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Pearl Health Raises $110 Million to Expand Its AI Platform Helping Providers Deliver Better Outcomes at Lower Cost for Medicare Patients
/PRNewswire/ -- Pearl Health, a healthcare technology company helping manage risk and deliver better care to Medicare patients, today announced a $110 million...
Shohei Ohtani hits 300th career home run
While Tuesday’s contest against the Colorado Rockies produced a more disappointing outcome compared to Monday’s walk-off, Shohei Ohtani started off the game with a historic blast. Ohtani smacked a leadoff home run against Michael Lorenzen on Tuesday, which was not only his 25th leadoff home run as a Dodger, but the 300th home run of […]
National report: Oregon great for giving kids health insurance, bad for teaching them how to read
A new national report finds mixed outcomes for child well-being in Oregon and Washington.
Make the Business Case for Your Sustainability Initiative
Sustainability proposals often stall not because they lack merit, but because they are framed in a language that does not match how senior leaders allocate capital. While CSOs tend to emphasize impact, materiality, and disclosure, CFOs and CEOs need to understand cash flow, risk, and return. External reporting frameworks are useful for accountability, but they are poorly suited to internal investment decisions, which require project-level comparisons rather than aggregated enterprise metrics. Sustainability investments should therefore be evaluated like any other investment: by showing how they reduce current costs, avoid future costs, generate new revenue, or protect existing revenue. Strong cases begin with a clear business story that links the proposed action to a specific business impact and cash-flow outcome, then quantify what can credibly be quantified while treating harder-to-measure benefits as either upside or an explicit strategic bet.
Integrating Behavioral Health Into Value-Based Care
Learn how a primary care–anchored model can improve behavioral health access, outcomes and value-based care performance
Colorado primary election voters shake things up
Every election has its surprises, but last Tuesday’s Colorado primary election results gave us several unexpected outcomes. U.S. Sen. Michael Bennett lost his bid to switch from the U.S. Senate and become Colorado’s next governor. Meanwhile, progressive Democratic U.S. Rep. Diana DeGette, from Denver, who had served 30 years in the U.S. House of Representatives, […]
Dangers of youth using AI for mental health care
A nationwide study finds more and more teens are using A-I to replace mental health professionals. It’s led to some scary outcomes, even tragic endings. NBC 7’s Shandel Menezes sat down with some teens to hear what type of support they need.
Heart health and heat: How hot is too much?
As temperatures rise, so does the risk of dangerous outcomes
Mamdani’s politics of joy: What can Arkansas politicians learn from New York’s jubilant mayor?
Zohran Mamdani’s first half-year in office has been a mixed bag when it comes to policy outcomes. There is, however, one area of unquestioned success for the NY mayor: the forging of a sustained politics of joy unmatched by that of any major American politician in recent decades.
Microsoft Frontier Company: AI engineering that amplifies and protects your intelligence
The pace of AI adoption is moving incredibly fast. Customers have moved well beyond experimentation and understand the importance of adopting AI to transform their business. They are now concentrating on delivering measurable business outcomes and demonstrating a return on their AI investments, while ensuring their intelligence is amplified and their IP is protected. Today...
Bonus 236: A Term of Self-Inflicted Wounds
Within minutes of the Supreme Court handing down the birthright citizenship ruling on Tuesday and rising for its summer recess, its defenders were pointing to that decision (alongside the late-arriving mail-in ballots ruling on Monday and the tariffs ruling from February) as decisive proof that the Court really is “above politics,” and that criticisms of the justices for behaving more like politicians in robes than like judges are thus unfair. For a particularly thoughtful version of this claim, see Professor Will Baude’s opening response to the latest New York Times written roundtable about the Court with Baude, Professor Kate Shaw, and me. In that roundtable, I already offered one of the two major arguments against this thesis—that it’s an assessment of the numerator without regard to the denominator, and that a full account of the Court’s behavior throughout OT2025 suggests that the Court behaved even more politically during the current term than during even the previous (highly politicized) one. Just to take one of many data points, last term (OT2024), there were six rulings in argued cases in which all six Republican-appointed justices were in the majority and all three of the Democratic appointees were in dissent (along with a slew of such rulings on the emergency docket). This term, there were … 13. (Along with two 6-3 summary reversals and 10 rulings on the emergency docket from which the three Democratic appointees all dissented.) Today’s bonus issue addresses the flip side of that coin. In particular, below the fold, I identify four different moments in which the justices could have acted in ways to specifically defuse charges of political behavior—and opted instead to lean all the way in. As much as end-of-term narratives focus on what the Court did, and on the takeaways from individual rulings, consider today’s post an attempt to identify opportunities that the Court missed, as well. At least in the examples discussed below, by opting for the outcome that made the Court look more transparently political, the Court inflicted a series of (unnecessary) credibility wounds on itself. For those who aren’t paid subscribers, we’ll be back Monday with our regular coverage of the Court. For those who are, please read on.
Applications Opened July 1 for Wyoming's Rural Health Transformation Funding
CHEYENNE, WY – Today, the Wyoming Department of Health (WDH) announced the opening of Requests for Applications (RFAs) for Wyoming’s Rural Health Transformation Program, a major initiative designed to strengthen healthcare access, improve health outcomes, and support innovative solutions for rural communities across the state. The funding opportunity represents an important step in implementing […]
ACCESS Model: behavioral health edition
A new value-based care program for chronic condition management begins July 5. | A new payment model is designed to pay digital health companies based on outcomes in chronic condition management. But where does behavioral health fit? This episode explores that question with SonderMind and Headspace, two companies participating in the model's behavioral health track.
Yankees ‘Run It Back’ Offseason Plan Receives Interesting Take
Coming into the 2026 MLB season, there was some concern about the New York Yankees, as they decided to "run it back" over the offseason following a disappointing postseason outcome.
The Four Business Outcomes That Break When Enterprises Stop Validating Their Defenses - SPONSOR CONTENT FROM AWS AND TERRA SECURITY
Sponsor content from AWS and Terra Security.
Recent Research on How Experiencing Racial Discrimination Impacts Health
This brief provides an overview of the relationship between racial discrimination and health and highlights research examining mechanisms underlying health outcomes linked to experiences of racial discrimination, including biological changes, chronic stress, mental health, substance use, pregnancy-related outcomes, and sleep.
Oil falls as investors focus on potential Iran-US talks in Doha
Oil prices dropped on Tuesday, with investors eyeing the outcome of potential U.S.-Iran talks in Doha amid weekend missile fire from both sides that tested an interim ceasefire to end the four-month-old war.
Netflix and Superheroes Are Having a Rough Stretch on Streaming....
(Welcome to my weekly streaming ratings report, the single best guide to what’s popular in streaming TV and what isn’t. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. If you were forwarded this email, please subscribe to get these insights each week.) I have a quick prediction before we start today’s article: You might see this data in future news articles. Not my specific charts or analysis, but the core trend I’ve been monitoring—Netflix is having a lackluster Q2—will become inescapable. Often, folks want to know “What does the data say?” Well, that’s what it says. I haven’t seen this analysis hit the trades really yet, but I have a feeling some other outlets are going to start making this case soon. Remember, you read it here first. You probably have read about the problems facing superhero films at the box office this weekend. Well, this week, I explore whether superheroes are dying on TV as well! And the data says: definitely maybe! We have a lot to cover in today’s Streaming Ratings Report, which covers the two weeks of 18-May and 25-May. Today, I’m just looking at TV, like Netflix’s disappointing Q2, superhero shows underwhelming, a few TV shows dropping off the charts, The Pitt finally ending its epic run on the viewership charts (and whether “view counts” change its status as one of the biggest shows of all time), all the flops, bombs and misses, and a whole lot more. Tomorrow, I’ve got a great rundown of the film side of things. Let’s dive right in! (Reminder: The streaming ratings report focuses on the U.S. market and compiles data from Nielsen’s weekly top ten viewership ranks, Luminate’s Top Ten Data, Showlabs, TV Time trend data, Samba TV household viewership, company datecdotes, Netflix hours viewed data, Google Trends, and IMDb to determine the most popular content. While most data points are current, Nielsen’s data covers the weeks of May 18th to May 31st, 2026. You can find a link to my terminology here.) Subscribe Television - Netflix’s Q2 Slump Continues Having analyzed streaming ratings for going on half a decade, I have learned to trust my gut, but I’m always relieved when I can find actual data to back it up. For example, after a string of very popular shows like Stranger Things, Bridgerton, The Lincoln Lawyer and The Night Agent came out, week after week, in January and February, my gut wondered if Netflix had enough new and returning TV shows to sustain them throughout the year. Since then, Netflix’s post-March slate of shows has not impressed me. This week seemed to feature a potential new hit, but then, like a classic Duffer Bros. TV show, there was a twist. I speak of The Boroughs, Netflix’s latest (and last) Duffer Bros. produced show. The pitch is “Stranger Things with older actors”. And it topped the Nielsen charts: With just two weeks of viewership, The Boroughs would have been a top 25 debut show last year: But here’s the twist: Netflix has already cancelled The Boroughs! What happened? Likely a few things. First, the show didn’t do as well globally as it did in the US. As What’s on Netflix showed, it lagged behind several other shows that got cancelled. Second, its completion rate was likely low; after an initial burst of interest, it quickly dropped off on the Samba TV and Luminate charts. Third, the Duffer Bros. left Netflix for Paramount, and that may have factored into Netflix’s decision here. (Though I tend to believe that if a show is doing well, Netflix would have kept greenlighting seasons.) Still, just because I can explain why Netflix may have cancelled this show doesn’t mean I’m justifying it. In particular, as I’ve noted before, Netflix is losing a lot of their bigger shows as they reach their natural ends, and they need to replace those shows. This show had the hallmarks of a big new genre show, and it’s their biggest hit of the last few months (in the US at least), but now it’s done. Netflix’s other show this week—The Four Seasons, the second season of the “hit” show from last year—definitely disappointed. Its sophomore season had about half the viewership of the first, only 12.7 million hours. It also only had a two week run on Samba TV, and its numbers were all down on Luminate too. In other words, even with two successes, the Q2 slump for Netflix looks real: I could add to the list of disappointments: Both Lord of the Files and Man on Fire had short runs on the Nielsen charts. Running Point’s sophomore season also opened to about half its viewership, similar to The Four Seasons. A Good Girl’s Guide to Murder’s second season—see below—didn’t even make any of the three viewership charts I track, unlike the first season. Netflix is absolutely having a dismal second three months of 2026. If this Nielsen data is any indication, and I think it is, I think this will show up in Netflix’s engagement report, and maybe even their financial outcomes. And the rest of June doesn’t look much better. We have two hit shows coming back—Sweet Magnolias, one of their quietest big shows, and Avatar: The Last Airbender, a big hit for them in 2024—but the other big swings are limited series crime thrillers i.e. no future season potential. Like I said above, sometimes when I uncover a juicy nugget like this, other outlets end up writing very similar articles mimicking the data without credit. We’ll see if that happens this time! Share Television - The State of Superhero Shows on Streaming When I first heard the pitch for Spider-Noir—a Sony TV show on Prime Video that binge-released eight episodes first on MGM+ then on Prime Video two days later—I had my doubts. It’s a live-action Spider-Man show set in the 1930s, starring Nicholas Cage, based on a cameo of a character in Spider-Man: Into the Spider-Verse. No, seriously, that’s the pitch. That could either go terrifically well or horribly wrong. Great because, Spider-Man. He’s the biggest superhero we have. I’ve seen tracking numbers that put the new _Spider-Man: Brand New Da_y as the blockbuster of the year and initial pre-sales back that up. And yet this Spider-Noir pitch feels very esoteric. (Also, the eight-episode binge release feels very “Amazon copying Netflix” again.) So what’s the data say? And what does this say about the future of superhero shows?
Clients push consultants to adopt outcome-based fees to share in risk
Consulting giants like BCG and Accenture are shifting from fixed rates to outcome-based fees as clients push them to share the risk of AI integration.
A Doctor At Home: The Rise Of Ambient Home Health Monitoring
There is significant opportunity to improve long term health outcomes with ambient home monitoring.
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.
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
Design and Early Implementation Outcomes of a Mobile Health-Enabled Social Support Intervention for Adults Living With HIV and Type 2 Diabetes in Uganda
Background: Adults living with HIV and type 2 diabetes experience complex treatment demands that affect medication-taking, clinic attendance, privacy, social support, and engagement with care. M...
A lack of funding, a glut of stigma: How Ohio LGBTQ+ health outcomes are impacted
Being able to access healthcare in general is a struggle for LGBTQ+ individuals, and with legislation in Ohio and elsewhere that banned gender-affirming care for minors, for example, a need for healthcare can often clash with the hesitation to seek help.
Consumer-Directed Health Care: Promise or Pitfall
This panel will examine the evidence and policy outlook for consumer-directed health care as a federal solution to expanded coverage, with a focus on affordability, access, and health outcomes.
From Linchpin to Lever — Part 1: Measuring Trust in Public Health
Learn how local health departments can measure public trust using existing public health tools to strengthen relationships and improve community health outcomes.
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.
Mental health as both outcome and determinant in climate adaptation
Nature Climate Change - Mental health should not be viewed solely as a passive outcome of climate adaptation. Rather, it serves as a key determinant of cognitive capacity and shapes the...
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.
Another look at carrots and eyesight; how to get more fiber; why mosquitoes bite some people and not others; plus other stories with Vanderbilt Health sources
AARP reporter Stacey Colino interviewed Milam Brantley, MD, Associate Professor of Ophthalmology and Visual Sciences, in 2020 for a story about whether eating carrots can improve vision. Sacramento Bee reporter Samantha Agate has now used Brantley’s comments in an AI-curated story created by content specialists on the same topic that has been picked up by MSN and others. Prevention magazine interviewed Heidi Silver, RD, PhD, Founding Director of the Vanderbilt Diet, Body Composition, and Human Metabolism Core, for a story about the importance of fiber and how people can get more of it in their diet. William Schaffner, MD, Professor of Preventive Medicine, was quoted by several news outlets about public health issues, including: Women’s Health (tick bites and alpha-gal syndrome); The Washington Post (tetanus); and Healthline (why mosquitoes prefer to bite some people and leave others alone). A visit to Monroe Carell Jr. Children’s Hospital at Vanderbilt by some Banana Ball baseball players was covered by The Tennessean and WZTV Fox 17 News, and The Tennessean’s story was also picked up by Yahoo! Sports. Clarksville Now published a story written by the Montgomery County Economic Development Team, whointerviewed Bradley Stancombe, MD, professor of Clinical Pediatrics, Vanderbilt Neonatology, about the new energy of Vanderbilt Clarksville Hospital and how the facility is recruiting physicians. Healio Allergy/Asthma group editorial director Richard Gawel interviewed Mark Rolfsen, MD, Clinical Fellow in the Division of Allergy, Pulmonary and Critical Care Medicine, for a story about his presentation at the American Thoracic Society meeting on metal health outcomes following ICU discharge. Nashville Scene reporter Hannah Herner interviewed James Crowe, MD, Director of the Vanderbilt Center for Antibody Therapeutics, for a story about his efforts to prepare for the next pandemic by isolating antibodies that can neutralize dangerous viruses. Medscape reporter Kathleen Doheny interviewed Neesha Choma, Associate Chief of Staff of Vanderbilt University Hospital, for a story about how hospitals can reduce readmissions.
A lack of funding, a glut of stigma: How Ohio LGBTQ+ health outcomes are impacted
For the 1 in 10 Ohioans who identify as LGBTQ+, media representation and social acceptance may have improved, but stigma and discrimination still impact them in large aspects of their lives, including healthcare access.
Healthcare Providers Look Beyond Price To Deliver Better Value
A new approach to procurement promises to not just produce much-needed cost savings but also improve outcomes for patients.
New Office at SBU Links Climate, Community and Health
Stony Brook's new Office of Health Equity and Climate Medicine Research brings together groups to better understand how the environment shapes health outcomes.
Los Angeles Business Journal Names Kristen Cerf CEO of the Year
This recognition reflects Cerf’s leadership and the collective commitment across the Blue Shield Promise team to improve health outcomes and expand access to care.
Opinion | Michigan has a strong maternal, child health budget. We can’t afford to lose it
Strong maternal and child health systems require sustained commitment. Programs that improve outcomes only work when families can count on them being there.
HRSA Announces Maternal Health Grant Opportunity
The grant will support produce prescription programs that aim to improve nutrition access and health outcomes for pregnant and postpartum patients and their families.
Books for Better Health: Can Parent Beliefs About Reading Affect Health Outcomes?
A new research study looking at shifts in parental beliefs about books, reading frequency, and health outcomes was launched at a free Scholastic book at Yale
A New Bill Would Ban Lawmakers From Betting on Politics and Elections in Prediction Markets
CNBC’s Emily Wilkins reported last week that House lawmakers have introduced legislation that would prohibit members of Congress, their spouses, and dependent children from placing wagers in prediction markets on political, policy, or election outcomes. “House lawmakers are just dropping a brand new bill that would ban lawmakers from making any bets in prediction markets ... A New Bill Would Ban Lawmakers From Betting on Politics and Elections in Prediction Markets
Employer Priorities: Advancing Organizational and Employee Health
Employers are uniquely positioned to drive internal and external change and meaningful outcomes for employees, their businesses, and surrounding communities thr
Poll: Americans draw a new line in the betting bonanza sweeping over Wall Street
A plurality of Americans believe betting on election outcomes should be illegal, The POLITICO Poll finds.
There are higher colon cancer rates among people of Cajun descent. Here’s what doctors are doing to help.
Learn about the significance of colonoscopies in detecting and preventing colon cancer, especially in high-risk populations like the Cajun community in Louisiana. Early screenings can save lives and improve outcomes.
New Listening Mothers survey: Pregnant patients struggling on Medicaid
A national maternal health survey found many mothers felt unheard during pregnancy and birth, with Medicaid patients reporting worse outcomes.
Conservatives are dying at higher rates than liberals. A new study points to mistrust in medicine
The health divide emerged over the last decade and has widened since 2020, according to research that links ideology to outcomes from heart disease, cancer, stroke, and other internal causes.
Video: A Small Election Could Change British Politics
Voters in the northern English district of Makerfield cast ballots on Thursday to choose their representative in Parliament, the outcome of which could lead to Prime Minister Keir Starmer’s ouster.
NM spent nearly $844M on behavioral health, but 'investment is not yet matching the outcome'
New Mexico has spent $843.5 million since 2022 to rebuild state’s behavioral health system but still faces problems.
Time, Outcomes, Adoption, Cost: The Four Metrics Redefining Digital Health
Despite rapid innovation, many healthcare organizations still struggle to translate new care models into system-wide impact.
How good (or bad) can it get? The best- and worst-case scenarios for every NFL team in 2026
Can the Cowboys finally break through? Will Patrick Mahomes regain his MVP form? Here are the dream and nightmare outcomes for your favorite team this fall
Merchants of Doubt and the attacks on Extreme Event Attribution science
Last week, I attended a meeting at Columbia University on attribution science and climate law, hosted by the Sabin Center. It was a fantastic event, bringing together scientists and legal experts working at the intersection of extreme event attribution and climate law. Subscribe For those unfamiliar with it, extreme event attribution attempts to quantify the contribution of climate change to an extreme event. For example, several groups analyzed the impact of climate change on Hurricane Harvey’s enormous rainfall totals over Houston, Texas and they found that climate change increased rainfall by 15 to 38%. One thing that came up again and again was how terrified fossil-fuel interests are of extreme event attribution science. They are acutely aware that this research could land them in court. And losing those cases would leave them legally liable for billions of dollars in climate damages. Because the legal stakes are so high, the blowback has turned ugly. I spoke with several scientists at the meeting who are facing ongoing harassment over their work. This blowback is a coordinated campaign to make the entire field look suspect. The goal is to create the impression that attribution science is too uncertain, too political, or too conflicted to be useful in court or in public policy. The strategy is not based on actual science or evidence of misconduct, but on the generation of doubt. The new Merchants of Doubt We’ve seen this before. In fact, not that long ago: We only have to go back a year to the Department of Energy (DOE) Climate Working Group (CWG) report to see an example of using doubt as the tool to push back against well-established science. This strategy is laid out in an email from a member of the CWG, Dr. Roy Spencer, that was released during litigation over the Climate Working Group process. The key quote is: About all I can hope is that what we write will provide sufficient “reasonable scientific doubt” regarding the science claims in the 2009 TSD [technical support document], based upon almost 2 decades of new science, to call into question the original reasoning for the EPA Administrator’s decision that CO2 presents a threat to human health and welfare. This statement is strong evidence that at least some members of the committee were working to support a particular policy outcome: revoking the Endangerment Finding. The email also explains how they planned to do it: by attempting to generate “reasonable doubt”. This is going to be hard, Spencer implies. Despite falsely claiming that “2 decades of new science” weakens the case, Spencer explicitly acknowledges that the actual peer-reviewed science of climate change overwhelmingly rejects his position: But if the science argument is decided upon by a vote, or by the number of published citations, we lose the science argument. We can go back even further: This CWG email shares unmistakable DNA with the infamous 1969 tobacco memo that declared: “Doubt is our product, since it is the best means of competing with the ‘body of fact’ that exists in the mind of the general public. It is also the means of establishing a controversy.” The tobacco memo also acknowledges the limit of this strategy: Like the CWG, they knew the science was not on their side. Share The new new Merchants of Doubt The people attacking the IPCC chapter on extreme event attribution are the newest iteration of the Merchants of Doubt. Their goal, like all Merchants before them, is to introduce doubt into the process. Because the report is not even out yet, they cannot attack its conclusions. So they are attacking the authors instead. Here is a press release from the House Science, Space, and Technology Committee: In the letter, the Chairmen express concerns about potential conflicts of interest involving members of the Attribution Committee, stating that “publicly available information suggests a troubling pattern” in which committee members are affiliated with nonprofits that support climate accountability lawsuits, “raising the appearance of impropriety and member bias.” To be clear, this is just innuendo. There is no actual evidence of bias. And given the robust process that these reports go through, including multiple lines of peer review, it seems very unlikely that significant bias can survive into the report. When the report comes out, critics will have the opportunity to make legitimate criticisms of the report — if any exist. If none do, however, they’ll still make criticisms, but they’ll be bogus, simply designed to generate doubt. We’ll see. A note to the press: Fix your frame To any journalists reading this: The public debate over extreme event attribution science is not going away. The science is simply too dangerous to fossil-fuel interests for them to stop fighting it. You very well might be assigned to write an article about this area of research in the future. When you do, do not automatically adopt the framing that climate misinformers want you to use. They want you to frame the story around questions like: Are climate scientists trying to put their thumb on the scale to achieve a predetermined, politically motivated result? Are climate scientists improperly letting their politics invade the science of the IPCC? That frame is a trap. Instead, you need to view this through the historical lens of the Merchants of Doubt. How does the ecosystem of doubt operate? Who funds it? What methods do they use to misrepresent science and slime researchers? What scientific results are they trying to keep people from understanding are legitimate? Ultimately, you instead need to focus your article on the generation of doubt as a way to maintain the fossil fuel industry’s social and legal license to keep burning oil, gas, and coal. If you treat the misinformers’ frame as a legitimate, good-faith scientific critique, you are helping them produce doubt. Don’t do it. Don’t be a Merchant of Doubt. Thanks for reading The Climate Brink! Subscribe for free to receive new posts and support our work. Subscribe other stuff The Staying Curious Substack has an interesting post about the different flavors of climate sensitivity. This is crucial information if you want to understand how scientists think about how much warming the Earth will experience. I’d be grateful if you could hit the like button ❤️ below! It helps more people discover these ideas and lets me know what’s connecting with readers.
Health Outcomes Data For Wearables Key To Medicare Coverage Expansion
Insurance coverage of wearables is spotty. This could soon change as Medicare begins a pilot to facilitate access to wearables while gathering data on health outcomes.
Apptio Unveils Conversational Insights and New Suite of AI-Powered Capabilities to Translate Complex Technology Spend into Measurable Business Outcomes
Apptio announced significant updates to its solution suite designed to turn technology investment into measurable business outcomes and establish best practices for the financial governance for AI in a time of record infrastructure investments.
Turner on Addressing Poor Mental Health Outcomes of Black and Latino Boys
Assistant professor of social welfare David C. Turner III argues that still more needs to be done to address the structural issues impacting the mental health outcomes of Black and Latino boys
From Managing Processes to Driving Outcomes: Oracle’s Latest AI Push Aims to Rewire Business
With a new class of enterprise applications that execute end-to-end processes, Oracle is showing how enterprise software has evolved from tracking work to driving outcomes.
Why Marketing Feels Harder as Your Business Grows by Nathan Tayloe
At some point, most growing businesses hit the same moment. What used to feel straightforward starts to feel more complicated. Marketing takes more effort. Results feel less predictable. What once worked consistently begins delivering mixed outcomes. It is easy to assume something is broken. In many cases, nothing is. The business has simply reached a different stage. What Worked Before Starts to Lose Its Edge Early on, growth is often driven by a few things working well at the same time: Referrals are strong The value of the offering is clear The team is aligned Decisions are made quickly Marketing, in that stage, tends to feel easier because the business itself is easier to understand. As the company grows, that simplicity fades. The audience expands. Services evolve. New people join the team. More channels are added. More decisions are made across more touchpoints. Marketing is no longer communicating one clear story. It is trying to represent a more complex business. Complexity Creates Friction That added complexity does not always show up immediately. It builds over time. Messaging starts to drift. Different parts of the business describe what they do in slightly different ways. The website no longer reflects how the company actually operates. Sales conversations evolve faster than the brand. At the same time, more activity is introduced to try to keep growth moving: New campaigns More content Additional platforms More tools and reporting The volume increases. The clarity does not always keep pace. That is when marketing starts to feel harder. It’s Not a Lack of Effort Most teams respond to this stage by doing more. More output More meetings More adjustments More experimentation That effort is not misplaced. It is often pointed in the wrong direction. When the underlying issue is a lack of alignment, more activity tends to create more noise. Results become harder to interpret. Decisions take longer. Progress feels inconsistent. From the outside, everything looks active. From the inside, it feels less certain. The Real Shift As businesses grow, marketing becomes less about execution and more about alignment. The companies that navigate this transition well tend to refocus on a few fundamentals: A clearly defined audience A strong, consistent position in the market Messaging that reflects how the business actually operates Alignment between leadership, marketing, and sales When those elements are in place, execution becomes more effective again. Marketing does not necessarily become easier, but it becomes more consistent. A Different Kind of Discipline Growth introduces more opportunity, but it also demands more discipline. What worked when the business was smaller often cannot be scaled without adjustment. The systems, messaging, and decision-making that once felt intuitive need to become more intentional. That is not a sign of failure. It is a normal part of growth. Marketing feels harder because the business has become more complex. The solution is not to outwork that complexity. It is to bring clarity to it. The companies that do that well tend to regain momentum quickly. Those who do not often stay busy without seeing the same level of progress. — Learn more about how we help organizations align strategy, brand, and execution. Visit tayloegray.com, or reach out directly at nathan@tayloegray.com.
Report finds deep racial and ethnic health disparities in Texas
We examine the Commonwealth Fund report's findings and what they reveal about health care access, affordability and outcomes across Texas.
'Let the candidates mix it up.': Ron DeSantis keeps pressure on Evan Power for GOP gubernatorial debate
'These ridiculous criteria are being used to renege on that promise and to engineer a preferred outcome.'
In Retrospect: Poland, Russia, Europe
In April I spent a few days with Zryw, a Polish non-profit organization that recruits young people to enter politics and public life. Their aim is to build a new generation of civic leaders in Poland. I’ve followed their evolution from the beginning; my son is one of the founders. (“Zryw” means “impulse” or “burst of speed” in Polish). Julie Chmielewska, one of Zryw’s leaders, interviewed me at the event. Here is the conversation, lightly edited for grammar and context: Julia Chmielewska: Assuming that culture shapes institutions, could we conclude that some cultures are more prone to authoritarianism? Anne Applebaum: I don’t think so. Every culture, every nation, and every country has the potential for change. When we look at history, we can see that nations do change. Poland has changed, for example, from the 1980s to today. There’s a completely different mentality here than the one I encountered when I first visited, in 1988. The current generation sees the world through a different frame. So no, I don’t believe that certain nations are doomed to authoritarianism, or to anything. Of course, there are political and cultural traditions, but they can always be challenged. JC: So do you think there’s something intrinsic in human nature that pushes people to democracy, freedom? AA: I think there is something in human nature, a deep instinct, that pushes people towards freedom, yes. People who live in authoritarian countries – and I’ve heard this from them over and over again – sooner or later find themselves angered by a feeling of helplessness. They can see the unfairness of crooked courts, irrational political decisions. They naturally dislike the fact that somebody has all the power while they have none. In those circumstances, people who have no political background at all sometimes are politicized just by that frustration. I’m thinking of Svetlana Tikhanovskaya, for example, who was a Belarusian housewife, until the circumstances of her husband’s arrest forced her to become a politician. I met a woman who is a Uyghur from China, and who had come to live in Turkey. After several of her family members were arrested, she too was propelled into a political role. These kinds of experiences make people interested in democracy or political reform, even if they thought they didn’t care. I also think that the opposite is true: some people instinctively prefer homogeneity, order, hierarchy. They don’t like the confrontation of opinions or the noise of debate, and they lean towards a single leader or a unified regime. I think that most of modern history is shaped by the clash between those two different sides of human nature. JC: Which force do you find more powerful today? AA: I think they both have a lot of power and there’s no way of predicting who wins. Even in countries that seem very shut off or stuck in an authoritarian system can change. We’ve seen that happen. And vice versa, I think democracies can also begin to fail and slide into authoritarianism. So it’s very important not to be complacent in either direction. JC: I want to go into your history and your experiences. You’ve lived in Russia during a time of incredible change in the late 80s, and then you came back to do research in post-Soviet Russia. AA: I was a student in Russia just before the collapse of the Soviet Union. I then traveled and worked there extensively in the 1990s, and I met people who really were full of hope. They hoped that Russia could become a democracy, or at least a place that guaranteed freedom of speech, freedom of the press. These weren’t ideas that came from Washington. Although now the narrative in the Kremlin is different, I met many people who were working towards exactly that kind of transformation. A friend of mine ran a series of seminars – once a year, and then later several times a year, in cities all over Russia – designed to get people to discuss politics in new ways. She invited young politicians and journalists, as well as foreigners. I went to many of them, in Moscow as well as Volgograd and Novosibirsk. Over two decades, hundreds of people came to these seminars, and all of them wanted Russia to be different. I remain convinced that many Russians still want Russia to be different. It’s just that the old system, in the form of Putin, a representative of that system, returned. The KGB reimposed their power. And this wasn’t because of something to do with culture, this was to do with money and politics, and who was in charge. JC: You’ve partially answered my question... I wanted to ask whether that excitement of the 1990s was an exception from the Russian historical norm which has been rather authoritarian? AA: Of course, if you look at the history of Russia since the 18th century, there have always been liberal groups, reformers and revolutionaries. There were the Decembrists, in the early 19th century, and the rural populists later on, who tried to organize the peasantry. A significant group of liberal Russians appeared at the turn of the 20th century, people like the father of the writer Vladimir Nabokov, who was a Russian politician before the revolution. These groups were small in number, but sometimes had a broader significance. The Russian dissident movement in the 1950s and 1960s actually invented the modern human rights movement. It was their idea to hold the leaders of the Soviet Union accountable for the language they used, to remind them of the treaties they had signed and the promised they had made. They created the Helsinki group, for example, that held Soviet leadership to the language of the Helsinki Treaty, which formally ended the Second World War and which contained guarantees of human rights, at least on paper. That idea spread to Eastern Europe, and similar tactics were used here in Poland. (Benjamin Nathans recently wrote a great book about the Soviet dissidents, To the Success of Our Hopeless Cause) JC: But seemingly, even if they do ever get power, they could never hold on to it. AA: We don’t know, because they have never really had power. But in any case, we also don’t know what will happen in the future. There is no reason to assume that Russia will forever be condemned to totalitarianism. Even during the first fifteen years of Putin’s regime there was some form of democratic politics. Only when the full-scale war began did he bring everything to an end: he shut down all remaining independent organizations and killed his most important opponent, Alexi Navalny. But does that mean he is popular, that he enjoys legitimacy? Even now, we don’t really know what Russians think about him, or about the war. There is no way of doing real polling in Russia because nobody will answer an independent pollster over the phone. JC: Do you think that the flock of young people, especially young men, who fled Russia after the start of the war represent a continuation of liberal movements that refuse to partake in the authoritarian state, or do you think they are moving for the sake of self-preservation – “I don’t want to go to the army, so I leave”? AA: I’m sure it’s both. I actually know many people who left Russia for political reasons either in the very last years before the war, or else just after the war began. JC: And do you see a change in the young generation versus the old one that have fled? AA: It’s hard for me to say because the people who I know were mostly already politicized. I do know some younger people who left, but most of them were already either active in the opposition, or working as journalists. Many of them very self-consciously think of themselves as maintaining Russian culture abroad, just as in the 20th century the Soviet dissidents or the anti-communist White Russians once thought of themselves as people who maintained the true Russian culture, outside of Bolshevik Russia. JC: Let’s move on to Poland. One of your first experiences with Poland was reporting on Margaret Thatcher’s first state visit, in the autumn of 1988. You followed her around the farmers’ market. AA: She was making a symbolic gesture. She wanted to welcome free markets, but the only one she could really visit was the farmers’ market at Hala Mirowska. JC: And I want to talk about this area because today you can look out of any window in that district, Mirów, and see rows and rows of skyscrapers. How does it feel to see a country built from the ground in such a short time, both politically and economically? AA: You know, when you’re living in a period of dramatic change, it’s always hard to know whether the change is positive or negative. The transformation in Poland created winners and losers, as well as new classes of people, new political movements of different kinds. At the time, it sometimes just felt like turbulence. Now, we can look back at the 1990s and early 2000s in Poland and see in retrospect that the country was headed in towards prosperity and European integration. In around 2009 or 2010, I remember speaking to a woman who worked cleaning government offices, and who asked me if her daughter should study in Amsterdam or in London. This seemed to me to be a real transformation, and it happened very fast: within a few years, Poles stopped feeling like second-class Europeans, and a generation of younger Poles appeared who had no qualms about crossing borders. JC: We again live in turbulent times. Do you think we’re heading towards positive outcomes? AA: I can’t make predictions, because everything that happens tomorrow depends on what people do today. Also, history doesn’t have a trajectory. It doesn’t move in a particular direction. You only think it does afterwards. As I said, you can look afterwards at Poland in the 1990s and you could say this was a period of great progress. But not everybody at the time saw that. Sometimes people are very wrong about a given country’s trajectory. I remember people writing about Ukraine in the 1990s, about how dangerous it was that Ukraine was independent, that this was going to be an anti-semitic state, that Ukrainian nationalism was going to come back... and although you can say many bad things about Ukraine, the country made many bad choices, actually it became a pretty tolerant state which now has a Jewish president and until recently a Muslim defense minister. JC: In the 1990s Poland’s and Ukraine’s GDP were roughly similar. Ukraine was even a bit richer. So the starting point was similar for both of these countries, but they’ve turned out very, very differently. Even if we stop in 2014. Why do you think Ukraine “chose East”? Was it external influence? AA: No, I think Ukraine was in a different position. First of all, central and eastern Ukraine had been part of the Soviet Union since the 1920s, and had therefore experienced a longer period of occupation, repression, Sovietization and even Russification. Ukraine did not have, as Poland did, an alternative elite: a large cadre of economists and politicians, who already had some experience in opposition politics and in independent thinking. In Poland, the transformative finance minister, Leszek Balcerowicz, had already thought about how an economy might be decentralized before he took office. We can argue about how successful he was, but at least he was prepared to try something new. In Ukraine, people weren’t prepared. For one, there hadn’t been much space even for an illegal opposition in the previous couple of decades. Ukraine was also in many ways still emerging from colonial occupation. For the previous couple of centuries, many of the most capable Ukrainians had moved to Russia, and the first generation of leaders in independent Ukraine tended to be former Soviet apparatchiks. They didn’t immediately seek to become closer to western Europe. Instead, they looked for some kind of economic and political “third way” and an accomodation with Russia. Ukraine became stuck in this position, half-in, half-out and became pretty profoundly corrupt. JC: The Polish alternative elite had a vision of where they wanted the country to go. I think the general perception now is that this vision ends with the next election, right? Is this a natural process of gaining power? AA: Their vision, and it was shared by the time by politicians who now call themselves both left and right, was that Poland should join the EU and NATO, as fast as possible. My husband (Radek Sikorski) was in the very first government that said it wanted to join NATO. At the time this was taken very badly in Washington: the demand for NATO membership absolutely came from Poland, not from the US. But even then, in the early 1990s, many Poles already understood that the Russian sphere of influence would grow once again, that it was important to become part of the transatlantic alliance and an integrated Europe as fast as possible: NATO, the EU, the Council of Europe, all of the trading and security alliances. That consensus lasted through several different governments and over many years, even governments containing former communists. For twenty years, right, left and center disagreed about many things, but they all agreed on the direction that the country should go. In retrospect, that consensus created the basis for prosperity in Poland. JC: And regarding the Polish-Ukrainian relations. We know that antagonisms, e.g. the myth of Wołyń [a massacre of Poles that took place in what is now Western Ukraine, in 1943] are increasingly used in Polish political discourse today. In Ukraine, nationalist historians make heroes out of UPA, the Ukrainian revolutionary army, which is held responsible for this tragedy. Where do you see a start for burying the hatchet? Is the reconciliation of our nations possible? AA: So here’s a strange thing: For more than a decade after they both gained independence, Poland and Ukraine participated in a number of projects that were designed to solve exactly these kinds of Polish-Ukrainian differences. Books were published that were jointly written by Polish and Ukrainian historians, monuments were built. These projects were successful: If you’d asked me this question in 2010, I would have said that there are no real historical issues between Poland and Ukraine, that the two countries had mostly reconciled. For a number of reasons, this began to shift. In Poland, children and grandchildren of victims of the Wołyń massacre felt their tragedy hadn’t been fully recognized. In Ukraine, nationalist groups wanted the UPA partisans who had fought against the Soviet Union recognized for their heroism, despite the fact that some in this broad and not well-defined group were also linked to Wołyń. In both eastern Poland and western Ukraine, the memory of the ethnic cleansing that took place there in the late 1940s - Poles were moved West, Ukrainians East - to accomodate new borders has left feelings of displacement and bitterness. The wave of Ukrainian immigration, which started before the war, may have provoked some of this. But don’t underestimate the role played by Russia, which has always wanted to create discord between Poland and Ukraine, and pumps out propaganda to that effect in both countries. Vandalism on both sides of the border, damage done to cemeteries and monuments, is sometimes carried out by provacateurs working for Russia, just to create bad feelings. The Polish-Ukrainian conflict also hides a different reality: although there are real grievances and bad memories, the truth is that the biggest tragedies both nations experienced in the twentieth century were inflicted by the Soviet Union and Nazi Germany. That should unite these two countries, not divide them. JC: This week (19.04.2026 – Ed.) in Hungary we saw that using historical narratives to create grievance has no longer worked. Are you optimistic about the direction after Orban’s loss? AA: The Hungarian election was really important because it shows that people can actually resist powerful, dominant propaganda. The ruling party Fidesz controlled all of the TV, 90% of the newspapers, the constitutional court, the bureaucracy... and yet people had the nerve to vote against it and resist it. It’s also an important election because Hungary created a huge network of well-funded think tanks and foundations that were funding other far right groups and projects. So that loss is going to have a knock-on effect in other places too, maybe even in Poland. JC: What you’ve said about resisting propaganda reminds me of one of the interviews you did about talking to Russians in the post-Soviet era who claimed that people knew that the system was lying. Why do people choose to believe in these regimes anyway? AA: Because it’s useful. Stephen Kotkin, an American historian, once described how people would learn how to “speak Bolshevik”: It was just a language that you needed to use in order to get by in society. If you didn’t talk the way the regime wanted you to talk, then you might have problems, or lose your job, or your kids would not get into university. It was a way of getting along. Communist Poland was similar, at least in the early years. When I was writing a book about the Sovietization of Eastern Europe after World War II, I met a lot of people who wanted to talk a lot about the war, when many of them had done really heroic things. But almost nobody wanted to talk about the decade afterwards, between 1945 and 1956. This was when you had the short period of terror, violence and Polish Stalinism. To stay safe, people felt the need to just go along with what others were saying, or stay out of politics, or use communist jargon without necessarily believing it. I don’t judge them for it, and I wouldn’t describe all of those people as collaborators. It’s easy to feel moral certainty in retrospect, because we know that communism ended. But if you were living in 1949, it might not have been clear to you that communism was going to end. In very repressive societies, maybe about 10% of people who are really evil – collaborators, torturers. Maybe 10% of people are really brave and who find ways to resist. And then around 80% of people have kids, they have parents, they have to have jobs and they’ve had to get through it somehow. Strange though it may sound, I’ve found that the work I did on that book is now very useful in explaining some of what’s going on in the United States today. There are plenty of members of the Republican Party in Congress who know perfectly well that Donald Trump says many things that aren’t true. But they avoid criticizing him because it’s inconvenient, because they would get in trouble, because someone would attack them on the internet. So actually you don’t even need mass terror to get people to conform. JC: Is Gen Z reinventing agency? AA: We’ll see. In any generation you can find groups of people who want agency. If you live in a society that’s unfair, for example where a tiny number of people have captured most of the wealth, then at a certain point people rebel. This is always easier for younger people, who have you have less to lose. The question now is how the internet will affect the relationships between citizens and the state, and how it will change organizations. The “Twitter revolutions” people spoke about as early as 2008-9, mass protests organized online, have often proved to be very superficial. Although you can easily join something just by clicking, the work of creating a real movement requires physical participation. Successful mass movements of the past, for example the Civil Rights movement in the United States, were built by people who had spent many years together. They had participated in non-violent workshops together. They practiced and prepared. Just using the you can get everybody to show up at a certain moment, but then when the protest is broken up, nothing happens. It’s also true that the repressive regimes have more recently learned how to use the internet to undermine leaders and movements. Most of all, they now understand how to make people cynical. The form of propaganda that most modern authoritarians use - and I think the Russians really pioneered this - deploys sneering cynicism. Instead of praising the rulers, the regime propagandists mock the opposition movement leadership for being supposedly corrupt or sexually degenerate, with the goal of undermining any kind of idealism. JC: MAGA grew on the internet? AA: MAGA is a real grassroots movement. They had symbols, red hats, they showed up at rallies. But you’re right that the cynicism, the sarcasm and the distrust that the movement embodies came originally from the internet, and this is different. Fifty years ago, most European political parties had a social base in real organizations, in trade unions for Social Democrats, in church groups for Christian Democrats. As people stopped going to church and as the trade unions became smaller, the social base of these parties disappeared. Now people who wouldn’t have known one another in the past meet on the internet and create new movements, many of which don’t last. JC: Is history ending? Going in stale circles? AA: History never ends. In truth, human beings want contradictory things at the same time: order and freedom, stability and change. These things are never resolved, and when a society swings too far in one direction, people always push it the other way. But each time that happens, the result is different. Certainly it is true that we are now in a period when old philosophers and ideas from the 1930s are undergoing a revival. Carl Schmitt, who was a philosopher who was very influential on the Nazis, is back as an influence on both the far left and the far right, once again inspiring people to think that all politics has to be existential, that all politics is about defining and defeating enemies. In the US, some are also bringing back dominionism, the idea that we need a Christian and not a secular state. It’s also true that we are living through a more fundamental shift. The old left-right divide, which was mostly about the size of the state, is much less important now. Instead, we are arguing about more fundamental things: what are our rights, what protects our freedom. Or how much power do we want to give small elites, versus how much power to give ordinary people. In America a small group of very wealthy people now control information, because they control the social media platforms and AI, which means they determine what people will read and learn. Finding a way to preserve preserve zones of autonomy and independent thinking, this is going to be the main task for the next generation. JC: What is the one book that a person interested in Central Europe should read? AA: You could read my book “Iron Curtain: the Crushing of Eastern Europe” which tells the story of how the Soviet Union imposed its culture on the region. Or read Tim Snyder’s history of the region, “The Reconstruction of Nations: Poland, Ukraine, Lithuania, Belarus 1569-1999.” And everyone should read “The Captive Mind” by Czesław Miłosz, which describes exactly the phenomenon we were talking about: why do people collaborate? I joined Scott Galloway and the brilliant Fiona Hill in a discussion about the wars in Ukraine and Iran, the future of global power, and what these conflicts reveal about America's role in the world. Scott told us that this was the 400th edition of his podcast, which is quite a number: My friend Francesco Chiamulera runs a brilliant series of literary events, Una Colline di Libri, A Hill of Books, in the Prosecco Hills, a region of vineyards and elegant hill towns in the Veneto, north of Venice. We did an event in Vittorio Veneto and also drove and biked around the countryside. Buy Autocracy Inc Buy Iron Curtain Open Letters, from Anne Applebaum is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Environmental roots of neonatal health: how social and structural exposures shape early-life outcomes
Pediatric Research - Environmental roots of neonatal health: how social and structural exposures shape early-life outcomes
New degree focus helps health professionals boost their communication skills
Communication plays a critical role in nearly every aspect of health and wellness. It shapes how patients understand information, how teams collaborate and how health organizations engage the communities they serve. But communication is rarely the primary focus of professional training. As health care and wellness organizations face increasingly complex challenges, professionals need advanced communication skills to navigate change, foster understanding and improve outcomes.
Redo TAVR with balloon-expandable valves linked to positive outcomes, key improvements
Researchers tracked real-world data from more than 140 patients who originally received a transcatheter heart valve from Edwards Lifesciences, Medtronic or Boston Scientific.
Study finds 5 daily servings may fall short of key heart-health compounds
Researchers report that many people in the U.S. and U.K. are not consuming levels of flavanol-rich fruits and vegetables associated with better cardiovascular outcomes.
Synthesia HR chief: Tokenmaxxing isn't the goal. Getting results is.
Companies are pushing workers to use AI. Synthesia's Laura Gonzalez says measuring token usage can reward activity over outcomes.
Forward Deployed Engineering: Delivering Business Outcomes with AI
Databricks is launching Forward Deployed Engineering: engineers embedded with our customers, with the single mission of delivering business outcomes from data and AI.
Why better AI doesn't always mean better outcomes
Users who adapt their prompting strategies can capture dramatically more value when generative AI tools improve, especially on tasks that require precision and control.
Rare or Unverified Outcomes Shape Vaccine Safety and Gender Care Debates
Two recent federal actions, including a memo about alleged COVID-19 vaccine deaths and settlements creating a “detransition clinic,” show how official actions can present uncertain or uncommon outcomes as representative and lend credibility to narratives that go beyond what evidence supports.
New report: Virginia is improving children's health outcomes, and more headlines
New report: Virginia is improving children's health outcomes, and more headlines
The Health and Wellbeing of Formerly Incarcerated People in Connecticut: Insights from the DataHaven Community Wellbeing Survey
By Carter Shannon, Nat Markey, Nora Hodgson, Samantha Lydell, Andrew Carr, and Mark Abraham, DataHaven About this Report Approximately 1 in 5 men aged 18–64 in Connecticut have experienced incarceration at some point in their lives. This population includes people who have been held in a local jail for a single night and those who have served lengthy prison sentences, and it cuts across race, age, geography, and socioeconomic background in ways that reflect broader structural inequities in the criminal legal system. Yet across nearly every indicator of wellbeing, formerly incarcerated people in Connecticut face significant disparities compared to those without an incarceration history. This report explores data on the experiences of formerly incarcerated men in Connecticut from the DataHaven Community Wellbeing Survey (DCWS). The DCWS illuminates significant gaps in economic wellbeing, physical health, mental health, and social support between men with and without incarceration histories in Connecticut. The survey also reveals worse self-reported outcomes for formerly incarcerated people across a range of quality-of-life indicators, with disparities that are often most severe among those who have been incarcerated more than once. These disparities do not arise by chance. They are shaped by a policy landscape that erects lasting barriers to housing, employment, and healthcare for people leaving incarceration, as well as by the physical and psychological toll of incarceration itself. This report is being written in the political context of federal funding cuts to social programs and proposed rollbacks to Medicaid eligibility, changes that will disproportionately impact people with incarceration histories, who are more likely to rely on public health coverage and other safety net supports.
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New OMB rule could break science in the United States
The drug that saved your mother. The treatment your doctor recommended. The clinical trial that bought someone you love more time. None of it was inevitable. It required a system built to operate outside politics and sustained over decades, because science doesn’t operate on the timeline of a politician. That system is now under direct threat. The Office of Management and Budget (OMB) has proposed a new rule to regulate all federal grants, not just science, but housing, education, defense, NASA and everything in between, that would fundamentally change how research is conducted in the United States. There have been a lot of fires in the past 16 months, and if everything is an emergency, nothing is an emergency. But this is a very big deal. These rules would strip away the independence that has kept science from becoming a political tool. The good news is there’s still something we can all do. How the grant system was designed to work When I was a new faculty member, I was full of millions of ideas, so I sat down and wrote an NIH proposal. I worked on it for months and thought it was so good. Then I sent it to my mentor. It came back covered in comments. Places where my reasoning wasn’t as airtight as I’d thought, methods that could be stronger, gaps in my thinking that I had been too close to the work to see. It stung, as honest feedback always does, but peer review almost always makes the work better. In fact, it’s the backbone of how American science has functioned for generations. At NIH, submitted proposals go to a panel of scientists who have experience in the field. These are the people who can read research methods and spot their weaknesses, who understand when an experiment is designed well and when it isn’t. Applications are scored rigorously, and often only the top 3-20% of proposals receive funding. The people making funding decisions are required to justify them based on these reviews. To be clear: this is not a perfect system, and good science still goes unfunded more often than any of us would like due to limited resources. There is also criticism that peer review may undervalue bold ideas that are risky but could have high payoffs. But the peer review system is nonetheless a meaningful part of the grant selection process. While thoughtful and careful changes could improve the system, the changes being proposed by OMB will not make things better. The rule that could change everything Through this OMB proposal, the system that helps decide what gets funded is being dismantled. There are many troubling elements buried in this proposal, but three provisions stand out in particular. Each would be damaging alone. Together, they would change what kind of science gets done in America, and who it serves. 1. Political appointees would decide which science gets funded, and peer review would be explicitly sidelined or ignored. The guidelines your doctor follows, the standards that determine what’s in your air and water, the drugs that get approved for your family: all of it starts with a funding decision. Right now, that decision is made by scientists who can evaluate whether the work is actually sound and whether it could move the needle forward. Under this proposal, funding decisions could be made by political appointees. The careful, expertise-driven review process that shapes grant funding would be effectively sidelined. That means that a poorly designed study could get funded simply because someone in a political office liked the sound of it, while rigorous, important work doesn’t get funded because it no longer aligns with the administration’s priorities. In other words, critical work that benefits all of us could now be missed just because it has become politically inconvenient. 2. Grants could be canceled at any point, without warning, in the middle of ongoing work. Say your tax dollars have been paying for a cancer study for two years. The grant was awarded for five years, so the team is mid-experiment. There are three additional years’ worth of answers that could change how the disease is treated for hundreds of thousands of people. With this new rule, the federal government could cancel the remaining funding tomorrow, walk away from the commitment it made with your money, and have no legal obligation to finish what it started. This is a huge waste of money. There are rarely other sources of funding for this work, which means the team, the graduate students, postdocs, and research staff who have dedicated years of their careers to this project could lose their jobs. Patients who have contributed their time to studies may not see it turn into useful learnings for others. Every hour of work already completed could result in nothing useful. Science can take decades to get to tangible outcomes. It needs a stable funding system to flourish. 3. Researchers would have a harder time communicating their findings without pre-approval from the federal government. There is a saying from Sir Mark Walport: “Science isn’t finished until it’s communicated.” Science is no use to anyone if it is kept locked away in the labs that produced the data. The proposed rule could make communicating research findings harder in a number of ways: Make it harder for scientists to widely share their findings in scientific journals. Publication costs, including journal fees that allow for broad public access, could not be paid for by federal funds which is often how scientists pay these costs. Restrict researchers from engaging publicly about how their findings should inform policy or public health guidelines. This would restrict scientists from doing the work that transforms years of lab work into decisions that actually affect people’s lives. Make it harder for scientists to attend conferences. Conferences would now need to be approved by the federal agency at the time of grant award. This disadvantages conferences or publications that are not politically aligned. Conferences are a key way in which scientists learn about work happening in their field so they can collaborate and build on each other’s findings. What good is science with a muzzle? The long-term impact These changes could (and hopefully would) be reversed under the next administration. But by then, damage has been done. Once projects are halted or denied funding by political appointees, people leave their science careers for other paths or even leave the country to do their amazing science elsewhere. You cannot pause a scientific study the way you pause a subscription you decided isn’t useful anymore. You cannot freeze a research team that depends on salaries to feed their families, causing a scramble for replacement funding that, in most cases, simply does not exist. When the money stops, everything stops, and all the work in progress and its potential are lost. Despite all of the language about reducing waste, fraud, and abuse, this new proposed rule increases the administrative burden tremendously. Every researcher watching this unfold will make a rational decision: don’t start anything that will take a decade to finish. This includes not building a team around funding that could vanish, or asking the big questions that need patience and stability to answer. The most consequential science, the kind that produces the treatments and the breakthroughs that reach your doctor’s office twenty years from now, is exactly the science that would be abandoned first. This is still a proposal, so we can all do something Some worry this rule is already a done deal. But by law, OMB is required to open a public comment period. Those comments matter because they inform members of Congress, they can be used in litigation, and they create a public record. So here’s what you can do: Submit a public comment. The public comment period on this proposed change is open until July 13. Anyone can submit a comment, and OMB is required to respond to substantial ones. Each comment must be different to count as distinct; identical comments will be counted only once. Comment as an individual, not on behalf of your organization. Here’s a full resource to help you, with useful examples, but in general: Share a story about how science or federal funding has benefitted you or is involved in your work. Are you or someone you loved a cancer survivor? Do you know someone with Alzheimer’s? Have you received NIH/NSF or other federal funding? All of these can be stories you use to highlight why you care. Explain why you’re worried about these proposed changes. You can use the wording found here or in other resources to help you. Ask them to withdraw this proposed rule. Contact your elected representatives. Congress allocates money to federal agencies to spend, and it has oversight of how that process works. You can let your representatives know this proposed change concerns you and ask them to intervene. There are levers they can push that can help at this moment. Let others know why federal funding matters. This isn’t just about science, but ALL federal grants, including for education systems, defense projects, and more. The process, including the importance of federal funding, is invisible to many. We can all make it more visible by sharing how science benefits us and why we value it. You can also share this article, or any of the resources linked here, to help spread awareness! Bottom line We are quickly losing ground in scientific research in the U.S. More changes, like the proposed rule by OMB, would decimate our ability to conduct research here, leaving us all worse off: fewer treatments for pancreatic cancer, less research on pollution impacts, fewer answers for patients with rare disease, and more unaddressed health needs. The impact will be very real for all of us, regardless of where we stand politically. Using our voices for science is more important than ever. Love, LM Big thanks to Dr. Megan Ranney for reading this over and providing brilliant insights, as always. Dr. Liz Marnik, PhD, is Executive Director of The Evidence Collective at YLE and a science communicator and immunologist working at the intersection of public trust, science, and public health. You can find her on Substack, LinkedIn, Instagram and Threads. Your Local Epidemiologist (YLE) comprises a team of experts, ranging from physicians to immunologists to epidemiologists to nutritionists, working together with one goal: to “Translate” ever-evolving public health science so that people are well-equipped to make evidence-based decisions. The YLE suite of newsletters reaches over 475,000 people across more than 132 countries. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: Subscribe
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We can create the future of science right now
Paul Litvak is the founder and Executive Director of the Robyn Dawes Institute and a Visiting Scholar at UC Berkeley. He has a PhD in Behavioral Decision Research from Carnegie Mellon where he studied emotions and the sunk cost bias. Over 15 years in industry, he solved a wide range of challenging technical problems. At Meta he created models optimizing the ad review process. At Google he ran experiments to measure social influence. At Airbnb, he was a product manager leading machine learning teams optimizing search ranking and price suggestions. He also co-founded and led product at Rhythmic Health, a venture-backed biosensing startup, creating an accurate low cost system using a color changing strip and a smart phone to measure salivary lactate. The bottleneck At this point, it is uncontroversial to say that science needs to stop using the PDF article as the unit of knowledge and currency. The unbearable slowness of scientific publishing, the profit motive and margins: I’m not saying anything new. The PDF also sucks because it’s hard to extract structured information, which makes it hard to do evidence synthesis. As a result, we do much less evidence synthesis than is needed. And evidence synthesis ultimately undergirds most policy and medical decision-making. I can see second-by-second real-time odds for any sporting or newsworthy event, but a school board can’t see the best evidence on whether their 8th graders should be taught algebra. As a society, we don’t treat this as an important problem. Again, not controversial. Not only is the problem well understood, but the solution has already been laid out. What we need is AI-assisted living evidence synthesis - (1) an open knowledge graph of atomic claims, (2) claims linked to evidence, (3) assessment and synthesis of each piece of evidence, and (4) continuous updating with new data. What few realize (yet) is that the technical capacity to build this vision for a significant portion of science already exists. Not only that, scientists and startup teams are already building many of these components. I know this because I’ve been surveying the space and talking to many of the builders. There are some missing pieces: for example, evaluations of how well some of the components work. But at this point, most of what’s missing is a fully end-to-end working integration of all of these parts. In the rest of this essay, I’m going to lay out all the parts of a working living evidence layer for science and who is working on them, and propose concrete next steps for building this system. What’s now possible The diagram above outlines the components of a living evidence synthesis platform, including some of the teams working on each component1. Scientific PDFs are processed into claims with associated evidence. The evidence is subjected to a forensic audit, methodological evaluation and robustness and reproducibility checks. Finally it’s given a weight in a continuously updating synthesis. What follows is a description and status of each component and a few of the teams working on them. Document understanding The first thing you need to be able to do is turn an article into structured data. Mostly that means parsing PDFs. There are often multicolumn layouts that confuse non-specialized PDF to text processing libraries. For scientific papers, there is the added complexity of parsing formulas and tables and figures. This is a really hot area - there are startups offering APIs, and it seems like a new open source package gets posted to Github every few weeks. What follows isn’t exhaustive. A package called GROBID was the state of the art for a while, they didn’t update their package for nearly two years until very recently. In the meantime reducto.ai released an AI powered PDF extraction API, PaddleOCR became popular, IBM released a model called Docling, and both Mistral and Gemini created models and libraries. I also know of at least one other well-funded psychology research group working on a paper parser. By contrast, there are few open evals in this space, with no extensive evals for complex table comprehension in particular. Nonetheless, I’m confident this will be a solved problem soon, given the combination of LLM advances and developer interest. Hypothesis level extraction There has been increasing interest in comprehending the extracted text of papers and linking information to evidence for each hypothesis. A lot of work has already been done. Trialstreamer (Marshall et al. 2020) and RobotReviewer LIVE (Marshall et al. 2023) demonstrated automated extraction of trial population, intervention, and outcome at scale on clinical RCTs. PaperQA2 (Skarlinski et al. 2024) and Ai2 ScholarQA (2024) extended this to retrieval-augmented question answering with citation grounding. Elicit, Consensus, and SciSpace operationalized claim-level extraction for end users. OpenEval (Booeshaghi et al. 2026) is the most recent and most ambitious: 1.96 million atomic claims extracted from 16,087 eLife manuscripts using Claude Sonnet 4.5, grouped into ~299,000 results, with LLM evaluations showing 81% agreement with human peer review on a 2,487-paper subset. None of these solutions link claims to test-statistics, as you would need to evaluate randomized controlled trials. This is why I built the evidence.guide API - to extract hypotheses and associated test statistics from behavioral science papers. The best public eval of this kind of extraction I’m aware of comes from the recent SCORE project - they had humans code thousands of psychology papers to extract their claims by hand. It would be extremely helpful to the world if all scientific PDFs were available as structured open data. I’ve been working to make this happen, both directly at Berkeley and through coordination with large entities I can’t yet speak of; as hard as it is to do, I think it’s possible2. Forensic audit A lot of work has been done on forensic audit, but some gaps remain. Of course, for biology papers that rely on images for evidence, there are a variety of tools (notably Proofig and ImageTwin) to spot anomalies. These are still well short of what sleuths like Elizabeth Bik can do on her own, but these tools are constant companions among fraud analysts. There’s someone working on auditing Excel files for anomalies, and a number of teams are automating numerical checks like GRIM and SPRITE, including Scrutiny project, the INSPECT-SR team as well as statcheck. The regcheck team is building a way to use AI to compare preregistrations to analyses in papers, to ensure there aren’t significant deviations. Nonetheless, there are many other kinds of anomalies to screen for, both public and less publicly known. And there are no formal evals for anomaly detection that I’m aware of. Still, there’s a lot to draw from in this space and I’m pretty certain we will be able to scan papers for most kinds of obvious anomalies in the near future. Methodological review This area has been white hot, though I fear for many of the startups in this space, because this capability may become commoditized. There are at least six different AI peer review companies, including Refine.ink, Reviewer3, ReviewerZero.ai, Q.E.D. Science, Paper Wizard, and Isitcredible. Coarse (a pun on refine) was also recently created as an open source alternative. These systems provide qualitative feedback on the content of papers, spotting methodological weaknesses and mathematical errors. They seem to work pretty well, and many academics report bitterly that they exceed the average quality of typical peer reviewers. But there are few evals here either. What evals exist so far involve using LLM-as-judge (circularity problems abound) or comparing against human reviews of questionable quality. What you’d ideally want is an eval that measures capturing known errors in papers3. Reproducibility and robustness Another active area has been using AI agents to automate computational reproducibility4 and robustness5 checks in papers that report numerical results. For more recent papers where data and code are available, AI agents can see whether they can re-run the analyses and produce the numbers reported in the published paper. In addition to a handful of individual academics who have been experimenting using Claude Code for this, the Institute for Replication is a leading group working on building an end to end system. The evals related to this problem are the most mature, with CORE-Bench (Siegel, Kapoor, Narayanan 2024) and PaperBench (OpenAI 2025) available to benchmark agents on this task. There is also work on getting AI agents to test alternative ways of analyzing the data to ensure the results are robust to small analytic design choices. Synthesis This is the most underdeveloped area where significant investment is required. Although some automated evidence synthesis systems exist — for example, otto-sr is building an AI agent to write systematic reviews — none of these incorporate the full range of paper level signals to weight evidence appropriately. Nor is there anything like an eval or a gold standard for a good systematic review. Arguably Cochrane reviews are the closest we have to gold standard human systematic reviews, though I’ve heard academics in the know complain about their uneven quality. A key question for a synthesis platform is how to weight anomalies and methodological issues in assessing the quality of a piece of evidence. This is an unsolved problem and one I’m very keen to work on. Continuous updating There are many pieces of basic infrastructure available for monitoring for new research and initiating updates. OpenAlex is the current open citation graph. Retraction Watch integrated into Crossref in October 2023. Scite tracks how citations support, contrast, or mention prior claims. The Living Evidence Network demonstrated continuous-update workflows in clinical guidelines. Engineering this is a relatively straightforward task. When you look over this technical architecture and all the progress being made, it’s hard not to be optimistic that a living guide to scientific evidence will be built. The stakeholders are ready The social infrastructure for this is starting to coalesce — it’s not just a pie in the sky academic exercise to imagine this coming into existence. Institutions like the Center for Open Science, the Institute for Replication, the INSPECT-SR, the Living Evidence Network and more are all working on scaling work to improve research quality. Funders are also aligned. The Sloan Foundation has funded living evidence work through COS. Coefficient Giving supports the Institute for Replication and COS. The Astera Institute and the Institute for Progress have shown interest in this space. NIH has established an Office for Replication and Reproducibility. Although there are (very unfortunately) serious headwinds in science funding generally, there is an active group of funders interested in metascience. A brief word about what I’ve been doing at RDI. First, as a Visiting Scholar at Berkeley I’ve been actively figuring out how a non-profit and a public university can conduct and make public the results of large-scale academic article data mining. With some of the money I raised from donors, I commissioned a legal analysis of recent case law and publisher text data mining (TDM) agreements in order to understand whether a massive open data mining of academic articles is possible (with caveats, it is). I’ve also been working to bring together stakeholders in this space, and identify gaps. I’ve also been doing some software development in this space, with more to come. A pilot proposal The assumption undergirding all of this is that an AI, given all this information, would make the right judgment about a scientific claim with lots of conflicting evidence, weighing all the factors appropriately. That’s the hypothesis we need to test. Randomized control trial research is the best place to focus on first. RCTs are used to make many of the important decisions in society - from medical trials to public policy changes. And they use a relatively uniform set of inferential statistics with lots of known and available diagnostics. Behavioral science experiments, within the broader realm of RCTs, should be first used as a testbed whose results can be generalized. Because behavioral science is at the vanguard of open science practices, replications abound (there are thousands of them) to serve as ground truth training data. Key Hypothesis Therefore the pilot would test, in behavioral RCTs that have been replicated, whether the quality of evidence for a claim can be used to accurately predict whether that claim will replicate. Secondary Hypotheses Compared to claims that replicated, non-replicated claims demonstrate a greater share of forensic anomalies in their source literatures. Hypothesis level claim and statistic extraction is accurate enough to scale living evidence without onerous human review costs. Replication prediction is more accurate than prediction markets6 or journal prestige. If all the different quality signals we gather do accurately predict which studies will replicate, then we can use that model to score evidence to power the living evidence layer. Why this is informative regardless of outcome If the pilot succeeds, the architecture extends to medical RCTs (where Living Evidence already operates and integration is mostly about claim representation), then to slices of basic biology with stable replication structure. If it fails, the field learns which quality signals are load-bearing and which ones metascience has oversold. Either result is a contribution to knowing what the literature supports. Implications for funders Because this burgeoning ecosystem of builders already exists, a well-informed philanthropic or government funder could play a crucial catalyzing role in bringing this future about. They could play at least three roles: creating open structured datasets, publishing open benchmarks and incentivizing the solving of key technical challenges. First, open archives of papers that the government maintains, like PubMed, could be turned into structured data amenable to large scale metascience and claim aggregation. I know the US government already has an interest in doing this, though some key open questions remain unanswered. How do you determine the best models and systems for accurately extracting information from papers? How can you establish a robust way to allow researchers to flag errors and correct them? And finally, how do you create a legal regime in working with publishers to maximize the scope of available papers? For the latter, a university or a private philanthropy may be better positioned to make structured data publicly available under journal subscription terms or fair use. Philanthropists or government funders could also coordinate to create or commission benchmarks that evaluate whether important problems have been solved. For example, an open benchmark for claim extraction from a range of different scientific article types would be extremely helpful. Ensuring the underlying data are accurate is vital for creating these evaluations. I’ve discussed opportunistically using various human-created datasets for this purpose, but a consistent problem is that errors in human data make it difficult for them to serve as a gold standard. Finally, with structured data and benchmarks available, the government or private philanthropy could use them to incentivize groups to develop machine learning systems that meet these benchmarks. Prizes are one potentially valuable tool for this. For example, you could establish a prize for a system that accurately updates a living meta-analysis for a small set of claims. Prizes are particularly useful as signals of problem importance, and can help create vibrant ecosystems of public and private research—see, for example the role the government played in kickstarting the current work on nuclear fusion. Conclusion The drawbacks of the current scientific publishing system are known. Scientists agree, metascientists agree, philanthropists agree: the published PDF plus citation graph isn’t the right substrate for maintaining a representation of the evidence base in science. The pieces needed to build the alternative either already exist or are rapidly taking shape. The community is forming around exactly this problem, with concrete partnerships and shared infrastructure. A pilot should start on behavioral science RCTs because that’s the slice of empirical science most amenable to legibility, where replication ground truth is richest, and where the failure modes are best documented. What’s been missing is the galvanizing mission to assemble these pieces into something that works. That’s what I’m proposing to build. *** 1 I have a broader field map that I’ll release publicly soon. This is me, building in public! 2 If this is something that you are excited about, please reach out and talk to me. 3 More on this very soon too! 4 This tests whether, given the code and the data, you can get the same statistics as reported in the published paper. 5 This tests whether the results are the same as a paper’s given alternative analytical decisions in conducting the analysis (like outlier omission). Closely related is the idea of a “multiverse” where you come up with many different ways of answering the same underlying research question with the same data, and test whether the results hold in all those alternative methods. There’s been work on the latter as well. 6 Some of the replications, e.g. those from the SCORE project, had paired the experiments with forecasts from prediction markets. So we get to look at this for free.
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