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Liverpool speak to Spanish giants over potential Slot successor
Liverpool Sound Out Real Madrid Over Alonso Amid Growing Pressure on SlotLiverpool’s interest in Alonso has moved beyond admiration and into serious due diligence, with reports from Spanish outlet A...
Deepfake “doctors” are a problem—here are 7 keys to stopping them
There’s a need for clear, enforceable protections against unauthorized AI generated deepfakes that threaten patient safety. Learn more with the AMA.
Evaluating Cboe Global Markets (CBOE) After Q1 Earnings Beat And Business Realignment Plan
Cboe Global Markets (CBOE) drew fresh attention after first quarter 2026 results beat revenue and earnings projections, alongside a realignment plan focused on core derivatives, index products, and new prediction market initiatives. See our latest analysis for Cboe Global Markets. The earnings beat and realignment plan have coincided with strong positive momentum, with a 30 day share price return of 17.78% and a year to date share price return of 40.49%. The 5 year total shareholder return of...
Business Lookahead: Trump on Tour
STORY: From Trump's trip to China, to a slew of new U.S. data releases, these are the stories to watch in business and finance in the coming week. :: Trump goes to Beijing U.S. President Donald Trump visits Beijing on Thursday and Friday.It will be his first visit to China in eight years.He'll try to lock in the trade truce agreed to in October in South Korea, and avoid a rerun of the tit-for-tat tariff battle that he set off a year ago.Fresh trade data should offer a reality check on whether a protectionist White House has managed to dent Americans' appetite for Chinese-made goods.:: Saudi Aramco posts resultsThe world's biggest exporter of crude oil, Saudi Aramco, reports first-quarter results on Sunday.The numbers are expected to show the pain from the more than two-month-old Iran war.This comes as efforts to end the conflict appeared to stall after the U.S. and Iran traded fire in recent days, with some of the biggest flare-ups in fighting in and around the Strait of Hormuz since a ceasefire began a month ago.:: U.S. economic dataA bunch of new data should give a clearer view of inflation in the U.S.Tuesday's April consumer price index is expected to rise 0.6% according to a Reuters poll.Prices at the pump are likely to loom large in the numbers.Producer price data for April on Wednesday is another inflation checkpoint after the Fed’s last meeting exposed a more hawkish tilt among some policymakers who are increasingly uneasy about price pressures.And retail sales figures on Thursday should show whether higher gas prices and other costs are starting to bite into household spending.
How Brazil is using health literacy to close the health gap | Health Inclusivity Index
Discover how Brazil’s Family Health Strategy is using community-based care and health literacy to improve access, reduce inequality and support more inclusive healthcare outcomes.
Purgatory: Florida congressional delegation in middle of pack in 'Biblical Business Index'
Could Florida legislators be more faith-based?
Small business hiring picks up pace in April, Paychex reports
Paychex reports small business hiring accelerated in April with the national jobs index rising 0.35 points, the largest monthly gain since last year.
McKinsey Small Business Report Shows Need for Indexing Cap Gains Amid $5 Trillion in Ownership Transfer - Americans for Tax Reform
A new report from the McKinsey Institute for Economic Mobility focuses on an unprecedented wave of small-business ownership transitions. By 2035, about 6
Nashville businesses say economy is holding up
The inaugural Quarterly Regional Business Confidence Index scored Nashville a 60.1 out of 100, according to the Nashville Area Chamber of Commerce.
Americans Say They're Feeling Prosperous, Defying Economic, Market, and Political Pessimism - According to Northwestern Mutual's Inaugural Personal Prosperity Index
Northwestern Mutual launches the Personal Prosperity Index: First-ever score is 68 out of 100, with Americans feeling good about the health of their mind, body, relationships, and money – and...
How Ochsner continues to prioritize physician well-being
At the Gulf Coast-based health system, Gold-level recognition helps drive culture change, strengthen recruitment and support physician retention.
Pearl of the week: What insurer data confirms about mental health access
A new index shows where costs and payment disparities are holding patients back
Higher Prices Sustained Small Business Sales Growth in April, Fiserv Data Shows
Fiserv Small Business Index remands steady at 144; year-over-year sales grew +1.1% MILWAUKEE, May 04, 2026 (GLOBE NEWSWIRE) -- Fiserv, Inc. (NASDAQ: FISV), a leading global provider of payments and financial services technology, has published the Fiserv Small Business Index for April 2026,
Former star admits Liverpool’s lack of identity is worrying
Daniel Sturridge Questions Liverpool Identity Under Slot After Old Trafford DefeatLiverpool’s 3-2 defeat to Manchester United did more than deepen the anxiety around a faltering Premier League campa...
A global spotlight on suicide prevention in health care
Henry Ford Health’s Brian K. Ahmedani, PhD, MSW, was named to the TIME100 Health list, spotlighting Zero Suicide and its growing impact worldwide.
Rival boss heaps praise on absent Liverpool star
Carrick revisits Anfield memory with clear intentMichael Carrick does not often indulge in nostalgia, yet ahead of Manchester United’s latest collision with Liverpool FC, he allowed himself a glance...
Manchester United Clearout Could Define Their Next Chapter
Manchester United Transfer News: Nine Players Could Leave in Summer ResetUnited Facing Major Summer ClearoutManchester United’s summer already feels less like a transfer window and more like a recko...
Mental Health Parity Index
This first‑of‑its‑kind, open-access tool uses real‑time data to reveal where mental health and substance use disorder care falls behind physical health care. Learn more.
How Northwell Health built a physician-led well-being strategy
Northwell Health has cut doctor burnout by 17% through physician-led change, local well-being efforts and systemwide action.
Advancing mental health and SUD parity—from promise to practice
A powerful new tool will help close the persistent gap in access to and payment for behavioral care relative to physical health services.
Liverpool star provides some Salah Injury hope
Andy Robertson Offers Hope on Mo Salah Injury as Liverpool Close In on Champions League ReturnLate season push gathers paceThere are moments late in a season when results matter, but context matters m...
Liverpool vs Crystal Palace: Relief and Reality in Chaotic Win
Liverpool Edge Past Crystal Palace as Lola Katz Roberts Dissects “Weirdest” WinLiverpool’s victory over Crystal Palace sparked an immediate and honest reaction on The Gags Tandon Show, where hos...
New York City is at major risk of flooding that could leave 4.4 million people exposed to extreme damage, study finds
The new flood risk index identified eight cities along the U.S. East Coast that are at high or very high risk of floods causing extreme damage.
Petersburg basketball team honored for historic win
The state champion Crimson Wave basketball team took center court April 22 at the Virginia General Assembly.
Volume 25 Science Of Speed
Our annual racing deep dive goes full engineering — from chassis and powertrains to tires, batteries, aero, and driver fitness, featuring machines like the new Corvette ZR1 and McLaren Solus GT.
J.P. Morgan lifts S&P 500 year-end target to 7,600 on AI-driven earnings
J.P. Morgan on Tuesday raised its year-end target for the S&P 500 index to 7,600, citing AI and tech-driven earnings, just weeks after lowering its forecast, with a ceasefire between the U.S. and Iran aiding sentiment.
South African rand flat as traders eye business confidence index, central bank policy report
The South African rand was flat in early trade on Tuesday as investors tracked geopolitical developments and awaited the release of a domestic business confidence survey and a central bank monetary policy review later in the day.
How Rush dermatology rebuilt culture, access and growth
A five-year transformation tripled access, expanded sites and aligned culture, structure and sustainability at Rush University System for Health.
Liverpool receive boost in pursuit of summer transfer target
Liverpool’s Midfield Reset Gains UrgencyLiverpool’s summer plans are beginning to sharpen into focus, and one name now sits firmly at the centre of the conversation: Camavinga. The French midfield...
Team News: Eight Liverpool stars set to miss Everton clash
Liverpool vs Everton Team News: Merseyside Derby PreviewThe Merseyside derby rarely needs extra context, but this latest chapter arrives with plenty riding on it for both Liverpool and Everton. With E...
Report: Romano claims full future agreement for Liverpool star
Robertson Exit Looms as Liverpool Face Summer ShiftThere is a quiet inevitability to the way football moves on. At Liverpool, where eras tend to be defined by consistency and identity, the prospect of...
Stock market today: Indexes hit records after Iran says Hormuz is open
US stocks surged and oil prices plunged after Iran announced the Strait of Hormuz was "completely open," removing a key overhang for markets.
Report: Liverpool interested in move to sign Tottenham Hotspur midfielder
Liverpool monitoring Archie Gray situation closelyLiverpool’s recruitment strategy has long favoured intelligence over impulse, and their reported interest in Archie Gray reflects that philosophy on...
Report: Shock Move Brewing as Liverpool Target Next Defensive Star
Liverpool Eye Daniel Banjaqui as Right-Back SolutionSearch for Alexander-Arnold Successor IntensifiesCredit to Anfield Watch for revealing Liverpool’s latest transfer thinking, as the club prepares ...
Barcelona’s €30m Question For Man United Forward
Rashford’s Barcelona Future in Doubt as Transfer Reality BitesCredit to Marca for the original reporting, which paints an increasingly uncertain picture around Marcus Rashford and his long term futu...
NFIB small business optimism index falls below 52-year average in March
Small business optimism declined in March as profit trends worsened and uncertainty climbed, according to a survey released Thursday by the National Federation of Independent Business. The NFIB Small Business Optimism Index fell 3.0 points in March to 95.8, dropping below its 52-year average of 98.0 for the first time since April 2025. The NFIB […]
Data highlights gaps in finding in-network mental health coverage
Americans across 43 states enrolled in health plans from the nation’s four largest commercial health insurers face potential disparities in finding in-network coverage for mental health care and substance use disorder treatment relative to physical health care, according to the Mental Health Parity Index released by the Kennedy Forum.
In the Katzmann Lecture, Senator Andy Kim takes aim at political corruption
Last year’s edition of Transparency International’s Corruption Perceptions Index, which gauges countries’ perceived resistance to corruption, gave the United States its lowest score since the index’s current scale debuted in 2012. That result likely would not surprise US Senator Andy Kim of New Jersey, who focused on corruption in politics when he delivered the fifth annual Robert A. Katzmann Lecture on April 6. The event honors the career and impact of the late Judge Katzmann of the US Court of Appeals for the Second Circuit, a professor of practice at NYU Law.
Small business optimism drops, more owners cautious on spending: NFIB
The National Federation of Independent Business (NFIB) Small Business Optimism Index fell 3 points in March to 95.8, falling below the 52-year average of 98.0. NFIB Research Center executive director Holly Wade breaks down the data and what factors are impacting American small business owners, including price pressures, as uncertainty rises.
English still dominates science, but its share fell from 94% to 85%
In 2023, about 85% of the roughly five million articles indexed in major global databases covering the natural, medical and social sciences were written in English. In 1990, the proportion was considerably ...
At HCA Healthcare, small ideas go big in fight to stop overdoses
From drug take-back events to multimodal post-op pain control, physicians see their innovations take hold to benefit patients and communities.
US small business sentiment falls to 11-month low in March
small-business sentiment dropped to an 11-month low in March as a surge in oil prices because of the war in Iran overshadowed the benefits from low taxes, a survey showed. The National Federation of Independent Business said on Tuesday its Small Business Optimism Index dropped 3.
Advancing Health Together: Progress Report 2025
Explore how Elevance Health works with care providers to deliver more affordable, connected, and high-quality care for the people we serve.
Stanford HAI 2026 AI Index: AI posts gains in science and medicine while often struggling to read a clock
Stanford HAI’s 2026 AI Index paints a split-screen picture for R&D. In the report’s science chapter, “frontier models outperform human chemists on average on ChemBench,” yet “score below 20% on replication in astrophysics and 33% on Earth observation questions.” In medicine, the report reaches a similarly mixed conclusion, saying AI is transforming clinical care, but…
FULL SHOW: Inside INdiana Business 4/12/26
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Nintendo's Animated Films Challenge Disney's Box Office Dominance
Nintendo's expansion into theatrical animation, with billion-dollar films and an annual release slate, is challenging Disney's dominance while strategically promoting its gaming hardware and franchises like the successful Switch 2.
Anthropic may soon pass OpenAI on this measure of AI business spending
Anthropic has seen a surge in business spending in recent months, according to Ramp's AI index.
Chelsea Star Speaks On Exit From Manchester United
Garnacho, Chelsea Move Signals Reflection After Man United ExitThere is often a moment, quiet and uncomfortable, when a young footballer begins to understand that talent alone does not carry a career....
“AI polls” are fake polls
A few weeks after Donald Trump’s second presidential win, I took the train up from London (where I was living at the time) to Oxford to attend a conference on polls and forecasts of the 2024 election. Most of the attendees were pollsters or academics, but I also watched presentations from Aaru and Electric Twin, two companies that do what is interchangeably called synthetic sampling, silicon sampling, or synthetic audiences. Stripped of startup jargon, that means they use large language models (LLMs) to simulate responses to public opinion polls by having AI agents take on the role of survey respondents. I had already heard of Aaru thanks to some articles with eye-catching headlines like “No people, no problem: AI chatbots predict elections better than humans” in the months leading up to Election Day. The founders were making some big, some might even say far-fetched claims, such as: “within two years, we will simulate the entire globe — from the way crops are grown in Ukraine to how that impacts production of oil in Iraq, trade through the strait of Malacca, and elections for the mayor of Baltimore.” When Semafor asked Aaru’s cofounders — Cameron Fink and Ned Koh — about my boss, they said “we respect all those who came before us.” Nate (as he so often does) shared his thoughts on Twitter: Fink and Koh were relatively good-natured about this back-and-forth when we spoke at Oxford. They even offered to mail me one of the t-shirts featuring Nate’s quote they apparently had made. I never took them up on the offer, which I now somewhat regret. These synthetic sampling companies fell off my radar for a while, but they do still exist. In fact, Aaru recently received a $1 billion valuation. Is what they’re doing anywhere close to the most important frontier in AI development? Not by a longshot, especially when Anthropic just developed a model so adept at exploiting software vulnerabilities that it’s only being released to 40 companies. Still, silicon sampling is increasingly finding its way into public polling. Axios reported in March that “a majority of people trust their own doctors and nurses” based on findings from Aaru — without mentioning that the “people” in that sentence were actually LLMs. Around the same time, the Public Sentiment Institute “boosted” their online sample of 373 real survey respondents with 114 AI agents.1 (Spoiler alert: even the co-founder of Electric Twin doesn’t think that’s a particularly defensible approach.) Polling companies like Qualtrics and Ipsos are also developing synthetic data panels. So, what should we make of these … “polls”? Let’s get one thing out of the way: whatever they are, they’re not polls in the way that term is usually defined. Subscribe You can’t replace polls with AI On one hand, using LLMs to essentially make up fake survey respondents sort of sounds like the dumbest idea ever, one that will at best imperfectly replicate real polls while introducing all sorts of biases. On the other hand, with LLMs improving at a remarkable, perhaps even alarming rate, maybe that means I’m a dinosaur at the ripe old age of 24 because I still want to rely on polls that talk to actual people. I’m not going to argue that synthetic samples are completely useless. In fact, as I’ll return to later, there is evidence that some techniques can replicate topline survey results quickly and cheaply. But the marketing from certain companies can be slightly optimistic. “No traditional poll will exist by the time the next general election occurs,” said Fink in 2024. We’re just 206 days away from the midterms, and based on the fact that I still have to collect a bunch of polls every day, I’d say he should have run that prediction by a sample of AI agents before the interview.2 To see why synthetic samples can’t replace polls, here’s a quick primer on how they work. The simplest version of these models involves taking a LLM (like ChatGPT or Claude), giving it a demographic profile (e.g., a white, college-educated woman who lives in Utah and makes $70k a year), and then asking it to respond to a survey question. You repeat that process a few thousand times using different demographic profiles and end up with a sample of synthetic survey responses. The actual models used by private companies are more sophisticated than this, usually because they incorporate more hypothesized demographic characteristics for each agent and provide them with extra information. Aaru, for example, feeds agents a diet of news and information they’d be likely to consume, while Electric Twin incorporates their customers’ proprietary data about the audience they’re trying to replicate. The way Ben Warner, the co-founder of Electric Twin, explained it to me was “we have a large amount of data on […] for instance, 5,000 people. Can we make an accurate prediction of how they would respond to another question?” Still, it should be obvious why synthetic samples can’t replace polls. Polling is fundamentally a data collection process. We might use surveys to make predictions by feeding them into election forecasts, but the main purpose of a poll isn’t prediction, it’s gathering new data about what people think and how they feel. Silicon sampling, on the other hand, produces no new data. It’s simply a model: you input LLM training data, demographic prompts, and a bunch of other information, and it spits out a prediction for what a poll would say. We love models here, but models aren’t polls. That difference is an important philosophical sticking point for most pollsters I talk to. “I think politics should stay away from [synthetic sampling], because we’re trying to […] represent the voice of the people,” said Natalie Jackson, a vice president at GQR Insights. Democratic pollster John Hagner told me: “I think I’m just incredibly skeptical of this idea. I don’t think it’s research. At that point, you’re asking the machine to tell you what you already believe.” Hagner has seen some presentations of early synthetic sampling experiments, but so far, “if it’s being used in a campaign, people are keeping it incredibly quiet.”3 But Eli, I hear you saying, aren’t polls themselves increasingly governed by modeling decisions? Indeed they are: pollsters’ choices on which sampling method to use, how to define their likely voter models, and how to weight their samples can and do lead to dramatic differences in the results they publish. Aaru even referenced these limitations in the methodology statement included with that maternal mortality “poll” — although I’m using the term “methodology statement” loosely here, because it doesn’t really explain how the model works at all. We can ignore the (frankly preposterous) implication that synthetic sampling isn’t subject to a separate set of biases. The important point is that there’s still a meaningful difference between using weighting and other statistical techniques on actual polling data and using a model to predict what a poll would say. The latter is far closer to election forecasts or techniques like MRP — potentially useful models, but not a replacement for polls.4 To be fair, other synthetic sampling companies are perfectly happy with the distinction between polls and models. Warner compared polling and synthetic sampling to different tools in a toolbox. “The mistake I think we make is we think that these new tools should either work in exactly the same way or somehow replace these old tools,” he said. “Rather than thinking of it as, okay, so we’ve always had the hammer, we’ve always had the screwdriver, now we’ve got a saw. But don’t use a saw to try [to] do the job of a hammer.” A quick comment from Nate Eli didn’t ask me for a comment — rather rude of him, don’t you think? But since I’m editing this story, I figured I’d add a few quick thoughts rather than putting words in his mouth. Beyond the frequently misleading marketing, what bothers me about the AI “poll” hype is that as AI tools make statistical inference cheaper and/or better (note that these are not synonyms) that actually increases the comparative value of collecting original data. You might be able to train a model to make a reasonable estimate of what some hard-to-reach poll respondent would say — say, a young Black man who voted for Trump. (Such a person checks a number of boxes for a voter who is usually hard to reach in surveys.) Indeed, this is closely related to what models like the Silver Bulletin forecast already do. They essentially smooth out the kinks in noisy survey data by making inferences based on past voting patterns or national polls or surveys of other states. But you don’t actually know what these voters think unless you’re reaching them directly. If there’s a shift in opinion among this subgroup, you’re not going to detect it. So if I were running a campaign, I’d invest more in going the extra mile to find a representative sample of those voters. And then I’d hire some smart quants — or Claude? — to figure out the implications for campaign strategy based on proprietary data that my competitors didn’t have access to. -Nate Silver Are these models any good? If synthetic surveys are just a new type of model, the next obvious question is whether the models are at least accurate. The answer very much depends on who you ask. On one end of the spectrum, you have the maximalist argument that synthetic sampling is more accurate than actual polls. “It’s an incredibly challenging problem to go to someone and say ‘hey, we’re going to be more accurate at predicting human behavior than you, even when you talk to your customers directly’,” Koh recently told CNBC. In his view, synthetic sampling isn’t a saw to polling’s hammer, it’s “magic.” There’s certainly evidence that synthetic samples can replicate certain survey toplines. But if Aaru does have any examples of their approach outperforming the polls, they’re keeping those to themselves.5 Aaru’s 2024 election model, for example, had Kamala Harris leading in Michigan, Nevada, Pennsylvania, and Wisconsin on November 4th. And although they’ve since taken down their forecast page, they gave Harris a 50.5 percent chance of winning the race on November 2nd.6 After the election, Fink told Semafor he was happy enough with those results because they were “within margin of error,” a term that is completely meaningless when applied to a “sample” of AI agents. And of course, Aaru says their models have improved since 2024, so supposedly now they’d be more accurate than the polls? Still, their stronger argument is on cost: “We are significantly faster and cheaper than traditional polling, and still more accurate,” said Fink. The first two claims are undeniably true, but the third brings us to the opposite end of the spectrum. Both Jackson and Hagner are skeptical that these models are reliable for anything beyond replicating common survey toplines. “I just […] don’t think the machines are what we want when we’re looking for nuanced views. My example on this is people in Arizona and Nevada in 2024 who voted for Trump and voted for expanding abortion in their states on ballot initiatives,” said Jackson. Hagner identified another issue. Maybe the synthetic respondents, like sycophantic LLMs, are inhuman in one important way: they’re too nice. “The reports that have come through at the meetings that I’ve been at are that the early experiments on this, they cannot get respondents to be as racist or sexist or, frankly, as negative as human respondents,” he said. Academic research mostly agrees on this point. While there are some papers that show promising results when using LLMs to replicate polling data, most show that LLMs suffer from various quirks like producing too few “don’t know” responses and can seriously overpredict the favorability of politicians like Donald Trump and Kamala Harris. They also seem to struggle with too little variation between demographic subgroups, so the difference in predicted opinion between Democrats and Republicans, for example, is too small. When I asked Warner about these studies, his response to these papers was that just because academics can’t get synthetic sampling to work doesn’t mean that the technique doesn’t work in general. “Actually, the argument is, okay, yours does not [work]. That does not mean […] for this complex set of machinery, which uses a lot of investment, a lot of time, a lot of money, you can’t get it to work.” Cards on the table, I’m somewhat sympathetic to this argument because academics aren’t exactly great at making election forecasts. Usually, the people with skin in the game are the most accurate. Warner’s argument is that the approach Electric Twin takes — which includes, for example, making multiple predictions for each synthetic respondent using different models and prompts and subsequently averaging those to get a final prediction in a sort of ensemble forecast — produces better results than the simpler academic models. Warner shared a comparison between his method and the method from a recent academic paper with me, and Electric Twin was indeed able to get more accurate replication. But even still, he acknowledged that synthetic sampling “is not a crystal ball.” “If you asked me, do I think using other data sources will be more accurate than asking somebody who they will vote for, I would probably say no. But if you asked me ‘would your system be useful for our turnout modeling today?’ I would say yes.” For better or worse, it looks like the method is already getting more popular in the market research world. Most of the clients Aaru touts these days are businesses like EY and McDonald’s. And AI will probably begin to pop up in other parts of the political polling process. Pollsters are already using it to code open-ended survey responses, and some firms, like YouGov, are testing using LLMs to ask survey respondents questions. More worryingly, one danger to actual polls is that AI agents can be used to infiltrate online surveys. Most online polls use various checks to prevent that from happening, but there’s conflicting evidence on how effective those filters are and how prevalent AI agents currently are in online panels. If those agents ever become impossible to detect, it might spell the end of online polling, but the solution isn’t to replace all of your respondents with ChatGPT. Silver Bulletin is a reader-supported publication. To receive new posts and support our work, consider becoming a subscriber. Subscribe 1 That particular poll obviously doesn’t meet Silver Bulletin standards for aggregation. But we exclude all Public Sentiment Institute polls from our averages because we classify them as an amateur polling firm. 2 You could argue that Fink meant the next presidential election, but (a) I’m also confident we’ll still have real polls in 2028 and (b) in that case he should have asked an LLM to define “general election.” 3 Quick caveat: that’s reporting from a Democratic pollster. It’s possible that Republicans are more willing to use AI in political campaigns. 4 Indeed, Silver Bulletin does not include “polls” produced by MRP in our forecasts or averages, and we think it’s extremely misleading when their practitioners describe them in a way that suggests original data had been collected among a large number of states or Congressional districts. 5 A recent report from Aaru and EY did show two examples of a synthetic estimate being closer than a survey to a real-world benchmark — but I’d take those findings with a grain of salt because the report reads more like an ad and didn’t involve any sort of prediction being made ahead of time. 6 For comparison, our odds for Harris on the same day were 48.2 percent.
Enzo Fernandez Future Back in Spotlight After Chelsea Peace Talks
Enzo Fernández and Chelsea Reconciliation Signals Crucial Turning PointDisciplinary drama resolved behind the scenesThere is something quietly significant about reconciliation in elite football. It r...
Inflation surged in March as Iran war's energy impact hit consumers
The Bureau of Labor Statistics released the latest consumer price index data which showed that CPI inflation surged in March as the Iran war's imapct took a toll on consumer prices.
U.S. Chamber of Commerce Small Business Index
Small businesses are healthy but cautious in Q1 2026, with inflation back as the No. 1 concern and owners dialing back growth plans.
Iowa convenience store chain reaches national business milestone
An Iowa-based company is being added to a prestigious list this morning. Casey’s General Stores is now on the S&P 500 stock index. The Ankeny-based convenience store chain is only the second Iowa company on the list, along with Principal Financial Group in Des Moines. The S&P 500 encompasses both the New York Stock Exchange […]
Small business sentiment declines as concerns about inflation rise
The quarterly Ipsos/U.S. Chamber of Commerce Small Business Index in Q1 2026 is down slightly from Q4 2025
Iowa Business Council projects positive six-month economic outlook
Iowa businesses are projecting a positive economic outlook over the next six months, with the Iowa Business Council’s first-quarter Economic Outlook Survey showing an overall index of 65.35 points — up 2.19 points from the fourth quarter of 2025 and more than 4.5 points above the survey’s historical average of 60.47. The quarterly survey measures […]
Small Businesses Cut Back Hiring Plans as Inflation Concerns Grow
The U.S. Chamber's Q1 2026 Small Business Index reflects rising concerns among small businesses about inflation and the economy.
Sky Sports: Two European giants in the race to sign Man City star
Man City News: Bernardo Silva Exit Confirmed Ahead of Summer WindowSky Sports have confirmed what many around Manchester City had begun to anticipate, Bernardo Silva will leave the club at the end of ...
MAGA Is Winning Its War Against U.S. Science
Source: NBER With all the other terrible news right now, you may not have noticed that Donald Trump is in the process of killing American science. OK, that’s an exaggeration — but not that much of an exaggeration. The Trump administration’s latest budget proposal calls for a gigantic increase in military spending combined with severe cuts to social programs. But as the chart above shows, it also calls for debilitating reductions in research funding. Furthermore, Trump appointees have already been strangling science by sharply reducing the rate at which research grants are approved. Here, for example, is the number of new grants approved by the National Science Foundation: Source: Nature Large numbers of existing grants have also been frozen or terminated, especially in the study of infectious diseases. Add to this a sharp drop in visas issued to foreign students, who often play a direct role in research and who help support academic departments that do research: Put all of this together, and much U.S. scientific research is set to come to a screeching halt — not a few years from now, but over the course of the next year or two. This new assault on U.S. science is taking place at a time when the role of American science in the world has already been greatly eroded. The chart below, based on research recently reported by the National Bureau of Economic Research, measures national strength in science by the share of publications in highly ranked journals. In the 1990s the United States had more such publications than the rest of the world combined. Since then we’ve dropped into third place — well behind China and slightly below the European Union. And this was before the Trump administration’s attack on science had time to take its full effect. Source Some erosion in U.S. scientific preeminence was inevitable given China’s growing sophistication and wealth. But we’ve also fallen behind Europe, even though everyone says that Europe is lagging economically and technologically. Claims about Europe’s underperformance are, in fact, dubious if one looks hard at the data. But it’s still striking to see America lagging. What’s going on? There are presumably multiple factors behind America’s scientific lag. But even before Trump II the growing hostility of the U.S. right to science surely had some negative effect. And since the rise of MAGA G.O.P. attitudes toward science in general have become overwhelmingly hostile. This is true even for the Republican rank and file: And while I haven’t been able to find good survey data, it’s obvious that the anti-science turn has been even more pronounced — and began earlier — among the Republican political elite. Chris Mooney published The Republican War on Science in 2005, and even then was describing a longstanding trend. Why have Republicans turned so anti-science? Part of the answer is that they believe that scientists don’t support them. And they’re right! A study of who scientists give money to shows that only a small percentage gave money to Republicans even 20 years ago, and that almost none of them donate to Republicans now: Social scientists have always been strongly pro-Democratic, while there used to be a significant number of physical, “hard” scientists supporting the GOP. But these days physicists are almost as uniformly Democratic, or at least non-Republican, as sociologists. Why are there almost no Republican scientists? It’s not a mystery. GOP political orthodoxy includes positions that are at odds with the scientific consensus on multiple issues, ranging from the validity of the theory of evolution, to the reality of climate change, to the efficacy and safety of vaccines. In each case the scientific consensus is solidly grounded in evidence. But even before the rise of MAGA the U.S. right was increasingly hostile to evidence-based policymaking — especially, of course, where the evidence is unfavorable to fossil fuel interests or quack medicine, both financial mainstays of right-wing politics. So scientists don’t support Republicans, and the feeling is mutual. Today’s Republican Party doesn’t like science or scientists. It doesn’t like having its preconceived views challenged by appeals to evidence. It knows that very few scientists are on its side electorally. In general, it sees scientific research as a threat to its grasp on political power. Add in MAGA’s combination of rabid anti-intellectualism and allergy to any hint of criticism, and one has the makings of a drastic anti-science turn in policy. “Ignorance is strength” might was well be an official MAGA motto. And as I said, we aren’t talking about something that will happen over the course of multiple years: The U.S. scientific enterprise is threatened with severe damage, even collapse, over just the next year. There are many reasons to find this prospect horrifying: Think of all the beneficial advances, affecting almost every part of life, that won’t happen because U.S. science — still crucial to the world — has been eviscerated. But think, also, of America’s international standing. Can a nation that has forfeited its role as a leader, or even a contender, in global science, still be a Great Power? No. MUSICAL CODA
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FULL SHOW: Inside INdiana Business 4/5/26
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FULL SHOW: Inside INdiana Business 3/29/26
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Your Thymus and Your Healthspan
Our thymus gland plays a central role in the development or our immune system, specifically for supporting T cell development (how these cells got their name, maturation and differentiation in the thymus) and discriminating between self and foreign, non-self antigen proteins with production of dendritic cells. As we age, our thymus gland shrinks—the process known as involution—with progressive change from spongy to fatty tissue, with loss of functionality. But this process, with respect to timeline and extent, markedly varies from one person to the next. And to make things even more complicated, our thymus gland anatomy and precise location in the chest also is highly variable. So the famous Frank Netter diagrams from the 1960s (such as at left below) don’t capture the remarkable heterogeneity that a random set of 12 chest CT scans (below at right). What I consider as 2 landmark papers in Nature this week (here and here) used AI to quantify health of the thymus in 2 large cohorts, and then correlate the metric to a broad array of health outcomes. In this edition of Ground Truths, I’m going to cover three questions: (1) How was thymus health determined by AI?; (2) How is thymus health linked to key clinical outcomes? and (3) Are there ways we can promote a healthy (aka rejuvenate) thymus gland in our later years? Subscribe 1. How was thymus health determined by AI? This was accomplished by extensive work developing and validating an AI pipeline for 2 stages, the first for localization and segmentation of the thymus bed, and the second to quantify a digital marker, termed the thymic health score. There’s a lot to this algorithmic development, so I won’t go into all the details, but just provide a rudimentary outline of what was done. The 1st stage used supervised learning with 2 radiologists reviewing 2,461 chest CT scans. That work trained a 3D U-Net model to automatically identify the thymic bed’s 3D cropped region using center of mass coordinates, which reached 99.8% accuracy. The 2nd stage used a foundation model that was pre-trained with SwAV (which stands for Swapping Assignment between multiple Views), a self-supervised model, that generated a high-dimensional thymus representation of 4,096 features. That compares to the radiology reductionist and subjective scoring of 0 to 3 where 0 means the thymus is fully degenerated and fatty, and 3 is considered dense, intact glandular soft tissue. Notably, the self-supervised learning (SSL) performance was superior to supervised (AUC ~0.75 vs 0.55, respectively) reflecting the shallowness of the 0-3 classifier vs SSL’s holistic, self-taught AI. The thymic health score ranged from 0 to 100, with the highest number indexed to fully preserved thymic health. The algorithmic work extended to explainability with both Shapely value distribution, meaning the model was holistic not relying on any “magic” pixel, and occlusion sensitivity, demonstrating the model’s performance was not affected by ribs, sternum, lung tissue, but rather focused on the thymic bed directly. Below are a few saliency maps from the occlusion sensitivity that indicate the thymic bed focus, not affected by neighboring structures, using the jet color scale. Now the AI was ready for processing ~25,000 CT scans, each over 30 MB files, from the 2 large participant cohorts to provide a thymic health score, it did so in less than 14 hours, which is less than 2 seconds per scan! Share 2. How is thymus health linked to key clinical outcomes? The two cohorts were the National Lung Screening Trial, NLST (N=25,031) and the Framingham Heart Study, FHS (N=2,581) each with baseline demographics and long term follow up of >12 years for health outcomes. From the NSLT, you can see below that increased age and body-mass index were correlated to reduced thymic health. And, overall, men had reduced thymic health scores compared with women. There are a lot of graphs in the paper for outcomes, for both the NLST and FHS cohorts. To simplify the major outcomes, below is a composite Figure with striking reduction of all-cause mortality and for the different causes of death. The results were consistent between the 2 cohorts. For example, the cardiovascular mortality hazard ratio average was 0.57 in NLST and 0.38 in FHS (weighted to be 0.53 for the aggregate). The reduction of mortality also extended to digestive diseases and pulmonary disease (data not shown below). Lung cancer incidence was reduced by 36% for high vs low thymic health (Figure below, with a panel -incidence and b panel-mortality, adjusted for age, sex, BMI, smoking status). Notably, there was a smoker’s paradox: lower incidence and improved survival for lung cancer in smokers who had a high thymus health score. Smoking was associated with lower thymic scores whereas alcohol was not. Higher thymic health was linked to higher HDL cholesterol, lower triglycerides, lower fasting blood glucose, and lower systolic and diastolic blood pressure. Inflammation biomarkers, such as C-reactive protein and interleukin-6, were elevated in the people with lower thymic health scores. In their second paper, the same team looked at the relationship between thymic score and outcomes for 3,476 patients receiving cancer immunotherapy. The non-small cell lung cancer progression-free survival was reduced in patients with low thymic health score. A parallel relationship for survival was seen for other types of cancer including melanoma, breast, and kidney with a 44% lower risk among high thymic scores (Figure). A similar pattern was seen with different immune checkpoint inhibitors. The thymus health score outperformed programmed death ligand-1 (PD-L1)and tumor mutation burden (TMB) assay of the tumor and was an independent prognostic marker of progression-free survival. In this dataset, a direct connect with thymus score and adaptive immune function was noted with a correlation before cancer treatment for both T-cell diversity and thymus T-cell production (a metric known as T cell receptor excision circles). Thymus Removal Study There is a highly relevant citation about thymus function before moving onto ways to rejuvenate it. In 2023, a very important study of thymus removal during cardiothoracic surgery was published, with 1146 patients undergoing thymus removal vs 1146 matched controls (mean age 55 years). The adverse outcomes for thymus removal were striking, with a 2.9 higher risk of all-cause mortality and doubling of cancer incidence, 1.5 fold increase in cancer mortality, and 1.5-fold increase in autoimmune diseases. The immune function showed marked compromise after thymus removal, as reflected by CD4+ and CD8+ T cells (Figure below) Share Ground Truths 3. Are there ways we can promote a healthy (aka rejuvenate) thymus gland in our later years? In recent months we’ve learned a lot about the process of thymus involution and the pathways by which this may be modulated. Thymus involution is primarily due to loss to thymus epithelial cells (TECs) and there are 2 subtypes with different functions: the cortical, responsible for positive selection of T cells, and the medullary, for negative selection. When adipose tissue infiltrates the thymus, thymic adipocytes are pro-inflammatory, knocking out T-cell output. Likewise, systemic inflammation, or “inflammaging,” from smoking, obesity, and chronic stress promote thymic adipocytes. Now, from preclinical studies, we know about key pathways that account for these processes. Historically, back in 2014, FOXN1 was recognized as a single master transcription factor essential for TEC function, with studies in mice with forced FOXN1 upregulation leading to thymus regeneration. That laid the foundation for potential regrowth of quiescent thymus cells. It took awhile to find pathways to accomplish this goal and to even refute its role as the master regulator. The Liver-Thymus Axis Feng Zhang and his team recently showed that injection of an mRNA vaccine to the liver encoding DLL1, IL-7 and FLT3-L in combination, factors known to support thymopoiesis (Figure), successfully enhanced immune function in aged mice. However, the effect was transient. The FGF21 Story Two reports in 2025 addressed the thymus gland’s production of FGF21, a growth factor (fibroblast growth factor 21) and its control of thymus involution. This growth factor is also produced by the liver, but it doesn’t have impact on the thymus in aged rodent models. In contrast, The liver’s hepatocyte growth factor (HGF) has been shown to reverse senescent TEC structural changes. Growth hormone stimulates production of insulin growth factor-1 (IGF-1) in the liver and the thymus. Two small studies in human participants (TRIIM, for Thymus Regeneration, Immunorestoration, and Insulin Mitigation) of 6 and 50 people, respectively, treated with combined human growth hormone, metformin and DHEA, suggested the potential of slowing epigenetic aging and improving thymus mass and function. But the combination of drugs, small sample, and lack of controls make conclusions murky. Increased thymus FGF21 led to increased CD8 T cells in old mice and extended healthspan and improved physical performance. Building on the previous FOXN1 data, ablation of β-klotho, the obligatory co-receptor for FOXN1, accelerated thymic aging. The benefit to FGF21 was confirmed in a companion paper using an FGF21 knock-in mouse model showing thymus enlargement and increased TECs throughout the lifespan. (schematic Figure below). The accompanying editorial for these 2 papers speculated: “The proposed link between age-associated thymus involution and organismal aging is intriguing, and suggests we might seek to achieve systemic rejuvenation by counteracting thymic involution.” Other Factors Lessons from the Axolotl (Mexican Salamander) In an elegant set of experiments of the axolotl (Figure), known for its complete thymus regeneration after total surgical removal, mediators were identified. Surprisingly FOXN1 was dispensable. But midkine, a growth factor, appeared to be the driver, the initiator of thymus cell growth, survival, and repair. Other components that contributed were Postn+ (periostin-expressing mesenchymal niches) and Ccl19, a chemokine protein from the bloodstream. RANK and RANKL RANK (receptor activator of nuclear factor κB its ligand (RANKL) have been considered key regulators of medullary TECs. In a study of both aged mice and human thymus cell cultures, their key role was confirmed, with multiple benefits of resorting TEC function, recruitment of progenitor cells, and T cell development. Subscribe Summing Up This body of work strongly supports the health of the thymus gland as a critical regulator of human healthspan, not just a correlate or link. The new landmark studies are reinforced by the regenerative biology experimental models that have shown, via an array of mediators, that healthspan of aged mice is at least in part dependent on thymus gland function and its critical role for maintaining adaptive immunity. It sure seems that we’d be better off having an immune reservoir of naive T cells instead of a profile in older adults of exhausted, low quality, memory T cells, with a senescent phenotype. It is striking that we ignored the importance of the thymus gland for many decades. A wake-up call was the results of the thymectomy matched control study reviewed here, with the opposite of high thymic health score improved health outcomes. The convergence of AI and healthspan here is notable. The exceptional and laborious work for developing and validating (no less explaining) the AI to quantify thymus health set the foundation for probing the connect the major health outcomes in two cohorts with extensive follow-up. We’ve never had a way to meaningfully quantify the thymus gland before, so this represents important leverage of supervised, self-supervised, and transformer models. The study wouldn’t have been possible without AI. And it begs the question as to whether there are ways we can maintain our thymus at a high health score. But it’s not so simple to rejuvenate our thymus. There are multiple risks including the induction of autoimmunity, increasing the risk of cancer, and inducing a pro-inflammatory state. For example, factors that increase TEC proliferation could compromise the medulllary negative selection process and leak out auto-reactive (self-attacking) T cells. Thymic cells could be induced to proliferate, but we know, for example, that growth hormone and IGF-1 are associated with an increase risk of cancer. If thymus rejuvenation doesn’t clear out the accumulated senescent cells in older adults, then inflammation within the gland could block the production of TECs. Keeping these risks in mind, we now have identified many ways to keep our thymus healthy as we age that undoubtedly will be tested in clinical trials going forward. Ultimately, the benefit-to-risk tradeoffs will be defined. In the meantime, we have desperately needed an immunome. As I’ve stressed in multiple prior Ground Truths, we have no test in the clinic to assess a patient’s immune status! It was very encouraging for me to get an email from Hugo Aerts, the senior author of the landmark papers in the days after they were published: “I also wanted to say that your Substack on “Why We Need an Immunome” was inspiring for this work. We found it a very compelling perspective and greatly enjoyed reading it.” Just having an assessment of a person’s immune status via a chest CT scan, with millions of these performed per year, might help in guiding the right immunotherapy for cancer (e.g. more intensive, combinations for those with low thymic health scores) and help define people who are increased risk for age-related diseases of cancer, cardiovascular, and neurodegenerative. The main theme of Super Agers is that we now have many layers of data (genetics, proteins, biomarkers, organ clocks that can be integrated via multimodal AI) for us to define a person’s specific risk decades before one of these age-related diseases leads to symptoms, enabling prevention. From the new studies this week, we can add thymus health score as yet another way to understand a person’s risk, a window into their adaptive immune system and healthspan. And perhaps someday we will be able to safely rejuvenate the thymus, or maintain its health through one’s life, and use the thymus health score to monitor. NB: I wrote this post (No A.I.) A Quick Poll Loading... ********************************************************************* Thanks to Ground Truths subscribers (now > 200,000) from every US state and 212 countries. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. Please join! If you found this interesting PLEASE share it! Share Ground Truths Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don’t hesitate to post comments and give me feedback. Let me know topics that you would like to see covered. Leave a comment Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years. It enabled us to accept and support 47 summer interns in 2025! We aim to accept even more of the several thousand who will apply for summer 2026.
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