognized for delivering exceptional experiences and advancing patient outcomes.
Council Explores AI, Quality Improvement and Patient Safety to Advance Community Health
The MHA Council on Health Access and Community Impact held its final meeting of the program year June 4 to examine emerging opportunities and challenges shaping healthcare delivery and advancing community health.
Starlink veterans launch startup to broaden megaconstellation ownership
Former SpaceX engineers who helped build and scale Starlink have launched a startup aiming to deliver megaconstellations for governments and companies seeking more control over space-based infrastructure.
Sweden and WHO launch new long-term initiative to transform Ukraine’s health system
WHO and the Swedish International Development Cooperation Agency (Sida) have launched a new multi-year cooperation project to support the long-term recovery and transformation of Ukraine’s health system. The new project, “Ukraine’s Health System Transformation Initiative: Strengthening Health Governance, Health Financing and Service Delivery for Long-Term Recovery”, was launched at the Ukraine Recovery Conference 2026 in Gdansk, Poland on 26 June, and will run from June 2026 to 2029. Sweden will contribute approximately US$ 26 million (240 million Swedish krona) to support this project. This contribution forms part of Sweden’s broader support to Ukraine through the Team Europe approach, which brings together the European Union, its Member States, and key partners such as the European Commission’s Directorate-General for Enlargement and Eastern Neighbourhood and Enabel, and WHO as lead health agency, to support Ukraine’s recovery, reform agenda and European integration.“Ukraine’s health recovery cannot be measured only by what is rebuilt, but by whether people can count on the health system when they need it most. The scale of the task is immense, with health reconstruction and modernization needs estimated at US$ 19.4 billion over the next decade. Sweden’s US$ 26 million contribution to Ukraine’s Health System Transformation Initiative is a timely investment in the institutions, financing and services that will support Ukraine’s long-term recovery and European integration. WHO remains a trusted partner of the Government of Ukraine in advancing this process. I am deeply grateful to Sweden for its consistent support and partnership,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. More than 4 years of war have placed unprecedented pressure on Ukraine’s health system, creating 3 interconnected challenges. The first is responding to the immediate consequences of the war and the urgent health needs of the population. The second is recovering and modernizing health services today. The third is continuing reforms and aligning the health system with European standards in the context of Ukraine’s future accession to the European Union. The war has led to large-scale population displacement, an increasing need for trauma care and rehabilitation, and shortages of health workers. High out-of-pocket payments in Ukraine make access to health services more difficult. Around 46% of total health expenditure is paid directly by individuals, placing a significant financial burden on many households and underscoring the need for reforms in health financing. Older people, persons with disabilities, women, children and veterans continue to face the greatest difficulties in accessing health services. “Ukraine is demonstrating that health system transformation can continue even during war. Ukraine is also continuing to align its health system with European norms and standards. WHO is committed to supporting Ukraine on this journey. We provide technical support, help coordinate partners’ efforts and support the institutional changes needed to strengthen the system. We are grateful to Sweden for its support. Through this partnership, we can help Ukraine build a more resilient, accessible and people-centred health system,” said Dr Jarno Habicht, WHO Representative in Ukraine. About the Health System Transformation InitiativeThe new initiative will support Ukraine through 3 interconnected areas: strengthening governance and coordination of health sector reforms through more inclusive coordination platforms and structured policy dialogue; transforming service delivery by reinforcing a primary health care-centred model that integrates family medicine, nursing and midwifery; and improving financial sustainability by supporting reforms that ensure the long-term viability of the national health system and reduce out-of-pocket payments for households. Overall, these reforms are expected to make the health system more coherent and easier to navigate, improve the quality and continuity of care, and ensure more equitable access to services, particularly for those who need them most. They will also support Ukraine’s progress towards a more modern health system aligned with European standards. “We are convinced that long-term recovery is not possible without strong, high-quality, person-centred health services that are accessible to everyone. Our partnership with WHO is designed to support deep and lasting systemic changes. Investments in human capital especially autonomous midwives, whose role for maternal, newborn and adolescent sexual and reproductive health cannot be understated, stronger governance, digital transformation and the financial sustainability of the health system are investments in Ukraine’s future. We are proud to support this process,” said Malin Perhult, the Head of the Ukraine Unit at Sida. Focus throughout implementation will be given to the most vulnerable population groups, including older people, women and children, and persons with disabilities, who have been affected by the war and face greater health-care needs. The initiative will be implemented in close cooperation with the Ministry of Health of Ukraine, the National Health Service of Ukraine, the Public Health Centre of Ukraine, regional authorities and international partners. This project will help Ukraine move towards a system where everyone can access the health care they need. It will strengthen primary care, make the health finance system more stable and predictable, and reduce the out-of-pocket costs that Ukrainians face when using health services. As a result, the Ukrainian health system will become more aligned with European standards and more sustainable in the long run.
Medical breakthroughs collide with the health system
The buzziest advances — like personalized gene therapies or AI-discovered drugs — may not deliver.
Making Our Own Luck
We are cross-posting a piece that former NIH official Kris Willis wrote for Macroscience. Kris is now the President and Founder of the Woodley Park Institute, for which I’m a board member. Picking winners or hedging bets? Federal science agencies have long wrestled with the question of how to ensure their billions of dollars of grants and contracts result in maximum benefits for Americans. On the surface, it might seem that a goal-oriented, interventionist style of management would be the best policy: prioritize our most pressing problems and distribute funding accordingly.This top-down strategy creates a unique hazard, though: bad choices can send resources in the wrong direction, resulting in slow progress that impedes the delivery of tangible benefits to citizens. Moreover, if decision makers pursue an applied advance when the underlying scientific principles remain poorly understood, they risk costly failures and a loss of support for the research enterprise at large. Examples include Nixon’s 1971 War on Cancer, undertaken on the premise that a cure could be achieved in less than a decade, the drive to build an operational commercial fusion plant by the mid-1990s, and the National Plan to Address Alzheimer’s Disease, which failed to produce the effective treatments and prevention strategies promised by 2025. The contrasting laissez-faire approach is to hedge your bets. If the path to an advance is impossible to predict, then the wisest choice might be to distribute funding to as widely as possible. The main risk of this strategy is that spreading funding thinly may limit the resources available to the most promising research, resulting in the same negative outcomes as the interventionist approach: limited support for the most promising topics, slow progress, and delayed returns. In reality, at science agencies like the National Science Foundation and National Institutes of Health, program managers navigate between these two extremes, setting some funds aside to target high-priority areas and using the rest to cover the widest possible range of meritorious proposals. This middle path seems like the most rational way to proceed, but it still requires making choices. How much should be set aside for high priority topics? What should those topics be? How should we define merit? Expert opinion can provide a helpful guide, but leading experts can have remarkably different opinions about what matters and what should be prioritized. Moreover, experts and administrators alike can be risk averse, giving an edge to high-profile, well-established concepts. What’s really needed is a data-driven framework to help guide decision-making, one that doesn’t simply repackage prestige or incumbency. Recognizing breakthroughs years in advance Many breakthroughs fail to attract funding or recognition at the earliest stages of development. Katalin Karikó, for example, spent years struggling to win grants for work on mRNA that would eventually win her and Drew Weissman a Nobel Prize. Similar stories can be told about Jim Allison’s groundbreaking studies leading to the development of cancer immunotherapy, Stan Pruisner’s demonstration that prions can self-replicate without DNA, or Robin Warren and Barry Marshall’s proof that Helicobacter pylori, not stress, causes ulcers. Yet at some point, the scientific community recognizes and responds to transformative breakthroughs like these. How does that change happen? And what if science funders could identify the areas that are on the cusp of a breakthrough? Those questions led my collaborators and me to study how scientists responded to past breakthroughs. Based on patterns in that data, we developed a means of predicting future breakthroughs, using biomedicine as a proof of concept. It’s worth taking a moment to describe how our approach works. Briefly, our prediction process begins by grouping the 18 million or so peer-reviewed papers in PubMed, the authoritative database of biomedical research, into roughly 50,000 unique topics. A small subset of these topics are so widely acclaimed as breakthroughs that they have been recognized with a major prize like a Nobel or a Lasker Award. We theorized that studying the development of these outliers over time, especially before they gained acclaim, was the key to identifying future instances of them. After defining topics, we chose 21 representative breakthroughs and asked what they looked like before they won prestigious prizes. To answer that question, we re-ran our topic-mapping algorithm repeatedly, winding back the clock one year each time, stringing together the years to follow the progress of each field as it grew and advanced. We found that in each case, the years leading up to a discovery followed a pattern: a burst of papers on a new, rapidly evolving topic, many of which quickly became influential. These characteristics—the percent of papers that are new, the percentage of papers that are brought in from other topics, and the influence of each individual paper—can all be measured separately for any given topic. Together, they act as a predictive signal that is detectable an average of five years before a transformative discovery is made, and up to thirty years before the discovery receives a major prize. Scanning the current research landscape for topics that display this signal allows us to predict what work will likely produce a future breakthrough. Each year we analyzed includes four or five signals, a number that appears to have remained constant across a twenty year time frame. In their classic work on the sociology of science, Bruno Latour and Steve Woolgar established that the desire to participate in a major discovery is an important motivator for scientists as they consider whether they should take up (or abandon) a research problem. Although further work is needed, the simplest explanation for our results is that this behavior is widespread enough to detect at scale. A foundational advance, or something like it, draws the attention of scientists and causes them to change the direction of their research. They vote with their feet, staking their own reputation and careers by publishing on and citing the new idea. That upswell of interest is the foundation of our breakthrough signal. What kind of research does our model identify as a breakthrough? After building a model based on the patterns in our 21 preselected breakthroughs, we tested it by identifying all early signals of discovery from 1994 through 1997. Of the 18 signals we found in that time period, 17 can be traced forward in time to a breakthrough. Examples include super-resolution fluorescence microscopy (see the image above), the directed evolution of proteins and enzymes (Chemistry Nobel, 2018), and sequencing the human genome (National Medal of Science, 2008). The discovery of the role of leptin signaling in obesity is a particularly interesting case study. Around 1950, scientists noticed the existence of a type of lab mouse that suffered from a unique inherited form of obesity. When given the freedom to choose their own diet, these mice ate more than normal and preferred food that was high in fat. Researchers had few clues as to why the animals overate; early experiments pointed to the existence of a soluble ob factor found circulating in the bloodstream that regulated appetite, but its identity was unknown. In 1994, Jeffrey Friedman and colleagues identified and sequenced the ob gene, noting that the protein it encoded appeared to fit the profile of a circulating factor. A year later, a trio of high-profile publications demonstrated that ob was a hormone that regulated body weight and fat deposition by regulating appetite. One of these was co-authored by Friedman, who christened it leptin from the ancient Greek word for thin. Using our model, the data from 1996 make it clear this advance would become a breakthrough. Scientists had flocked to study the biology of the new hormone, generating the flurry of new papers and citations required to produce a signal. One of these demonstrated that serum leptin concentrations reflected the amount of adipose tissue in the human body, providing clinical validation of the earlier mouse studies. Before the identification of leptin, scientists were unable to point to a specific molecule that controlled appetite and adiposity, so that it was impossible to rule out non-physiological causes of obesity; its characterization fundamentally changed our concept of weight gain. In 2010, Friedman and fellow pioneer Douglas Coleman were awarded a Lasker for the discovery. Our work also identifies breakthroughs in clinical practice and behavioral and social sciences, even though these areas are less likely to draw the attention of major prize committees. One example that falls into this category is the introduction of endovascular aneurysm repair, a minimally invasive surgical procedure for the treatment of abdominal aortic aneurysm, a leading cause of death among Americans over the age of 65. Relative to the previous standard of care, it reduces in-hospital mortality by almost four-fold. In 2017, Timothy Chuter received the American College of Surgeons’ prestigious Jacobsen Innovation award for his multiple refinements to the technique. Another under-recognized breakthrough identified by our model is the development of standardized survey instruments to assess the quality of life for HIV+ patients. The antiretroviral cocktails introduced in the mid-1990s reduced AIDS mortality, but treatment came with serious side effects. The new evaluations showed that patients whose disease progressed had worse physical functioning than Americans with other chronic diseases, while those who were asymptomatic maintained a health-related quality of life on par with the overall US population. This evidence made it possible for patients and activists to argue that even in the absence of a total cure, and in spite of the side effects, alleviation of symptoms was a worthwhile priority for clinicians. My colleagues and I have failed to identify any significant recognition for the physicians and health policy experts who pioneered this advance, although in 2016, researchers called for the World Health Organization to set targets for good health-related quality of life as part of its framework to end the AIDS pandemic. From forecasting to funding How should science funders use our predictions? Any serious discussion of what we should do with this new capability needs to begin with an understanding of its limitations. We can’t (and shouldn’t) invest all of our resources in the small number of topics predicted to produce breakthroughs. Innovative new fields are born from existing ones; they rarely arise de novo. If funders don’t maintain a diverse portfolio, the breakthroughs of tomorrow will have no antecedents. Think of this as eating the seed corn, or killing the goose that lays the golden egg. There are also multiple goals of funding beyond basic scientific discovery, including translating discoveries into clinical practice, developing new technologies, supporting economic development, and training new scientists. The investments needed to accomplish these goals are likely different from those required to support emerging breakthroughs. Finally, we must be aware that we may not capture every instance of a breakthrough. The concept is fuzzy, and not every significant discovery is recognized with a major award. Further, breakthroughs are rare, meaning that our dataset is, by necessity, small. This makes formal estimates of accuracy challenging. Although our overall success rate appears to be high, any one signal may turn out to be a false positive. We found one apparent example: the development of the third generation COX-2 inhibitors, Vioxx and Celebrex, which were much celebrated in the early 2000s as effective but non-addictive pain relievers, meets all the algorithmic criteria of a breakthrough. Five years after it received FDA approval, researchers demonstrated that Vioxx was associated with serious cardiovascular complications, and the manufacturer voluntarily pulled the drug from the market. Celebrex remains available, although like other NSAIDs, it carries an FDA warning for increased cardiovascular risk. Decision makers who were overly focused on the breakthrough potential of this research might have wasted substantial resources nurturing an area that ultimately proved to be a failure—but so would those who relied on expert opinion at the time. That said, the potential benefits of funding the next mRNA vaccine or cancer immunotherapy years earlier than we might have are large. When we can’t assume the outcome of an action, it’s worth conducting an experiment. Can targeted support for areas that are poised to produce a breakthrough increase the return on scientific investment without cannibalizing future advances? With the necessary administrative infrastructure in place, conducting this experiment would be straightforward. First, identify all the breakthrough signals between 2018 and 2023, select half at random, and commit to a decade of investment. For biomedicine, a six year window should yield about 30 topics with the potential to produce a breakthrough. Providing strong support to half of these might be accomplished for $300 million a year. That’s roughly half of the recent annual budget of the NIH Common Fund or around 20% of the fiscal year 2025 budget for ARPA-H. After five years, then again at ten, compare to see which group — the one that was actively managed, or the control — produced more breakthroughs, and on what timescale. Although we used biomedicine as an example, the same experiment could just as well be run for physics, materials science, or any other discipline. Any attempt to undertake such an experiment should keep three points top of mind. First, we can predict the topic of future breakthroughs, but the people and vision for how to move the work forward are still important. In practice, this means success requires active program managers with the expertise to develop the science and the authority to do so, including by recruiting investigators. Second, we would be wise to learn from the failures of past attempts to fund transformative research. High among these are funding modestly repackaged work, confusing the genuinely novel with the merely unfamiliar, and relying too much on incumbent investigators. All of these risks can be mitigated by thoroughly and intelligently integrating high quality data into portfolio management. Finally, we need to have patience. Even with strong funding support, producing a breakthrough takes time. If supporting breakthroughs is the best way to nurture the birth of new fields, we also need to accurately describe and properly manage the other two stages, so that we invest wisely throughout the productive lifetime of ideas and divest once they reach the point of diminishing returns. We would benefit from more study of all of these phases, especially the transition from one to another. More research could answer questions like: When does a breakthrough become an established field? How do the availability of funding, the size and characteristics of the available workforce, and the accumulation of evidence that disagrees with prevailing models affect a field’s decline? Exactly how do old ideas give birth to new ones, and can we speed up the process? The more we understand about the dynamics of scientific progress, the better we can maximize the odds that our curiosity leads to results. I’d call that finding a way to make our own luck.
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