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Franciscan Health Dyer adds OrderAhead food locker in partnership with Food Bank of NWI
Technology enhances partnership aimed at fighting Region food insecurity DYER, Ind. – Franciscan Health Dyer now has an OrderAhead food locker thanks to a partnership with the Food Bank of Northwest Indiana and generous donations to the Franciscan Health Foundation. The OrderAhead food locker program was designed by the Food Bank of Northwest Indiana for neighbors with chronic concerns about adequate food access. The lockers allow food-insecure individuals to place an order online for pickup at a scheduled time. “We are thankful to be able to further enhance our impactful partnership with the Food Bank with the addition of the
From Paper to Action: How Systematic Monitoring Can Help Health Benefits Packages Deliver on Their Promise
Health Benefits Packages (HBPs) can be a strategic tool to advance Universal Health Coverage. But their impact depends not only on the services included, but also on whether people effectively receive those services with adequate quality and financial protection. It also depends on the factors behind implementation gaps. While there is no shortage of guidance for using evidence-informed priority-setting approaches, less attention has been paid to monitoring whether, how, and why HBPs deliver (or not) in the real world. This gap matters, particularly in the context of stagnating progress towards Universal Health Coverage, because it leaves policymakers in the dark: Are HBPs delivering on the promise made to the population? If not, why, and what corrective action can be taken?
Tunisia: Authorities must immediately release Rached Ghannouchi amid severe fair trial violations and serious health concerns
Tunisian authorities must release prominent opposition politician Rached Ghannouchi, quash his convictions and end the politically motivated prosecutions against him marred by significant due process violations, Amnesty International said today. The organization is also urgently calling for him to receive access to adequate healthcare pending his release. The 84-year-old leader of the Ennahdha party and former Speaker of Parliament has been held in arbitrary detention since his arrest in April […]
Ohtani Shuts Out Rival, Continues to Strengthen Cy Young Case
Shohei Ohtani has had a legendary career already. He’s won the Rookie of the Year award and four MVP awards […]
How Americans’ Financial Health Is Faring In The “K-Shaped” Economy
Hey all, Jason here. Money20/20 is still two weeks away, but I’ve already started packing (not procrastinating for once!). My calendar is already filling up with various sessions I want to catch, meetings, and of course happy hours, dinners, and other side events. If you’ll be in Vegas and want to catch up, let me know by replying to this email, and we can try to find a time amidst the chaos of the Venetian. A big if not totally unexpected piece of news dropped on Friday: the Independent Community Bankers of America, a trade group that represents smaller U.S. banks, filed a lawsuit against the OCC and Comptroller Jonathan Gould, arguing that the regulator’s move to grant trust bank charters to firms seeking to use them to conduct substantial non-fiduciary activities exceeds the authorities granted to the OCC by Congress. I haven’t had time to fully digest the legal filing or speak to folks in my network about it, but you can expect to see coverage and analysis on it in next week’s newsletter. Subscribe or Support by Upgrading The NerdCon agenda just dropped. It’s stacked. Partner content: Nubank built an AI-first bank. Chime built its own banking core. Figure and Valon are rebuilding the mortgage stack. At NerdCon, you’ll hear from the people behind those bets: what they chose, what they learned, and what they’re still figuring out. The agenda is live, with leaders from Nubank, Chime, OpenAI, Remitly, Mercury, Figure, Valon and more. Follow the mainstage conversations, bring the problem your team is wrestling with to a hands-on workshop, or pull up a chair at a roundtable. Pick your quests. Meet us in San Diego, November 18–20. Fintech Business Weekly readers save 20% with code FBW20. Explore the Agenda Things To Know & Other Good Reads Federal Reserve Board finalizes changes to enhance the transparency and public accountability of its stress test and reduce volatility in its stress test-related capital requirements (Federal Reserve Board of Governors) FDIC Announces Conclusion of Independent Monitorship (FDIC) Modernizing Financial Regulation: Initial Observations from eSLR (Fed Vice Chair for Supervision Michelle Bowman) The Data Version of Godzilla versus Kong: FRED Takes on AI (Fed Governor Christopher Waller) Financing the AI buildout (Brookings) Q3’26: Rules for Banks but Not for Crypto (Fintech Takes Banking) The Inevitability of Local Stablecoins (Lombard Notes) Delusions of AI Governance: The Human-in-the-Loop Comfort Blanket (Fintech Snark Tank) Stripe agrees to acquire Parafin to expand revenue opportunities for platforms and help small businesses grow (Stripe) Listen: Fighting Fraud in the Age of AI, with SEON’s Tamas Kadar (Fintech Business Weekly) How Americans’ Financial Health Is Faring In The “K-Shaped” Economy If there is one overarching theme across the economy and politics in the U.S. at the moment, it’s “affordability.” The term is vague enough to encompass a panoply of factors shaping Americans’ day-to-day lives: rising costs for the hallmarks of being “middle class,” including healthcare, housing, childcare, and education, inflation and rising interest rates, and a job market with the specter of AI hovering over it. At the same time, policy shifts under the Trump administration have resulted in reduced subsidies to those who get health insurance under the Affordable Care Act and new restrictions on qualifying for Medicaid and SNAP, the impacts of which have yet to be fully felt. These factors are contributing to declining consumer confidence and general dissatisfaction with the economy, despite continuing GDP growth and stock market records. This divergence is encapsulated in the idea of the “K-shaped” economy, in which a small proportion of Americans have seen their wealth balloon, while the majority of American households struggle to preserve the lifestyle they have. Perhaps the greatest determinant of which branch of the “K” a household is on is whether their wealth and income are primarily derived from employment vs. from assets. Nearly two decades of low interest rates and, more recently, elevated rates of inflation have benefited asset owners, while those whose income is primarily or solely derived from labor have largely seen real purchasing power stagnate or decline. This is reflected in recent Bureau of Labor Statistics data showing that labor share of U.S. GDP — the fraction of economic output that accrues to workers as compensation in exchange for their labor — dropped to just 52.8% in Q2 2026, the lowest since the BLS began keeping records. In 1947, approximately 2/3rds of economic output accrued to workers; even as recently as 2001, labor’s share of GDP was 64.1%. Against this backdrop, we’ve seen the rise of more credit and credit-like products: cash advance apps, “no-fee” overdraft, earned wage access, and buy now pay later, which are often used as small-dollar short-term borrowing mechanisms to meet immediate consumption needs or pay other bills (eg utilities, cell phone, other debt payments). With the markers of a middle class existence and, increasingly, basic financial stability seemingly out of reach for many, it should be no surprise there’s been an increase in “financial nihilism,” something industry peers like Alex Johnson and Frank Rotman have discussed and analyzed the roots of. The explosion of gambling and gambling-adjacent products and services — often marketed under the guise of being an “investment” — is inextricably intertwined with the rise of financial nihilism. Crypto, sports betting, and, more recently, prediction markets offer an escape or even hope of sorts, like a contemporary, digital version of a scratch-off lottery ticket, while leaving the overwhelming number of people who use such products worse off. Share of Households That Are Financially “Vulnerable” Ticks Up The Financial Health Network’s 2026 Financial Health Pulse® report adds context on how American households are faring. (I linked to this report in last week’s newsletter, but wanted to take time to further unpack the data in the report this week.) The Financial Health Network publishes the report annually, providing insight into how Americans’ financial circumstances are changing over time. The 2026 report is derived from a survey fielded in April and May 2026. The report leverages survey responses to assess indicators of financial health across spending, saving, borrowing, and planning/protecting and to determine a zero to 100 “FinHealth” score. Those with scores between 0 and 39 are considered “Financially Vulnerable,” consumers with scores ranging between 40 and 79 are defined as “Financially Coping,” and those with scores of 80 to 100 are “Financially Healthy.” The report found that moderate improvements in 2025 were reversed, with the share of respondents considered financially “vulnerable” rebounding to 17%. The longitudinal data reflect the impact of pandemic-era programs, like expanded unemployment, cash stimulus payments, and pauses of federal student loan payments. The positive impacts of those programs, as reflected in the Financial Health Pulse reports, had largely disappeared by 2023. While pandemic-era inflation — to be fair, in part caused by the various support and stimulus measures — had come down from as high as 9% in 2022, it has rebounded since the start of Trump’s second term, with tariffs and energy market disruptions owing to the war in Iran pushing prices back up. Specific indicators in the survey that deteriorated from 2025 to 2026 include the share of respondents spending less than their income over the past 12 months, the share paying all bills on time over the past 12 months, the share that have a manageable amount or no debt, the share that are “moderately” or “very” confident their insurance is adequate to cover them in an emergency, and the share that “somewhat” or “strongly” agree that their household plans ahead financially. Unsurprisingly, lower- and moderate-income households are more likely to struggle to pay their bills on time and have any funds leftover to save. The share of low-income households whose income exceeded their spending dropped from 35% in 2025 to 31% in 2026, while the share of upper-income households whose income exceeded expenses remained unchanged at 63%. Households with student loans or revolving credit card debt reported having “a bit more” or “far more” debt than was manageable at rates far higher than those not carrying these types of debts. The share of those with student loan debt indicating their debt load was too high to manage increased from 50% in 2025 to 55% in 2026, while the share of those with revolving credit card debt saying the same ticked up from 51% in 2025 to 54% in 2026. Households that had student loans were markedly more likely to be financially “coping” or “vulnerable” vs. those without student loans. In 2026, 27% of households with student loans were considered financially vulnerable, a jump of 6% points vs. 2025. Households without student loans saw just a 1% point increase (not statistically significant) in those considered financially vulnerable. Households’ perception of the affordability of categories of goods and services paints a stark picture, with less than one-fourth considering higher education affordable, about a third deeming childcare affordable, and less than half viewing healthcare as affordable. Fintech Business Weekly is made possible by the generous support of paying subscribers — bringing you independent analysis of banking, fintech, and crypto without fear or favor. You can support my work by becoming a paying subscriber if you aren’t already. Paying subscribers enjoy: access to the entire archive of nearly six years of newsletters extended versions of the weekly newsletter, with additional content and analysis and (for founding member tier) quarterly personal 1:1 fintech Q&A / strategy calls with me, tapping into my unparalleled knowledge of the intersection of banking and fintech and experience working in the sector, including helping to launch Goldman Sachs’ retail bank Marcus Support Fintech Business Weekly You can also support Fintech Business Weekly by sponsoring a newsletter or podcast, putting you in front of 93,000+ of the most influential decision makers in banking, fintech, and crypto. Learn more about sponsor opportunities or request a media kit by dropping me an email. Democratic Senate Report Highlights How Iran Uses Tether to Evade U.S. Sanctions Iran uses stablecoins, specifically Tether, to evade sanctions, fund regional proxies, and to purchase military drones, a report released last week by the Senate Permanent Subcommittee on Investigations says. The report was authored by committee ranking member Senator Richard Blumenthal (D-CT) and the minority staff. Crypto and stablecoin proponents will often push back on criticism that criminals make use of these assets by arguing that, on an absolute dollar basis, far more illicit funds flow through traditional banking systems and payment rails than via crypto and stablecoins. And while that is likely true, it elides the reality presented in news story after news story: whether state actors — Russia, Iran, North Korea — or criminal groups, those looking to engage in illicit transactions increasingly favor stablecoins and, specifically, Tether (USDT). The report from the Senate Permanent Subcommittee on Investigations released last week adds context to how Iran uses Tether has a lynchpin in its shadow banking system. The report analyzed 846 wallets that have been sanctioned or targeted for seizure, finding that 84% of them transacted exclusively or primarily in Tether. The ability to create near limitless, anonymous wallets and to move funds effectively instantaneously and irreversibly have made crypto a favored financial mechanism for bad actors. Stablecoins solved key drawbacks of bitcoin, namely, the original cryptocurrency’s highly volatile value in dollars. And while Tether (the company) has the technical ability to “freeze” or destroy funds, the company is often limited and reactive in its approach to doing so, the Senate report argues. Tether, which is nominally based in crypto-friendly El Salvador, “has stated that its compliance with OFAC sanctions is ‘voluntary’ and that it follows ‘OFAC guidelines,’” the Senate report says. Owing to these favorable attributes, Tether “became a primary cryptocurrency for Iran, Hamas, Hizballah, and the Houthis beginning in 2023 and has expanded in scale since,” according to the report. Tether’s role in Iran’s shadow banking system, the report says, is enhanced by crypto exchanges like Bybit, Kyrrex, OKX, Gate, and Binance, and through “over the counter” exchanges and hawala networks. The consequences of these financial flows aren’t hypothetical. The Senate report links Tether as a funds transfer mechanism to Iranian proxies in the region, including Hizballah, the Houthis, and Hamas. Tether has also been used to make payments to secure components necessary to manufacture drones, the report says. The report concludes by arguing that “[s]tablecoin issuers with a significant nexus to the United States, particularly those that offer dollar-denominated stablecoins, should be subject to American sanctions law rather than being allowed to hide behind foreign jurisdictions.” Stablecoin issuers like Tether must be held accountable for repeated failures to prevent illicit finance and sanctions violations by law enforcement, the Department of Justice, the Securities and Exchange Commission, and OFAC, the report argues. [Paying Subscriber Exclusive] OUSD Goes Live, Make Your Own Neobank, U.S. Sanctions Russia’s A7 Network As “Transnational Criminal Organization” OpenUSD, the stablecoin issued by the Open Standard consortium that includes Stripe, Visa, Mastercard, core providers, crypto firms, and numerous banks, went live last week. Social commerce platform Whop raised eyebrows in fintech by offering creators on its platform the ability to launch their own neobanks, which the company describes as “great businesses that are easy to run,” in just 15 minutes. And OFAC and FinCEN target Russia’s “shadow banking” A7 Network — more on these stories after the paywall.
Business Restructuring Review Vol. 25 No. 4 July-August 2026
In This Issue New York Bankruptcy Court: Premature Allegations of Creditor Mistreatment Insufficient to Deny Chapter 15 Recognition of Foreign Restructuring Proceeding In In re ARD Finance, S.A., No. 25-12794 (MG), 2026 WL 817458 (Bankr. S.D.N.Y. Mar. 25, 2026), the U.S. Bankruptcy Court for the Southern District of New York was presented with a petition seeking chapter 15 recognition of Luxembourg's recently enacted bankruptcy law governing judicial reorganization proceedings. The court granted the petition, turning aside challenges to recognition voiced by a creditor group arguing that recognition should be denied based upon allegations of unfairness to creditors in the Luxembourg proceeding that would make recognition manifestly contrary to U.S. public policy. According to the bankruptcy court, recognition was warranted because: (i) the rules and procedures governing the proceeding under Luxembourg law were fundamentally fair; (ii) the petition otherwise satisfied chapter 15's recognition requirements; and (iii) the creditor group's allegations were premature, given the fact that the Luxembourg court presiding over the debtor's restructuring proceeding had not confirmed a restructuring plan, and all creditors had the right to participate fully and voice their objections in the proceeding (including the right to appeal an order approving a plan). [read more …] Florida Bankruptcy Court Examines Scope of Discovery in Chapter 15 Cases In In re Banco Master, S.A., No. 25-24568-SMG, 2026 WL 931729 (Bankr. S.D. Fla. Apr. 6, 2026), the U.S. Bankruptcy Court for the Southern District of Florida granted in part and denied in part post-recognition motions filed by an insider of a foreign debtor seeking to bar or limit discovery sought by the debtor's foreign representative concerning allegedly voidable transfers involving the debtors' U.S. real property. According to the court: (i) although chapter 15 includes its own discovery provisions among the relief that may be granted to a foreign representative, the expansive discovery available in cases under other chapters of the Bankruptcy Code is also available in chapter 15 cases; (ii) the discovery sought by the foreign representative was permissible; (iii) discovery regarding matters that were the subject of a pending adversary proceeding had to be undertaken under the more restrictive rules applicable to such proceedings; and (iv) a discovery request would be barred to the extent that it sought production of documents or testimony from a subpoenaed entity that exceeded the geographic limitations specified in such rules. [read more …] Delaware District Court Affirms Chapter 15 Recognition Order Enforcing Nonconsensual Third-Party Releases In U.S. Int'l Dev. Fin. Corp. v. Credito Real S.A.B. de C.V. SOFOM, E.N.R. (In re Credito Real S.A.B. de C.V. SOFOM, E.N.R.), 677 B.R. 192 (D. Del. 2026), appeal filed, No. 26-2356 (3d Cir. June 5, 2026), the U.S. District Court for the District of Delaware affirmed a bankruptcy court order granting chapter 15 recognition to a Mexican "concurso mercantile" proceeding and enforcing nonconsensual third-party releases approved by the Mexican court. Agreeing with the bankruptcy court that the releases were not manifestly contrary to U.S. public policy, the district court concluded: "It is well settled that U.S. bankruptcy courts can give effect to foreign orders in recognized foreign proceedings pursuant to the authority granted in Chapter 15, even when those orders contain relief unavailable under U.S. law. [The appellant's] arguments misconstrue the Supreme Court's narrow holding in Purdue, applicable in Chapter 11 cases, as well as the statutory framework of Chapter 15 and its core policy objectives. Accordingly, I will affirm the Enforcement Order." The ruling has been appealed to the U.S. Court of Appeals for the Third Circuit. [read more …] Fifth Circuit: Bankruptcy Court, Not State Court, Had Jurisdiction to Allow or Disallow Administrative Expense Claim In Storey Minerals Ltd. v. EP Energy E&P Co., LP (Matter of EP Energy E&P Co., LP), 169 F.4th 609 (5th Cir. 2026), the U.S. Court of Appeals for the Fifth Circuit affirmed lower courts' rulings disallowing a creditor's administrative expense claim. It also rejected the creditor's argument that, because the claims were predicated on state law, a state court should adjudicate the merits of the state law causes of action before the bankruptcy court could allow or disallow the claim as an administrative expense. According to the Fifth Circuit, even though the causes of action were based on state law, the bankruptcy court had jurisdiction to determine whether the creditor's claims should be conferred with administrative expense priority in the debtors' chapter 11 case. [read more …] New York Bankruptcy Court: Dismissal of Involuntary Chapter 11 Case Filed Prior to Commencement of Foreign Restructuring Proceeding Unwarranted In In re Xinyuan Real Estate Co. Ltd., No. 25-10745 (PB), 2026 WL 592250 (Bankr. S.D.N.Y. Mar. 3. 2026), the U.S. Bankruptcy Court for the Southern District of New York considered the bona fides of an involuntary chapter 11 petition filed by certain holders of U.S. dollar-denominated notes against a holding company for a group of Chinese property development companies that filed a restructuring proceeding in the Cayman Islands after the noteholders filed the involuntary chapter 11 petition. The court denied the debtor's motion to dismiss the chapter 11 case. Given the timing of the filing of the Cayman Islands restructuring proceeding, the absence of any progress in the proceeding for seven months, the debtor's need to restructure notes governed by U.S. law, and the debtor's lack of any meaningful contacts to the Cayman Islands, dismissal of the chapter 11 case was unwarranted under the applicable provision of the Bankruptcy Code, international comity, or the doctrine of forum non conveniens. [read more …] Bankruptcy Court Evaluates Trustee's Authority to Sell Avoidance Actions and Right of Target Defendants to Object In In re Law Enf't Officers Sec. Union, No. 24-70277-JAD, 2026 WL 560452 (Bankr. W.D. Pa. Feb. 27, 2026), a chapter 7 trustee sought court approval to sell certain avoidance actions to a creditor of the debtor's estate. Potential targets of the subject avoidance actions objected, arguing that such claims were nontransferable powers of the trustee rather than saleable estate property and urging the court to approve their competing settlement with the trustee. The U.S. Bankruptcy Court for the Western District of Pennsylvania disagreed with the potential defendants, holding that they lacked standing to object to the proposed sale, that avoidance actions are indeed estate property, and that the sale—rather than the settlement—best served the estate's interests. [read more …] U.S. Supreme Court Bankruptcy Roundup in Brief In Keathley v. Buddy Ayers Construction Inc., No. 25-6, 2026 WL 1686028 (U.S. June 11, 2026), the U.S. Supreme Court overturned a Fifth Circuit decision judicially estopping a chapter 13 debtor from asserting a personal injury claim against a construction company because the debtor failed to disclose the claim during his bankruptcy case. In so ruling, the Court held that "[t]he Fifth Circuit erred by artificially narrowing its inquiry to whether the debtor had knowledge of the underlying facts or a potential motive to conceal the claim." It represents the first time that the Court has applied judicial estoppel in the bankruptcy context, although it has suggested in other contexts that it may be inappropriate where an inconsistent legal position resulted from "inadvertence or mistake." Also in June, the Court denied petitions for certiorari in a few notable bankruptcy cases. [read more …] Newsworthy Heather Lennox (Cleveland/New York) (Star Individual), Bruce Bennett (Los Angeles) (Senior Statesperson), Kevyn D. Orr (Washington) (Eminent Practitioner), Gregory M. Gordon (Dallas) (Band 1), Carl E. Black (Cleveland), Corinne Ball (New York) (Senior Statesperson), Brad B. Erens (Chicago), Jeffrey B. Ellman (Atlanta), T. Daniel Reynolds (Cleveland), and Dan T. Moss (Washington/New York) were recognized as leading lawyers in the practice area Bankruptcy/Restructuring in the 2026 edition of Chambers USA: The World's Leading Lawyers for Business. The 2026 edition of Lawdragon 500 Leading Bankruptcy and Restructuring Lawyers ranked the following lawyers: Corinne Ball (New York) (Hall of Fame), Bruce Bennett (Los Angeles), Carl E. Black (Cleveland), Jeffrey B. Ellman (Atlanta), Brad B. Erens (Chicago), Gregory M. Gordon (Dallas), Heather Lennox (Cleveland/New York), Joshua M. Mester (Los Angeles), and Kevyn D. Orr (Washington). Fabienne Beuzit (Paris) and Jasper Berkenbosch (Amsterdam) were among the "Leading Individuals" ranked in the 2026 edition of The Legal 500 EMEA guide in the field of Restructuring and Insolvency or Insolvency. Rodolphe Carrière (Paris) was named a "Next Generation Partner" in the practice area Insolvency. Sid Pepels (Amsterdam) was selected by Global Restructuring Review's 40 under 40 2026. He was identified as a Rising Star within the global cross-border restructuring community. Global Restructuring Review is a leading digital subscription service, news outlet, and information platform dedicated exclusively to cross-border insolvency and corporate restructuring law. Fabienne Beuzit (Paris), Rodolphe Carrière (Paris), and Isabelle Maury (Paris) were recognized in the 2027 edition of The Best Lawyers in France™ in the practice area Insolvency and Reorganization Law. An article written by Corinne Ball (New York) titled "Comity and Fairness are Critical to Granting Additional Assistance under Chapter 15: A Canadian Reverse Vesting Order and Related Releases in Proceedings Involving Canadian and U.S.-Affiliated Companies Are Approved" was published in the June 24, 2026, edition of the New York Law Journal. An article written by Caitlin K. Cahow (Detroit) titled "New York Bankruptcy Court Weighs In on Adequate Assurance of Future Performance under Assigned Leases and Chapter 11 Plan Exculpation Provisions" was published on June 8, 2026, in Lexis Practical Guidance. An article written by Trisha L. Mowbray (Real Estate; Chicago) and Ryan Sims (Washington) titled "Chapter 11 Plan that Abridged Non-Debtor Lessee's Rights to Remain in Possession After Rejection Unconfirmable as Having Been Proposed in Bad Faith" was published on June 16, 2026, in the Harvard Law School Bankruptcy Roundtable. An article written by Dan T. Moss (Washington/New York), Corinne Ball (New York), Isel M. Perez (Miami), and David S. Torborg (Washington) titled "Texas Bankruptcy Court Adopts Barnet Rule Requiring Foreign Debtor to Have U.S. Assets to Be Eligible for Chapter 15 Relief" was published on June 10, 2026, in Lexis Practical Guidance. An article written by Daniel J. Merrett (Atlanta) and Nathaniel Parr (Atlanta) titled "Southern District of Texas Clarifies Post-Purdue Course for Consensual Third-Party Releases and Gatekeeping Provisions" was published on June 11, 2026, in Lexis Practical Guidance. An article written by Corinne Ball (New York) titled "LMEs, Sophisticated Investors and Equitable Mootness: The Fifth and Third Circuits Warn Against Testing the Limits of Chapter 11" was published in the June 2026 issue of the American Bankruptcy Institute Journal. Nicholas J. Morin (New York) was quoted in an article titled "Serta Ruling Offers Damages Road Map in Lender-on-Lender Disputes," published by Bloomberg Law on July 7, 2026. The article discussed U.S. Bankruptcy Judge Christopher Lopez's July 7, 2026, ruling that participating lenders in Serta Simmons Bedding's 2020 non-pro rata uptier exchange breached the credit agreement's ratable-sharing provision, and awarding excluded lenders more than $261 million in damages. The opinion resolves six years of litigation related to Serta's 2020 transaction, where it raised $200 million in new financing and exchanged $1.2 billion of term loans for $875 million in superpriority debt. Judge Lopez found that the debt-for-debt exchange constituted a "payment" under the credit agreement, requiring proportional sharing among lenders, and dismissed various defenses raised by the participating lenders. The case is Serta Simmons Bedding LLC v. AG Centre Street Partnership (In re Serta Simmons Bedding LLC), 2026 WL 1968535 (Bankr. S.D. Tex. Jul. 7, 2026). The New York Law Journal has recognized Andrew M. Butler (New York) as a 2026 "Rising Star" in Restructuring/Bankruptcy as part of the New York Legal Awards. The Rising Star category recognizes New York's most promising lawyers age 40 and under who have distinguished themselves through exceptional legal work, leadership, and contributions to the profession. Lawyer Spotlight: Daniel J. Merrett Dan Merrett, a partner in the Atlanta Office, has spent nearly 20 years representing all manner of stakeholders in complex corporate restructurings and chapter 11 reorganizations. His practice extends to related transactions and disputes involving acquisitions; divestitures; credit facilities; securities; environmental obligations; and vendor, employee, and governance matters. Dan has substantial experience managing mass tort liabilities, including the restructurings and related chapter 11 cases of affiliates of Georgia Pacific and Johnson & Johnson, implemented to resolve asbestos and talc liabilities. He also represents key parties in energy and infrastructure matters, including facility owners, EPC contractors, and joint-venture parties. Dan was a key player in the restructuring teams in the historic bankruptcies of the City of Detroit and Chrysler. His other significant representations in chapter 11 cases include AFA Foods, Alpha Natural Resources, Dana Corporation, M&G Chemicals, McDermott International, Monster/CareerBuilder, Transtar Industries, and Westinghouse. He is licensed in both the United States and England & Wales and recognized in restructuring by Chambers USA and Best Lawyers.
Video Q&A: Why enrollment growth can hide years of risk for health plans
Health plans are moving past simple membership growth as the standard for success toward a model that brings pricing, network adequacy and acquisition cost information into one connected view. In this interview, a health payer strategy expert explores: Why enrollment is a leading indicator that can mask trailing risks for 12 to 24 months What […]
As deaths mount at Michigan's women's prison, critics impugn health care
Five women have died at Michigan's women's prison since May, sparking allegations of poor medical care. State officials insist it is adequate.
The Big Holes in Wearable Heart Rate Variability And Readiness Scores
On September 9th, Apple announced it was revamping its Apple Watch Health Sensing System, rolling out a Readiness score (0 to 10), and increasing the frequency of heart rate variability (HRV) outputs 24-fold. This can be viewed as upping its competition with various other consumer wearable sensors. These “readiness scores” as a composite of multiple metrics, with heart rate variability (HRV) being front and center for most. The majority of Americans are now using wearable sensors, which equates to well over 100 million adults. HRV and Readiness scores are increasingly being marketed as a measurement of autonomic nervous system health, a digital marker for future disease, a clock for biological age, and a holistic metric to promote healthspan and even longevity. (Apple also introduced a new longevity tab and “Health Age”.) None of this has been proven. In this edition of Ground Truths I am going to review what we know about heart rate variability and readiness scores. Heart Rate Variability HRV is the variation in normal heart cycle timing. The variability of the heart rate, the barely perceptible millisecond changes in time between consecutive heart beats (see R-R intervals in the Figure below, left panel), is due to interplay between the sympathetic and parasympathetic (vagal nerve) inputs. Distinct from heart rate, individuals with the same heart rate can have very different HRVs. It is a rough reflection of the autonomic nervous system (ANS) activity, inadequate to say whether a person’s ANS function is abnormal. For more than three decades, heart rate variability (HRV) has been measured and several studies have found an association of low HRV and clinical outcomes, particularly a link with higher all-cause and cardiovascular mortality. There have also been less well established links of low HRV to risk of early cognitive impairment, dementia, mental illness, Type 2 diabetes and substance abuse. An important reminder is that HRV is a surrogate marker without any established cause-and-effect relationship. If you increase your HRV, that doesn’t mean it will improve health outcomes. In fact, there is no hard evidence for that. All that work linking to health outcomes was done with electrocardiogram (ECG) derived HRV. Now, in the era of consumer wearables, this is getting assessed differently, by optical pulse (yes, the lights you see) plethysmography (PPG) or what is called pulse rate variability (PRV). They are not the same, as shown below (right panel) and only concordant when the delay between the ECG and pulse is kept constant, which basically means at rest. I should mention there’s also what I will call MPV, a mattress mechanical movement sensor, a derived heart rate variability, that companies like Eight Sleep use, even further away from directly measuring HRV. HRV has not one uniform measurement but many different types of quantification, such as RMSSD, the magnitude of difference between successive R-R intervals of normal sinus beats (N-N) or SDNN, the standard deviation of NN intervals, both in milliseconds. SDNN is one of the so-called frequency domain HRVs (others are LF, HF, LF/HF). Different wearable sensors use different metics; Apple has relied on SDNN and nearly all of the others use RMSSD, which is generally considered the more accurate metric. There’s also the different length of time measured, such as for a matter of minutes, all day, or an overnight’s sleep. Short measurements are especially problematic since they don’t capture enough of respiratory modulation and other factors that influence HRV. Share Ground Truths How well does HRV correlate with PRV? There are very limited studies, especially independently done. One that is commonly cited was conducted by Air Force researchers in only 13 healthy adults assessing Oura ring 3 and 4, Whoop 4.0, and Garmin Fenix 6 and showed a correlation coefficient of 0.88 to 0.97 and a mean absolute percentage error from 6 to 10%. The correlation is not a perfect 1.0, but there’s at least a fairly high level of correlation. HRV is supposed to increase during the night due to takeover of the parasympathetic nervous system, and higher during deep sleep. A recent example of my 1 week, all day “HRV,” and one during sleep is shown below. As you can see, the N of 1 data are inconsistent for the same days from different sensors (Oura, AppleWatch, Fitbit Air, and Eight Sleep) by patterns, absolute numbers, and comparison with prior days and weeks. The largest study in over 8 million Fitbit users (the old version, not Google Fitbit Air, introduced in May 2026) gives you a sense of the effect of age, sex, and the 2 different main HRV (here PRV) metrics, with RMSSD on the left and SDRR (=SDNN) on the right below. That study, from data collected in 2018, is a major outlier, since all the more recent ones are tiny with respect to sample size. Many of the companies have not had independent evaluation of their HRV, such as Eight Sleep, but have published a low standard error on their website. There are some other published studies on the correlation between HRV and PRV, but they are all small and only in healthy adults. A scoping review emphasized the lack of study in underrepresented individuals, including the aged, people of color (which affects the PPG signal), and individuals who are underweight or obese. Add the typical adult age 60 plus with one or more chronic diseases. For example, one study in over 900 adults found poor correlation of HRV and PRV, non-uniformly underestimated across many chronic diseases (cardiovascular, endocrine, neurological, respiratory, and others), concluding PRV is “an invalid surrogate for HRV.” A recent systematic review of 43 studies comparing HRV and PRV found reasonable pooled absolute standardized error (HRV as gold standard) but only 10 of the studies provided quantitative synthesis in ideal conditions. Their main conclusion was similarly cautious: “PPG-derived HRV [PRV] should not be regarded as universally interchangeable with ECG-derived HRV across all devices, populations, and recording contexts.” Factors Affecting HRV and PRV That gets me to the long list of factors that affect HRV (and PRV) besides the device, the type of measurement (RMSSD, SDNN or others), the person’s signal, the sensor site, the duration of data capture, if weighting by sleep stage is used, how artifact is processed and corrected. And this list is not complete!: Oura puts out data from their community of users (who input data) on what affects their overnight HRV. The factors currently provided are: no alcohol (increase 8%), melatonin (increase 2%, float tank (increase 2%), wine (decrease 4%), and party (decrease 14%) in overnight HRV. Must be some big parties! Subscribe What is a PRV measurement good for? It has been falsely characterized as an index of “autonomic balance” and a specific indicator of stress. A 2018 review of the studies available for HRV and its relationship to stress, not using any of the current wearables, found that stress can lower HRV. But so can many other factors. The non-specificity of the signal, indexed to the table above, is striking. Evidence from a UK Biobank study of over 46,000 participants with actual HRV looked at genetically predicted HRV, a genetic risk score, that failed to show the expected HRV-mortality link, indicating that _HRV is likely not causa_l, but rather a reflection of person’s physiologic state. A review of consumer wearable HRV data from 5 longitudinal studies showed that nighttime PRV was not associated with perceived stress, and surprisingly higher HRV, in the largest cohort (N=717 participants), was correlated with higher stress. An Oura ring cohort of 525 first-year college students found a link between overnight PRV and perceived stress, but that was also seen with resting heart rate, sleep, and respiratory rate. Several very small studies have examined the relationship of HRV and athletic injuries or guiding training with mixed, and predominantly negative results. HRV biofeedback training with paced breathing had no significant effect on reducing stress or raising HRV, as demonstrated with sham controlled trials. When HRV for multiple days showed a decline in conjunction with body temperature, the Oura ring published data for prediction of Covid. The WHOOP company sponsored an observational study, published in 2026, of 30,000 users for 72 weeks, without a control group, that reported reduced alcohol intake (5.8 % points) by self-report. That doesn’t tell us much, and particularly about the merits of HRV for behavioral change. If you use the same device and conditions as longitudinal trends for multiple (at least 2-3) weeks that may be the one way to get something useful from the measurements. Data for overnight sleep with minimal motion and using RMSSD is the best proxy for real HRV. The reason to look at trends rather than any given night is that it more likely represents something, even though you won’t know with certainty what the “it” is. Keep in mind there are no data, no peer-reviewed evidence, to show that HRV fluctuation in-person has any correlation with health outcomes. Share Readiness Scores These are proprietary scores that integrate different metrics for each of the wearables: no algorithms have been disclosed. They are unvalidated against health outcomes. In a review of 14 composite health scores of readiness and recovery, HRV contributed 86% to the scores, followed by reading heart rate (79%), physical activity and sleep duration (both at 71%). That review noted the substantial variability in measurement protools and lack of standardization. Sleep staging is notoriously inconsistent and inaccurate by these sensors, which adds further to the HRV uncertainties for what the scores, which use sleep stage data, mean. Only resting heart rate has been shown consistently across devices to be extremely accurate. I’ve made a Table to summarize what we know about which metrics are included, the scores, any peer-reviewed studies that compared the readiness score with health outcomes, and the corresponding (if any, NA-not available) citation. You will note that some companies do not use the term “readiness," such as WHOOP for recovery, and Garmin, which has 2 different scores, one of which is Body Battery. Eight Sleep uses the term “Fitness Score.” They all include HRV; Apple includes a new metric they call “Recovery HRV” which among other components uses 7-days of sleep, but it is unclear what this means or how it is differentiated from other scores (there are clearly no data for outcomes). We have no knowledge of how the different components are weighted or whether any of these scores are better than resting heart rate, HRV alone, physical activity, or any other single metric. Since none of these are standardized, they are not interchangeable, so if you get a 90 for Oura that has no relationship to a 90 on a Google Fitbit Air. Notably, the company can update its algorithm for readiness score at any point without notification to device users. Without any useful evidence of actionability for these scores or established relationship with health outcomes, it is hard to make a case for their value. At the Apple recent announcement they showed their Readiness score (0-10) on the watch (Figure below) but there are no published data on this score, not even on their website. It’s available only on their new Watch Series 12 or Ultra 4 [of course, ;-)]. That exemplifies the problems with these scores, lack of data and evidence for being meaningful to promote health. Perhaps the best study (which isn’t saying much) is the WHOOP Recovery for golfer performance, because it did correlate with an objective outcome, even though there was no control group and the authors were all from the company. Among the 389 pro golfers, an absolute 10-per cent point increase in Recovery score was associated with about 0.5 fewer strokes per round. But that’s hardly a health outcome! WHOOP is also conducting a study in over 2,700 runners to see if their recovery score will be linked to less injuries and improved performance, but that is not yet published and has no control group or randomization. Putting This in Context For two decades I’ve been enthusiastic about the potential for digital health and particularly wearable biosensors. Over the years, we’ve seen some great progress for their ability to promote physical activity and accurately detect atrial fibrillation (the first FDA cleared deep learning AI for consumers). That work was the subject of rigorous research. But there are holes in the data and evidence for other metrics. One notable one is the “VO2 max” story that I wrote about earlier this year. At that time many subscribers asked me to cover heart rate variability, which I finally got to here. When I dived into the research and publication for HRV and readiness scores, I expected to find at least some that were of high quality and demonstrated their utility by linkage to health outcomes. To my surprise, I found none. The wearable sensor measurements for HRV (PRV) are, for the most part, accurate, but that validation work has only been done in small studies of healthy adults and does not take into account the long list of factors, from the device, software side, and the user side, that affect HRV measurements. Moreover, this metric chiefly relies on optical sensing and, as we have learned for heart rate PPG sensing, may be less accurate in people of color. Keep in mind that all of the health outcome association evidence comes from ECG-derived HRV; none are from wearable sensor data. I will repeat the key point: there's no peer-reviewed evidence to show that in-person HRV fluctuation—or efforts to raise your HRV— has any correlation with health outcomes. For those of you who look at your HRV on awakening, or even 2+ week trends of it being low, I hope this context helps to relieve any anxiety. Yes, low HRV (not PRV) has been shown to increase risk of some diseases as summarized above. But efforts to raise your HRV—a surrogate metric— has not been established for improving any health outcomes. HRV does not have any evidence of causality (the genetic evidence actually goes against this possibility). In this summary, I have not included data for other wearable sensors such as Polar, Samsung, Withings, Suunto, Amazfit, Coros, Ultrahuman, or additional mattress sensors. These are beyond my first-hand experience, and as far as I know from my in-depth review none have any peer-reviewed published data that differ from the 6 sensors I’ve reviewed here. From the points I’ve gone over above, we’re not ready for readiness scores. Besides being proprietary, they are predominantly based on metrics that have their own issues. It’s compounding the problem, like building a house without a solid foundation that has never undergone a rigorous inspection, and then selling it. Like I mentioned for PRV, you can look at trends over weeks rather than any single day, to get a handle, but even that may not be helpful. There’s simply no evidence that these scores meaningfully relate to health outcomes. I’d emphasize they might, but that requires doing prospective or randomized studies to prove it. None exist. There’s great promise for HRV/PRV utility_. For example**,**_ Prof Maiken Nedergaard, who discovered the brain glymphatics that are essential in eliminating metabolic waste products from the brain during sleep, has posited that HRV could be a non-invasive marker for neuromodulator oscillations, brain-body regulatory circuits, and brain clearance. That would be extremely useful, but like everything else on HRV and readiness scores it requires solid research and validation. The lay media isn’t helping much to get the story straight. Earlier this year The Economist published a piece entitled “The most useful indicator of your overall health” which ordained HRV as an “accumulated stress score.” That’s akin to the false assertion about VO2max: “V02 max is the singular most powerful marker for longevity.” As I’ve summarized here, that is not established. The fact is that so many things can lower HRV, including physical exercise (especially an intense workout), reduced sleep quality, stress, the list above, no less the device, signal, and software. Whatever fluctuations observed have not been correlated with any health outcome. Sadly, “datamaxxers” are widely using HRV and readiness scores that have never been validated to mean anything. We already know that for some people using the sensors for sleep metrics, it can induce “orthosomnia,” an obsession to get high sleep quality, with associated high levels of anxiety. In an experiment done by a company to promote sleep quality for its employees, “For those employees who did use the trackers, many reported feeling perfectly rested until their tracker told them they had had a terrible night. Others were told that they had slept like a baby when they had actually been lying awake worrying about the quality of their sleep. “ The same problem can result from preoccupation with HRV or readiness scores, with anxiety that would lead to further reduction in both. It you are using a wearable like >100 million American adults, it’s OK to look at these data, but contextualized with the major caveats reviewed here. If you are one to require evidence that HRV or readiness scores are linked to health outcomes, you may not even want to look. The companies make it hard to turn them off! Let me end with the companies that make and sell wearables. Apple’s doubling down on HRV (24-fold more reporting and heart rate very 5 seconds) and introduction of a Readiness score tells us that consumers have bought into these metrics and they are joining the club. However, all of this is occurring with a backdrop of tens millions of users, claims about the data that are not backed up by adequate evidence, marketing way out in front of whatever limited data exists, and not being transparent about their readiness score algorithms. The companies can well afford to do the research that is needed to connect these metrics with health outcomes show, once and for all, that increasing HRV or using readiness scores promotes our health. If they believed and invested in the products they are selling, we’d not be in this position of not knowing. That’s essentially where we are with HRV and readiness scores. Perhaps someday this will change and we’ll have good reason to embrace them. NB: I wrote this post. No AI. I have no conflicts of interest with any of its content. Loading... Ground Truths has 215,000 subscribers from every US state and 214 countries. There are over 300,000 followers of Ground Truths so more than 90,000 folks who can easily convert to be free subscribers. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. If you’re not a subscriber, please join! If you found this interesting PLEASE share it! Share Ground Truths The proceeds from all voluntary paid subscriptions go to support our summer internship program. It enabled us to accept and support a record number of 62 summer interns that joined us in 2026! These are high school, college and medical students selected from thousands of applicants. We couldn’t do this expanded program without the funds coming in through Ground Truths. Thank you!
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Cuba: US Embassy issues health alert due to GI pathogens like norovirus, Shigella
The US Embassy in Havana issued a health alert last week after seeing a significant increase in diarrheal illness across Cuba, associated with the continuing degradation of the water and energy infrastructure. This degradation affects water supply, and food storage and temperature control. Recent cases have included E. coli, norovirus, Shigella, and other gastrointestinal pathogens. This comes after a health alert dated August 28 which noted that Cuba’s water delivery infrastructure is increasingly unstable. The Embassy is aware of reports of residential neighborhoods that have gone for long periods without receiving water from municipal or public sources. Dengue cases surge in the Tampa Bay area Prolonged and worsening water issues and power outages caused by the regime’s mismanagement of public infrastructure impact the entire island. Water often only flows to residences when city power is on for a sufficient amount of time. Media reports indicate wells are running dry across the country due to drought, aggravating the ability to supplement water delivery. The lack of water, coupled with power shortages that have disrupted cold chain networks, can present significant health and safety challenges. We remind U.S. citizens to be aware of the risks when traveling to Cuba and take precautions. Embassy officials offer the following precautions to prevent illnesses: Avoiding Foodborne Illness: Be cautious of meat, poultry, seafood, eggs, dairy, and other perishable foods that may have been inadequately stored. Avoid foods that appear to have been sitting at room temperature for extended periods. Avoid raw or improperly washed vegetables. Be cautious of food cooked and then cooled, stored, or reheated, as improper temperature control can allow pathogens or toxins to develop. Wash hands thoroughly with soap and water before eating and after using the restroom. Hand sanitizer may be less effective against certain gastrointestinal pathogens, including norovirus. Outbreak News Today is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe Water Safety: Use only water known to be safe for drinking, brushing teeth, making ice, and cooking. Use bottled or appropriately treated water; check that bottle seals are intact before opening. Avoid ice unless the water source is known to be safe. Do not use untreated tap water to prepare beverages or food. Be aware that contamination can occur when food, utensils, and surfaces are washed with contaminated water. If You Become Ill: Stay hydrated, especially with frequent diarrhea or vomiting. Most illnesses are self-limited and improve within several days. Seek medical attention for persistent or severe diarrhea, bloody stools, high fever, significant abdominal pain, repeated vomiting, signs of dehydration, or symptoms not improving. Common medications (e.g., acetaminophen, ibuprofen, antibiotics) are frequently unavailable in Cuba; consider bringing your own supply. If you like the reporting on Outbreak News Today, please consider a paid subscription for $5/month or $30 a year. Help support the cause of this niche journalism. It is appreciated.
Truth and Politics in the Age of Post-Truth
Get E-International Relations delivered to your inbox, free of charge. As you sign up, consider becoming a paid subscriber, or make a donation, to support our work. Subscribe This is an excerpt from Global Politics in a Post-Truth Era. You can download the book free of charge from E-International Relations. The term post-truth is by now so ubiquitous in describing the state of politics in the Western world and even beyond that the most pressing issue of the day appears to be about making democracy work in the era of post-truth rather than questioning the normalisation of the term itself in the first place. The critical turning point appeared to have occurred in 2016 when the term was chosen by the Oxford English Dictionary as ‘The Word of the Year.’ On its website, the Dictionary notes the transformation of post-truth from ‘being a peripheral term to being a mainstay in political commentary and connects ‘the spike in frequency’ directly with the Brexit referendum in the United Kingdom and the election of Donald J. Trump in the United States – both occurring in 2016. Paired with the noun ‘politics,’ post-truth is defined as an adjective ‘relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.’ The Oxford English Dictionary traces the first use of the term to a 1992 essay in The Nation by the playwright Steve Tesich as he reflected on the 1980s Iran-Contra scandal and the 1990–91 Gulf War: We are rapidly becoming prototypes of a people that totalitarian monsters could only drool about in their dreams. All the dictators up to now have had to work hard at suppressing the truth. We, by our actions, are saying that this is no longer necessary, that we have acquired a spiritual mechanism that can denude truth of any significance. In a very fundamental way we, as a free people, have freely decided that we want to live in some post-truth world (Tesich 1992, 13; emphasis added). He then continued, The Gulf War is over but the war at home goes on. The gulf between rich and destitute widens – between those of us who live in a modern post-industrial nation and those of us who live in the Third World countries of our inner cities. The present administration’s response to this internal crisis has shifted from benign to malignant neglect. The current levels of misery and decomposition of our cities and the economic gulags of our ghettos are acceptable. Since there is only so much hope to go around, there is a freeze on hope. The have-nots have now been reclassified as never-will-haves (Tesich 1992, 13). In the context of Tesich’s essay, truth includes both facts, as in what happens, and ‘moral absolutes,’ as in the ‘self-evident truths mentioned in our Constitution’ (Tesich 1992, 14). Together, these two notions of truth entail the obligation to both act and react. The two passages cited above show that even in the early post-Cold War years, Tesich was already deeply concerned that the American people are neither prepared to act on truth nor react to truth that is disconcerting, or what he calls ‘bad news’ (Tesich 1992, 12). Accordingly, Tesich’s insight as captured by the term post-truth is not that truth is irrelevant to what we know, but rather it is irrelevant to how we act. In contrast, ‘post-truth politics,’ as defined by Oxford as a term that pitches ‘objective facts’ against ‘emotion and personal belief’ such that the latter appears to have overtaken the former in shaping ‘public opinion’ and thereby, democratic politics. When Tesich’s post-truth politics and its current usage are juxtaposed, the two are in fact not identical in terms of what truth is and how it relates to politics. Against such consideration, this chapter provides a critical survey of selected historical events and theoretical considerations for the purpose of gaining a more nuanced understanding of the relation between truth and politics. Truth and Language One notable impact of post-truth politics is that language is being overtly deployed as a political weapon not only by politicians and those in power, but among the general population. It seems that once facts are irrelevant to the validity of what is being said, language becomes the platform for an all-out political contest in which what is said is no more than an act of will expressed as an assertion of power and/or an exercise in defiance. As early as in the writings of Thucydides (460–400 BCE), the vulnerability of logos – which is the human capacity for rational discourse in tumultuous times – was already noted. Thucydides belonged to a school of Greek thought which maintained that language is conventional and that the association between name and things is a result of ‘human use and habit’ rather than ‘nature or divine dispensation’ (Connor 1984, 99). The conventional nature of language means that it is incapable of providing its users with any independent criteria for judgement. In Thucydides’ study of the Peloponnesian War (431–405 BCE), the subversion of logos as seen in the manipulation of language was introduced through his account of the civil war in Corcyra (Thucydides 1972, 236-245). The war first broke out in 427 BCE between the pro-Athenian democratic faction and the pro-Spartan oligarchic faction before it spread to the rest of the Greek world. There was a general breakdown of law and order, resulting in extreme violence and death. Language underwent changes that were reflective of the events of the time. The English philosopher Thomas Hobbes (1588–1679) translated Thucydides’ description of the situation as follows: The received value of names imposed for signification of things, was changed into arbitrary. For inconsiderate boldness, was counted true-hearted manliness: provident deliberation, a handsome fear: modesty, the cloak of cowardice: to be wise in everything, to be lazy in everything... he that had been so provident as not to need to do the one or the other, was said to be a dissolver of society, and one that stood in fear of his adversary. In brief, he that could outstrip another in the doing of an evil act, or that could persuade another thereto that never meant it, was commended (Hobbes 1839–1845, 8: 348; Thucydides 1972, 242-243). What concerned Thucydides most was that the meanings of words are no more than linguistic conventions that require logos to support them. The Corcyrean civil war was a reminder that such capacity cannot be assumed. This is why history understood as an authentic account of what happens matters. Guided by logos, the historian’s task is ‘the search after truth’, which is established through ‘the absence of the fabulous,’ including ‘the rejection of myth and unverifiable stories’ (de Jonge 2017, 2). Thus, history plays an important role in facilitating the stability of language – without which distinctions and judgements cannot be rendered communicable. Just like Thucydides, Hobbes was a nominalist who subscribed to the view that there is no inherent meaning to words. Hobbes’ state of nature, where there is no common authority, is precisely one in which distinctions cannot be made. As Hobbes put it, there is ‘no Mine and Thine distinct’ nor is there distinction between ‘the notions of Right and Wrong, Justice and Injustice’ (1968, 188; emphasis in original). This is clearly an unsustainable condition for everyone. Behind Hobbes’ famous words that life in the state of nature is ‘solitary, poor, nasty, brutish, and short’ is his uncompromising argument for the ‘Leviathan’, which is described by the late American political theorist, Sheldon Wolin (1922–2015), as the ‘sovereign definer’ (Hobbes 1968, 186; Wolin 2004, 238–243). Accordingly, the social contract is importantly a ‘linguistic contract’ that binds all parties to ‘general names agreed upon’ (Peters 1979, 125; Hobbes 1968, 111). Through Thucydides and Hobbes, we can identify a line of thinking that sees politics as a contestation over the use of language, which is based on shared conventions and norms. Thus understood, politics is not a collective quest for the true nature of our being or an epistemological exercise in pursuit of true knowledge. Rather, politics is about humans living with one another by finding a shared language to communicate with one another on matters that affect them all. Truth is in that sense contingent on what is being said as opposed to setting the standard for it. In other words, truth is the embodiment of shareability among us. While truth as such ensures the viability of a political entity, truth by no means represents a normative standard to adjudicate among contesting actors in what they say, let alone in what they do. During Thucydides’ times, ancient China was also experiencing a tumultuous time as the ruling Zhou dynasty deteriorated into the period of the Warring States (481–221 BCE). This was when the rulers of Zhou no longer presided over the territories brought under its control through conquest. Instead of professing allegiance to the Zhou royalty, the lords of these territories became kings themselves to rule over their own land. The period was one marked by endless military campaigns as each of the seven major states aimed to conquer the rest (Lewis 1999). Yet, the period was also known for its intellectual vibrancy as different thinkers challenged the restoring of order among these warring states – including offering ideas and advice to rulers on good governance. Among these thinkers was Confucius (551–479 BCE). His thought, which came to be known as Confucianism, went on to become the state ideology of China from the Han dynasty (206 BCE–222 CE) until the end of the Qing dynasty in 1911 when China became a republic. The founding text of Confucianism was the Analects, which is a collection of dialogues between Confucius and his students as recorded by them. One key concept Confucius advanced is the ‘rectification of names’. Though the term only appears in one exchange in the Analects, it is considered a major aspect of Confucius’ thought. Generations of Confucian scholars from past and present, including Western academics, have debated over its interpretation (Makeham 2003). The passage in question reads as follows: Zi Lu said: ‘The monarch of the state of Wei wants you to govern the country, what is the first thing you plan on doing?’ Confucius said: ‘First it is necessary to rectify the names.’Zi Lu said: ‘Is that really what has to be done? You are being too pedantic, aren’t you now? How will you rectify these names?’Confucius said: ‘Zhong You, you are too unrefined. A gentleman, faced with a matter that he does not understand, takes a skeptical attitude. If names are not correct, one cannot speak smoothly and reasonably, and if one cannot speak smoothly and reasonably, affairs cannot be managed successfully. If affairs cannot be managed successfully, rites and music will not be conducted. If rites and music are not conducted, punishments will not be suitable. And if punishments are not suitable, the common people will not know what to do. So, when the gentleman uses names, it is necessary to be able to speak so that people understand. If one can say it, one can definitely do it. A gentleman should not be careless with words’ (Analects 13:3 in Cao 2016, 148). This translation is offered by the contemporary philosopher Cao Feng. As Cao notes, the passage is what started the whole debate over ‘exactly what kind of names did Confucius... wish to rectify’ (Cao 2016, 148). Of the three major groups of interpretation examined by Cao, beginning with classical Confucian scholarship, one is arguably the most influential and certainly most pertinent to the issue of language and politics. This is the interpretation that was first associated with the Neo-Confucian master, Zhu Xi (1130–1200), who argued that the ‘rectification of names is simply the rectification of politics’ (Cao 2016, 149). Within this interpretive framework, rectification has the dual functions of correction and prescription by ensuring that predetermined hierarchical roles are strictly adhered to through following ‘the system of rites and propriety’ (Cao 2016, 151). In addition, the rectification of names entails ‘using names to rectify actuality’ (Cao 2016, 151). Yet Cao rejects this whole body of interpretive works by arguing that these were ideas developed later. Instead, Cao suggests the following: The original meaning of Confucius’ rectification of names may, then, be quite simple. Confucius did not mean to establish a concrete, normative system of “names”; rather, Confucius was simply the first person in history to realize or remark upon the importance of language in politics. As a politician, he noticed and foresaw the impact that the indeterminacy, ambiguity, and arbitrariness of names would have on politics. Confucius recognized the political consequences of language’s not accurately expressing meaning or not being accurately received by people. He realized the great role that names, as a means of distinguishing right and wrong and establishing norms, could play in society and politics (Cao 2016, 168). Scholarly debates aside, Cao’s view has the advantage of identifying an interpretation of this controversial exchange in the Analects that enables its readers to extrapolate from it the observation that the meaning of words depends as much on their users as on their interpreters; neither of which can be predetermined. Accordingly, a good ruler is someone who can speak without ambiguity to his subjects and make good his words through actions. Stated differently, Cao’s view on what concerned Confucius then, who was living through times of protracted political upheaval, is that language is an indispensable political tool for those in power and can be deployed by both good and bad rulers alike. To sum up, this historical survey shows that politics as a war of words is by no means a distinctive marker of contemporary politics nor the Western world. Be it ancient or current, east or west, language is subject to manipulation to serve political purposes and when there is an outright war of words that defies existing norms, it is indicative of a political situation in which people no longer share a language and truth becomes irrelevant. Accordingly, political order entails stability in language use. Truth and Politics As previously noted, current use of the term post-truth as an adjective to the term ‘politics’ suggests that once there was a time when politics aligned with truth. Indeed, if we start with Plato’s Republic as the key founding text of Western political thought, we see that the ideal polis (city-state of ancient Greece) is where truth and politics converge, and justice is achieved. Written around 380 BCE when Athens was still coping with its defeat by the Spartans in the Peloponnesian War, the Republic is a defence of the rule of the ‘philosopher king’, defined as someone who is ‘guided by the truth’ and is ‘always and in every way’ in pursuit of the truth (Plato 1974, 490a). For Plato, truth converges with virtues and hence, letting the philosopher take charge of politics is to let the wisest and the most virtuous lead the less wise and the less virtuous even if it requires compulsion (Plato 1974, 499b). In Plato’s words, ‘…until the philosophers attain power in a city there will be no respite from evil for either city or citizens…’ (Plato 1974, 501e). The uncompromising rule of philosopher-kings is made palatable by the claim that we are all ‘earth- born brothers’ with random mixtures of gold, silver, bronze and iron, but only the gold can rule (Plato 1974, 414–415). Understandably, academic debates over the interpretation of Plato’s Republic revolve around the question of whether truth as attained in philosophy can be realised in politics as action and whether such a connection is even desirable. Without getting into the details of these scholarly exchanges, I suggest that they all share the concern that truth acquired through the rigorous process of philosophical reasoning is not without problem when applied to the real world of living humans. This is because not all humans are philosophers – and indeed, in Plato’s view, not everyone is capable of becoming a philosopher given the protracted and arduous training that one needs to endure to become one. Hannah Arendt (1906–1975), a highly influential political philosopher of the twentieth century, notes that ‘Plato was the first to introduce the division between those who know and do not act and those who act and do not know’ and that such a separation has remained ‘at the root of all theories of domination’ (Arendt 1958, 223, 225). What Arendt points out in this remark is not the gap between theory and practice, but rather that Plato provides the normative ground for those who know the truth to tell those who do not know what to do. Arendt herself took on the challenge of understanding the relationship between truth and politics through her analysis of Nazism and Stalinism. Arendt’s insight, which was controversial when The Origins of Totalitarianism was published in 1951, was to identify Nazism and Stalinism as representative of a new form of political rule – totalitarianism – making it distinct from ‘other forms of political oppression... such as despotism, tyranny and dictatorship’ (Arendt 1973, 460). Arendt defines totalitarianism as a self- contained system of ideas driven by their ‘logic’ and marked by a mode of reasoning called ‘ideological thinking.’ Ideological thinking as such is a distinctive form of political reasoning defined by three characteristics. First, ideological thinking claims to provide a ‘total explanation’ of all historical happenings, encompassing the past, the present, and the future. Second, while ideological thinking is an attempt to account for ‘factual reality’ in its totality, this mode of thinking is paradoxically divorced from reality and experience. This is because experience, being rooted in specificity, is clearly limited in its claim to totality. It follows that as its third characteristic, ideological thinking aims to emancipate thought from the limitation imposed by experience through a ‘specific method of demonstration.’ The method involves arranging facts into an ‘absolutely logical procedure’ that starts from an ‘axiomatically accepted premise’. It is, in short, a ‘process of deduction from a premise’ – which is the only possible movement in the realm of logic that leads to one definitive conclusion. This is how the ‘logicality of ideological thinking’ provides the basis for total explanation and the ‘principle of action’ for totalitarian movement (Arendt 1973, 468–474). Stated differently, totalitarianism is a form of uncompromising idealism that exists in one’s head irrespective of shared reality as experienced. It is the perverse form of what Arendt later refers to as ‘rational truth’, which is the product of the ‘speculative mind’ that belongs to philosophy, mathematics and the sciences. The ‘speculative mind’ is the mind working on its way to generate axioms and theories by relying on the cognitive capacity of the human brain (Arendt 1977, 231). The presence of others has no bearing whatsoever on rational truth. In contrast, ‘factual truth’ is what happens when humans are ‘living and acting together’ (Arendt 1977, 231). Factual truth is therefore particular and temporal by definition. But more importantly, factual truth is ‘political by nature’ because it can only be validated in the context of the human community (Arendt 1977, 238). In other words, factual truth is about humans in their plurality rather than in their singularity. For factual truth to be sustainable, we need what Arendt calls ‘common sense’ – understood as ‘community sense’ (Arendt 1982, 72). There is also another distinction about truth that Arendt makes which is pertinent to understanding how totalitarianism works. The issue is whether the so-called totalitarian ideology is simply an unnecessarily cumbersome way of saying that it is an all-round and polished lie. Here, Arendt calls totalitarian ideology the ‘modern lie’ – in contrast to the ‘traditional lie’. The latter is restricted by two conditions: that it is a lie about the ‘particulars’ and that it deceives only the ‘enemy’ – which means that the liar is not engaged in self- deception. The modern lie, however, involves a ‘complete rearrangement of the whole factual texture’. It also intends to deceive everyone alike, to the extent that those who initiate the lie eventually ‘fall victims to their own falsehood’ (Arendt 1977, 249–254). This distinction between the traditional and modern lie is important. It indicates that not only is totalitarianism a lie, but the lie is in fact too big to fit into the standard meaning of the word. To tell a lie from truth, we need a common standard. In the case of a traditional lie, the common standard is precisely ‘the fabric of factuality’. As such, a lie always appears as a ‘tear’ to that fabric. Yet, modern lies require making a surrogate reality with a completely different context for facts to fit ‘without seam, crack, or fissure, exactly as the facts fitted into their original context’. Arendt notes that as long as those who concoct the surrogate reality are prepared to engage in self- deception to ‘create a semblance of truthfulness’, there is nothing to prevent ‘these new stories, images, and non-facts from becoming an adequate substitute for reality and factuality’ (Arendt 1977, 253–254). Totalitarianism therefore requires a person to stand outside of the system itself in order to make sense of it. Arendt points out that it is futile for us to argue with (for example) a Nazi or a Stalinist on race or class. To confront totalitarianism requires more than just a confrontation with specific facts. It is a more fundamental confrontation between reality as experienced and its total rejection. This means that Nazism and Stalinism are more than radical ways of conducting racial conflict or class struggle. Rather: Totalitarian politics – far from being simply antisemitic or racist or imperialist or communist – use and abuse their own ideological and political elements until the basis of factual reality, from which the ideologies originally derived their propaganda value– the value of struggle, for instance, or the interest conflicts between Jews and their neighbours – have all but disappeared (Arendt 1973, xv). Accordingly: The ideal subject of totalitarian rule is not the convinced Nazi or the convinced Communist, but people for whom the distinction between fact and fiction (that is, the reality of experience) and the distinction between true and false (that is, the standards of thought) no longer exist (Arendt 1973, 474). Who then is the ‘ideal subject’ of totalitarianism? Although there is a revival of interest in Arendt’s observation on truth and politics since the onset of post- truth politics, not enough has been said about her reply to the question (Hyvönen 2018; Klinkler 2018; Lee 2019; Zerilli 2020). Yet if we take a look at Arendt’s portrait of this ideal subject, her view is even more pertinent to our current challenge. As a self-contained system of ideas that is detached from experience, totalitarian thinking offers consistency in ways that reality cannot. Arendt notes that this kind of consistency is especially appealing to those who have lost a sense of bearing in the world (Arendt 1973, 353). They constitute what she calls the ‘masses’. The ‘mass man’ is thus a highly isolated and atomised individual, who is ‘obsessed by a desire to escape from reality’ (Arendt 1973, 318, 352). In his ‘essential homelessness’ the mass man can ‘no longer bear its accidental, incomprehensible aspects’ (Arendt 1973, 352). This longing for escape from reality is a ‘verdict against the world’ in which one is ‘forced to live’ but ‘cannot exist’ (Arendt 1973, 352). Such a situation is ripe for the ‘revolt of the masses’ against ‘common sense,’ which is ‘the result of their atomisation, of their loss of social status’ and with it, the ‘whole sector of communal relationships in whose framework common sense makes sense’ (Arendt 1973, 352). In short, the masses are people who are considered to be ‘superfluous or can be spared … [who] cannot be integrated into any organisation based on common interest’ (Arendt 1973, 311). Whether one agrees with Arendt’s analysis of the social conditions in the interwar years that led to the formation of the ‘masses’, her portrait of the ‘mass man’ is a powerful account of what can happen to an individual who has become disposable to the society that they used to belong to. Hand in hand with this phenomenon is indeed the collapse of ‘common sense’ that leaves the dislodged individual scrambling for reconnection. By offering the masses a substitute reality validated by the ‘logic of an idea’ rather than by experience, totalitarianism makes it possible for them to live in a world where there is no condition of plurality. Between ‘facing the anarchic growth and total arbitrariness of decay’ and ‘bowing down before the most rigid, fantastically fictitious consistency of an ideology’, the masses will likely ‘choose the latter’ (Arendt 1973, 352). A world created by ideology, then, is more attractive to the masses not because ‘they are stupid and wicked, but because in the general disaster this escape grants them a minimum of self- respect’ by conjuring up ‘a lying world of consistency which is more adequate to the needs of the human mind than reality itself’ (Arendt 1973, 353). Moreover, it is precisely this ability to guarantee consistency that makes it possible for the leaders of totalitarian movements to demand ‘total, unrestricted, unconditional and unalterable loyalty of the individual member’ (Arendt 1973, 323). While this chapter is not a study of the social factors that led to specific contemporary developments such as the result of the Brexit referendum or the election of Donald Trump in 2016, Arendt’s ‘mass man’ seem to have found their counterparts among the supporters of Brexit and Trumpism. Studies of voters’ profiles in both events point to a disproportionate share of supporters from white male lower income backgrounds without university educations. These are individuals who have either already lost their jobs to globalisation or who are at high risk of losing their job with very little capacity to be retrained for the twenty-first century market economy of advanced industrialised states (BBC 2016; Pew Research Center 2018). In short, these displaced workers are part of the tapestry forming the modern equivalent of Arendt’s ‘mass man’ – ready to be the recruits of totalitarianism. Conclusion If we step back to take a more comprehensive approach to the relationship between truth and politics, both historically and theoretically, it is not so obvious that 2016 is a defining moment. From ancient China and ancient Greece to our so-called post-truth age, the indeterminacy of language appears to be a persistent political challenge. Language is always open to manipulation by its users to serve power. Nonetheless, the tendency these days is to single out the ubiquity of social media and the proliferation of Internet platforms as the incubator for the countless cyberwars of words that in turn fuel the real world of politics. In this context, language is no longer the conveyor of objective facts and accurate information, but rather the medium for expressing subjective opinions and feelings, as captured by the Oxford Dictionary’s definition of the term ‘post-truth politics’. In contrast, the historical approach used in this chapter shows that it is in fact too easy to point the figure at the Internet and digital communication for the political challenge that we face today. What is being suggested here is that with or without the Internet, language, be it used to convey facts or emotions, is simply a tool for communication that humans have invented. While language per se cannot adjudicate what is true or not true, what is right or wrong, it embodies such capacity when language is a shared norm. That shared norm cannot be sustained without some semblance of cohesion in any given community. Any war of words, irrespective of its platform, is indicative of the breakdown of such cohesiveness. Returning to the original context in which the term post-truth politics was first used by Steve Tesich helps to identify the important distinction between truth as the standard for knowledge and truth as the standard for action. The two do not necessarily coincide. Placed in the context of the history of political thought, this distinction is in fact at the heart of Plato’s Republic. Yet when the philosopher as the quintessential bearer of truth becomes king, the polis that he rules over is far from the ideal of a just state that it purports to be. Instead, it is one that is held together by lies and coercion. What Arendt reveals through her study of Nazism and Stalinism is that it is dangerous for the kind of truth that philosophy generates – ‘rational truth’ – to become the guide to politics. Politics guided by rational truth can only be uncompromising and follows a logic of its own that cannot afford the ambiguity and indeterminacy of reality as lived experiences of humans. A world of post-truth politics can be an opportunity for a new kind of politics if it is indeed about dismantling the idea that truth is the ideal that politics should strive for. But as it stands, the post-truth politics of today is more about invoking a past that never exists to judge the presence as a crisis in naming when the real crisis is about rebuilding a shared space that has room for all – be they of the left, right or centre; cosmopolitan or parochial; civic-minded or self-centred; liberal-minded or bigoted. Politics is and always will be about striving for that space, without which no human can thrive. References Arendt, Hannah. 1958. The Human Condition. Chicago: The University of Chicago Press. Arendt, Hannah. 1973. The Origins of Totalitarianism. Rev. ed. New York: Harcourt Brace Jovanovich. Arendt, Hannah. 1977. “Truth and Politics.” In Between Past and Future, 227–264. New York: Penguin Books. Arendt, Hannah. 1982. Lectures on Kant’s Political Philosophy, edited by Ronald Beiner. Chicago: University of Chicago Press. British Broadcasting Corporation. 2016. “Brexit vote: The breakdown.” BBC News, December 7, 2016. https://www.bbc.com/news/uk-politics-38227674 Cao, Feng. 2016. “A New Examination of Confucius’ Rectification of Names.” Journal of Chinese Humanities 2: 147–171. https://doi-org.subzero.lib. uoguelph.ca/ doi/ 10.1163/23521341-12340032. Connor, W. Robert. 1984. Thucydides. Princeton: Princeton University Press. de Jonge, Casper C. 2017. “Dionysius of Halicarnassus on Thucydides.” in The Oxford Handbook of Thucydides, edited by Sara Forsdyke, Edith Foster, and Ryan Balot. Oxford University Press. DOI: 10.1093/ oxfordhb/9780199340385.013.17 https://www-oxfordhandbooks-com.subzero. lib.uoguelph.ca/view/10.1093/oxfordhb/9780199340385.001.0001/oxfordhb-9780199340385 Hyvönen, Ari-Elmeri. 2018. “Careless Speech: Conceptualizing Post-Truth Politics.” New Perspectives 26 (3): 31–55. https://www.proquest.com/ scholarly-journals/careless-speech-conceptualizing-post-truth/ docview/2204515132/se-2?accountid=11233. Hobbes, Thomas. 1839–1845. The English Works of Thomas Hobbes, edited by Sir William Molesworth. London: John Bohn. Vol. 8. Klinkner, Melanie. 2018. “Reasonable Truth.” International Journal of Media & Cultural Politics 14 (3): 393–99. doi:10.1386/macp.14.3.393_7. Lee, Haiyan. 2019. “When Nothing Is True, Everything Is Possible: On Truth and Power by Way of Socialist Realism.” PMLA/Publications of the Modern Language Association of America 134 (5). Cambridge University Press: 1157–64. https://doi.org/10.1632/pmla.2019.134.5.1157 Lewis, Mark E. 1999. “Warring States Political History.” In The Cambridge History of Ancient China: From the Origins of Civilization to 221 BC, edited by Michael Loewe and Edward Shaughnessy, 587–650. Cambridge: Cambridge University Press. Makeham, John. 2003. “Zheng ming (Rectification of names).” In RoutledgeCurzon Encyclopedia of Confucianism, edited by Xinzhong Yao. Vol. 2: 813-814. New York: Routledge. Oxford Languages, n. d. “Word of the Year 2016.” Accessed 19 August 2017. https://languages.oup.com/word-of-the-year/2016/ Peters, Richard. 1979. Hobbes. Westport: Greenwood Press. Pew Research Center. 2018. “An examination of the 2016 electorate, based on validated voters.” Report, August 9, 2018. https://www.pewresearch.org/ politics/2018/08/09/an-examination-of-the-2016-electorate-based-on- validated-voters/ Plato. 1974. Republic. Translated by G. M. A. Grube. Indianapolis: Hackett. Tesich, Steve. 1992. “Watergate Syndrome: A Government of Lies.” The Nation: 12-14. January 6/13, 1992. Thucydides. 1972. The Peloponnesian War. Translated by Rex Warner. Harmondsworth, England: Penguin Books. Wolin, Sheldon. 2004. Politics and Vision: Continuity and Innovation in Westen Political Thought. Expanded Edition. Princeton: Princeton University Press. Zerilli, Linda M. G. 2020. ‘Fact-Checking and Truth-Telling in an Age of Alternative Facts.’ Le foucaldien 6, no. 1: 2, 1–22. Theresa Man Ling Lee is an Associate Professor of Political Science at the University of Guelph (Canada). Lee is a political theorist who specializes in contemporary political thought. Her research and teaching areas include continental philosophy, Marxism and critical theory, feminism, postmodernism, philosophy of social science, psychoanalysis, multiculturalism, human rights, disability studies, modern Chinese political thought and comparative political theory. Lee has published on a wide range of subjects in these areas, including intercultural pedagogy and the challenges of teaching as a person with multiple minority designations in a Canadian university classroom.
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Shaky political "science": breakdown of the peer review process
[This article is the latest in our “Shaky Political Science” series. In our 38 page report, “Shaky political ‘science’ misses mark on ranked choice voting,” released in December 2025, we examined over 40 studies focused on ranked choice voting (RCV). Many of these studies suffered from puzzling research methodologies, poorly constructed surveys, unrealistic simulated elections, cherry picked data and faulty analyses that often were contradicted by results from real-world elections (a link to our full paper is here). Here are links to the first four articles in our series: the first one summarizing the overall results of our report; the second one analyzed a study co-authored by University of Minnesota academic Larry Jacobs, which was one of the most error-prone of all the research we reviewed in our report; a third article showing an admirable example of two political scientists holding two other political scientists accountable for their flawed, sloppy research; and a fourth article that analyzed seven studies sponsored by New America’s political reform program that deployed flawed methodology based on “simulated” elections instead of real-world elections, which when combined with some basic misunderstandings of RCV, produced odd and misleading results]. In this fifth article in our “Shaky Political Science” series, we examine two flawed studies on the impact of RCV on voter turnout authored by San Francisco State University professor Jason McDaniel. McDaniel’s research in these two papers stands out for its puzzling methodology, inadequate and cherry-picked data, and faulty analyses that not only misunderstands ranked choice voting but reflects a basic misunderstanding of politics in general. The first of the McDaniel studies actually passed through a peer review process and then was subsequently published by the Journal of Urban Affairs, despite its obvious errors. It is perplexing that a jury of peer political scientists did not catch the errors and send it back to McDaniel for a rewrite or outright rejection. This calls into question the credibility of the peer review process itself. The peer review process is supposed to represent the intellectual pinnacle of the profession – a way for academics to certify the quality of each other’s work, and to act as a check against sloppy research. In the case of the McDaniel study, the peer review process failed. Yet his flawed study has been cited dozens of times by other political scientists in their own flawed works — an unvirtuous circle of academic research. Here is the first Jason McDaniel study that we analyzed: “Writing the Rules to Rank the Candidates: Examining the Impact of Instant-Runoff Voting on Racial Group Turnout in San Francisco Mayoral Elections,” by Jason McDaniel, 2016, Journal of Urban Affairs. This study covered San Francisco’s use of ranked choice voting (RCV) in mayoral elections, purporting to show that RCV reduces voter turnout overall, increases voter errors, and has a negative impact on “marginal populations,” i.e. racial minorities, mainly as the result of the alleged complexity of RCV asking voters to rank candidates and having to be familiar with multiple candidates and related dynamics. McDaniel reached these conclusions by examining five San Francisco mayoral elections taking place in odd years (i.e. where there are no federal or state races on the ballot) from 1995 to 2011, comparing three earlier non-RCV races (in 1995, 1999 and 2003) with the later two RCV races (in 2007 and 2011). Only two RCV races were studied, and as McDaniel acknowledged, only the contest in 2011 was “competitive” (that contest in 2007 was the first mayoral election using RCV, and incumbent mayor Gavin Newsom won easily in the first round of counting, earning 74% of first choices and far ahead of the second place candidate who had just 6.3% of first choices). Yet even the allegedly competitive contest in 2011was won by an incumbent with a landslide margin of nearly 20 points. No other elections were studied by McDaniel, even though San Francisco elects 17 other offices besides mayor with RCV, including the 11 seats on the Board of Supervisors (the name for the city council) in even years, and six other citywide offices in odd years. Previous academic research has found that competitive elections can stimulate greater voter involvement and higher turnout. For unexplained reasons, this study ignored at least 34 other RCV races between the years 2004 to 2011, many of which were very competitive and had high voter turnout. Instead, McDaniel’s analysis based its conclusions on data from only a single, marginally-competitive mayor’s race using RCV. These 2007 and 2011 mayoral elections were the only two RCV elections that McDaniel used as the sole basis for his small data set to determine the impact of RCV on voter turnout. Despite having no meaningful data to inform his study, McDaniel nonetheless concluded that RCV lowered turnout when compared to the previous three mayoral non-RCV elections using two-round runoffs. Then, using the same inadequate database of San Francisco elections, McDaniel also found that “Instant-runoff voting is associated with a significant decline in Black voter turnout and White voter turnout…On average, Black voter turnout decreases by 18 points and White voter turnout decreases by 16 points …” But how could he credibly arrive at that conclusion when his study was based on voter turnout in two RCV contests that were not even remotely competitive? Beyond that, McDaniel tacitly admits that the key determining factor driving Black voter turnout was not RCV vs non-RCV elections, but the presence of a viable Black candidate. McDaniel wrote, “Black voter turnout was about 17 percentage points higher for the two elections that featured an African American candidate compared to the three elections that did not” — but one of those three elections did not use RCV. The same dynamic was present for White voter turnout, in which higher turnout was not correlated with RCV vs non-RCV elections, but the presence of a viable White candidate. Beyond that, McDaniel’s voter turnout results, whether correlated with the race of the candidates or RCV vs non-RCV elections, showed no clear patterns. In his Figure 1, he shows low Asian voter turnout in the non-RCV elections in 1999 and 2003 when there was no viable Asian candidate running, but in the 2007 mayoral election using RCV, there is still no viable Asian candidate, yet Asian turnout increases dramatically. For Latinos, voter turnout is virtually the same in 1999 (no viable Latino candidate, non-RCV elections), 2003 (leading Latino candidate, non-RCV elections), 2007 (no viable Latino candidate, RCV elections) and 2011 (leading Latino candidate, RCV elections). Meanwhile White voter turnout increased dramatically from a low in the 2007 mayoral election, in which the leading candidate was a white incumbent, to the 2011 election in which there were no leading white candidates that finished any higher than sixth place with 5.6% of the vote. Clearly other factors were determining voter turnout than either the race of the candidates or RCV vs non-RCV elections. Despite these inconsistent findings, McDaniel boldly marches forth to render conclusions about the impact of RCV on different groups of racial voters, even though his conclusions are not remotely supported by his data. This looks like the worst kind of “data cherry picking” to cover up a puzzling conclusion based on a poor data set involving only two RCV elections, neither of which were remotely competitive. McDaniel’s cherry picking didn’t stop there. In calculating voter turnout for the three non-RCV mayoral elections in 1995, 1999 and 2003, he failed to mention that in each of these years there was a two-round runoff election, with a first round election in November in which no candidate garnered a winning majority of the vote, followed by the decisive runoff in December. So there were two non-RCV elections in each election year. But McDaniel only decided to include one of the two elections in his data set, apparently the December runoff in each year (which had higher turnout in two out of the three mayor’s races, and lower turnout in the third). So he ignored the November 1995 election, the November 1999 election when turnout was only 45 percent, and the November 2003 election when turnout was only 45.7 percent. This is flawed methodology based on blatant cherry picking, since McDaniel simply omitted three elections worth of data that did not fit within his frame. His study should never have made it through a peer review process, and it is an embarrassment to political science that not only was it approved for publication, but it has been uncritically cited by dozens of other political scientists. Share A “study” without wider context or credible data Lacking a data set that included even a single competitive RCV mayoral race, McDaniel declared that RCV lowered voter turnout in 2011, when turnout was 42.5 percent. But he also ignored -- or did not realize -- that voter turnout in mayoral elections during 2011 had sharply declined in all big cities, including far more steeply in nearby Los Angeles and other cities. In fact, San Francisco’s election in 2011 had the second highest turnout of any mayoral election in the nation’s 22 largest cities from 2008-2011. Was 2011 just a particularly low turnout year all across the country, perhaps because the country was still reeling from the aftermath of the housing market collapse in 2008-2010? McDaniel ignored this factor and did not search for alternative explanations beyond his flawed thesis. Furthermore, while McDaniel suggested that RCV leads to more “overvotes” – which is an invalidated ballot in which a voter, in either a non-RCV or RCV race, makes a mistake and selects two candidates for a single choice – he failed to address that in the June 2012 US Senate primary contest, which used the typical “one-choice” plurality method and did not use RCV, there was more than five times as many overvotes in San Francisco and Oakland than in the RCV mayoral elections in those cities. Additionally, turnout had been significantly higher and more representative in RCV elections for the San Francisco Board of Supervisors races -- that McDaniel didn’t even bother to study -- as compared to previous “delayed two-round runoffs” for those offices, often higher by as much as 40% in the RCV races. Perhaps the most surprising irony was that an earlier study co-authored by McDaniel (Overvoting and the Equality of Voice under Instant-Runoff Voting in San Francisco by Francis Neely and Jason McDaniel, 2015, California Journal of Politics and Policy) found that overvotes are often more common in lower-income precincts, but that the pattern of overvoting is similar in both RCV and non-RCV contests. Wrote Neely and McDaniel: “[Overvote] errors appear to be a function of complexity in general and not IRV per se…. the pattern of overvoting is similar in both IRV and non-IRV contests…Even among votes cast in a top-of-the-ticket race like U.S. Senate, overvoting occurs in an uneven fashion” (IRV, or ‘instant runoff voting,’ is another name for ranked choice voting in single-winner contests). So McDaniel not only contradicted his own conclusion in his earlier study with Neely, but the earlier study had been an important corrective for one of the most frequently made mistakes made by anti-RCV political scientists – a continual failure to provide crucial context by pairing a comparative analysis of real world RCV elections with an analysis of real world plurality or other electoral methods. Unfortunately McDaniel’s earlier study does not get cited much by other researchers, and McDaniel did not even cite it in his own flawed study analyzed above. Incredibly, McDaniel cherrypicked McDaniel, even as his flawed study has been cited dozens of times. Despite being a textbook example of poor political “science,” featuring both inadequate as well as cherrypicked data, the shelf life of McDaniel’s study has been extended endlessly by other political scientists and media outlets who have cited it uncritically. Equally troubling, the Journal of Urban Affairs put this paper through its peer review process and published it despite its numerous flaws. McDaniel gets it wrong, Part II Not content with producing one shoddy, confused paper, McDaniel produced another one a few years later, here is the link: Electoral Rules and Voter Turnout in Mayoral Elections: An Analysis of Ranked-Choice Voting by Jason McDaniel. San Francisco State Univ. (McDaniel, 2019). In this paper, McDaniel extended his previous flawed research focused on San Francisco, about voter turnout and voter impact, to multiple RCV cities through the 2018 elections. In his data set he included San Francisco, Minneapolis, St Paul, Oakland, Berkeley, San Leandro and Santa Fe. He then compared their turnout in mayoral elections to non-RCV cities, and to mayoral elections in those cities held before first RCV usage, and concluded “a significant decrease in voter turnout of approximately 3–5 percentage points in RCV cities after the implementation of RCV.” But he replicated many of the same mistakes as his first study presented above. While in this study McDaniel attempted to distinguish between various factors, such as odd year vs. even year elections, competitive races vs. noncompetitive, contests with open seats and other factors, the analysis is superficial and inadequate. He attempts to incorporate so many often-conflicting variables that his conclusions are once again unsupported by the actual data, and ultimately unconvincing (this second study never underwent a peer review process). For example, McDaniel declared that for RCV cities “in elections that are more competitive than average (margin of victory less than 20%), there is no significant RCV effect on voter turnout.” Yet McDaniel is a professor in a city, San Francisco, in which the 2018 special election using RCV to fill a mayoral vacancy was exceedingly close, decided by a margin of only one percentage point, and resulted in the second highest turnout in San Francisco history for a mayoral election. Illustrating the complexity involved in assessing the critical factors in turnout, that special election was held on the same election day as federal and state offices, which tends to boost turnout. Yet more voters participated in that RCV mayoral election than voted on the same day in the non-RCV primary for governor in which former San Francisco mayor Gavin Newsom was running. Even more puzzling, in this study McDaniel inaccurately cited his own previous study from 2015 with Neely. McDaniel wrote, “Neely and McDaniel (2015) examine individual ballot image files within a natural experiment, and find higher rates of ballot errors in RCV elections compared to non-RCV elections” (emphasis added). However, we quoted from that 2015 study several paragraphs above, and in actual fact Neely and McDaniel actually concluded the opposite -- that the pattern of overvoting – which is the most common form of ballot error – is similar in both RCV and non-RCV contests. McDaniel also ignored the fact that in Bay Area RCV elections held in even years – at the same time as federal and state elections, when turnout is highest -- the “undervote” (that is, the dropoff in ballots cast for governor or mayor) has declined, which contradicts his thesis that the act of ranking ballots in RCV elections is too complex and presents a barrier for certain demographics of voters. To his credit, McDaniel actually acknowledged another contradiction in his own paper, which found a negative RCV turnout effect in some odd-year elections but not others, admitting that “may present a challenge to the theory that increased complexity [from RCV] will have a marginal negative effect on voter turnout.” But he tried to wallpaper over that contradiction by blaming it on an unlikely source -- bad election administration. McDaniels wrote, “This would suggest that the negative impact of RCV on voter participation may be alleviated by high quality election administration,” without presenting any data or even anecdotes to support such an unfounded theory. While competent election administration of any election, whether RCV or non-RCV, is crucially important, there is no credible research that supports the far-fetched notion that the quality of election administration has much of an impact on voter turnout in US elections, whether using RCV or otherwise. Upgrade to a $5 subscription The unvirtuous circle of academic research It is puzzling how McDaniel’s first study could have survived the peer review process for the Journal of Urban Affairs. The mistakes in McDaniel’s first study above should have been obvious to anyone with a basic understanding of ranked choice voting as well as elections in general, and elections in San Francisco specifically. It undermines faith in the credibility of the peer review process to think that a jury of peer political scientists did not catch the egregious errors and reject McDaniel’s sloppy research and paper. And it remains a black mark on political science that this thoroughly discredited study has been cited dozens of times by other researchers. Indeed, in our research paper it became apparent that many political scientists cite each other’s flawed research to pad their list of citations and to legitimize their own flawed research, creating an unvirtuous circle of political science. More broadly, McDaniel’s voter turnout studies, like other studies evaluating RCV’s impact on turnout, lacked a recognition that no credible opinion or research can claim that RCV increases voter turnout merely because so many voters are excited to vote for their favorite candidates instead of “lesser evil” candidates without worrying about spoilers. Instead, with respect to turnout, the advantage of RCV has always been that, in most places where it has been used, it has eliminated a pre-November primary or post-November runoff, which usually saw about half the turnout of the November general election. This is especially true during even years when there are state and federal elections on the ballot which substantially drive turnout more than local contests. Any study that does not adequately account for this non-November primary/runoff vs November general election dynamic, or odd year vs even year election factors, is simply not credible. Both of McDaniel’s studies largely failed on those grounds. Steven Hill and Paul Haughey Share Upgrade to a $5 subscription Thanks for reading DemocracySOS…your digital portal for the pro-democracy movement. Subscribe for only $5 per month to receive full benefits and to support our work. Subscribe
New commission works to untangle challenges at health licensing boards
After state audits reported inadequate response times by some health licensing boards to complaints about licensees, and other boards behind on healthcare facility inspections, lawmakers set up a new commission to address the issues causing those oversight issues.
U.S. Embassy in Havana issues health alert as sanctions limit imports to Cuba
The embassy issued a health alert Friday warning of a “significant increase in diarrheal illnesses across Cuba” caused by contaminated water and inadequate refrigeration.
Healthcare unions: Staffing shortages mean there are CT hospitals violating law with inadequate oversight
The hospital’s responsibility is simply to sign off that they are staying compliant with the law, but there is no follow-up or checkup by DPH,” said Gadomski
Heavy Metal Sausage was forced to stop serving dinner. It may shutter the acclaimed South Philly restaurant
The South Philly butcher shop's acclaimed trattoria dinners are on pause after a health inspector found Heavy Metal Sausage Co.'s layout inadequate for indoor seating.
Virginia DEQ fines Microsoft $2.5M over Leesburg data center
Virignia DEQ issued about $2.5 million in penalties to Microsoft after its Leesburg data center exceeded permitted fuel and emissions limits.
Macomb takes first step in the creation of a sports complex
The Macomb City Council approved sending a letter of intent to use STAR Bonds for a sports complex project.
ICE arrests a woman who had gone through miscarriage
For several nights, ICE held her at the agency's field office in Burlington without medical care. For more than a year, immigrants and their attorneys have alleged inadequate conditions at this facility.
September Monthly Review: Health MCP Guy?
For all the time I spend talking about APIs and data exchange, this newsletter has had embarrassingly little interoperability of its own. It’s old-school SaaS, baby - UI or bust. Not all of that is my fault! Substack, for all its popularity, is (as mentioned before) really frustrating as my system of record. The primary user it optimizes towards is the reader, whose attention feeds the app, the Notes feed, and the recommendation network that Substack is actually selling. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe They’re falling into the same trap that Medium once sprinted into, albeit at a much more glacial speed. Younger generations may not remember (or never knew) it, but Medium once lured publications like The Ringer and Signal v. Noise onto its platform, only to lose them as it rebuilt itself around a paywall and an algorithmic feed. Substack’s original pitch circa 2020 was the antidote (you own your list), but every new feed feature chips away at it. I get it: writers are generic supply in the eyes of the Substack product team. Generic supply follows demand, so the consistent pressure on the PMs is to generate demand, which leads to every product cycle going toward discovery (Notes, recommendations, the app, live video). The end result lackluster author tools (laggy and broken analytics are truly crippling) all despite the premium price point. The archive is where it crosses from authorial gripes to actual reader impact, though. Across Substack and LinkedIn, I’ve published 1,218 posts and nearly 900,000 words since 2018. Substack’s native search can see only the 464 posts that live on Substack, and even there it’s woefully inadequate at surfacing relevant content (even for the guy who wrote it)! Readers have the same problem, writ large. Ask the Archive Fixing search (for both my readers and my own use) turned out to be extremely non-trivial, unfortunately: There’s no public API for readers to access content RSS exists for new content notification, but it only carries the 20 most recent posts and cuts paid ones off at the preview The only Substack MCP is an admin tool for analytics The export exists for authors, but it’s painfully awkward and slow. So I built something to work around that: the Health API Guy MCP. It’s a private MCP server holding the full text of everything I’ve written across Substack and LinkedIn. Add it to Claude or ChatGPT as a connector and you can ask things like: It pairs keyword search (for acronyms and case names, of which we have many) with semantic search. Every post is also labeled by topic, form, and court case, so you can pull a lawsuit’s (or multiple cases’) entire docket across Substack and LinkedIn in one query: Hail, Healthapiguyhydra This is also a bit of me eating my own cooking. I’ve spent the year arguing that headless healthcare is arriving and that developers want primitives over abstractions. Last week in Hail, Benihydra, I watched Salesforce plug its platform into Claude and bet that the records underneath outlive whatever interface sits on top: Salesforce must believe that the Hydra’s immortal head is the records, permissions, and business logic (in that they will survive whatever happens to the interface). It felt a bit hypocritical to keep my own archive behind a Substack search bar. The archive is the body. Substack is one head, and now whatever tool you might use is another. Will the EHRs follow my lead? Probably not imminently, but one can hope! Why Founding Members Only The MCP is available to Founding Member subscribers. A few reasons: It costs money and time to run. Hosting, the database, Clerk usage and AI compute for search and labeling are significant operational costs (that increase with usage). Substack gives me no way to automate access. There’s no API to check whether someone is a paid subscriber, so every user is manual operations for now. It’s a beta. We’ll need to improve things and parts will break. I’d rather they break for a small group of dedicated readers who will tell me about it. The Founding tier deserved a real benefit. Until now it was mostly a generous tip. Now it comes with something. If you’re already a Founding Member, reply to this email with the address you’d like provisioned. If you’re not and want in, upgrade here. Larger teams (such as companies) can get access too: group subscriptions at the Founding tier come with the group discount. The admin for the subscription can reply with the list of addresses to provision. Get 20% off a group subscription Pricing Founding membership is now a flat $200 a year, replacing the old suggested $150 that readers could adjust. Existing Founding Members will have access grandfathered in at their previous rate. Month in Review Articles Published Make Networks Dumb Again (Sep 11): AI is making old analog networks cheaper to use and flooding them with machine traffic in the process. A plea for agent-native rails with the intelligence at the endpoints, and for Washington to drag them to ubiquity. Interoperability, Unbuttoned (Sep 29): Interoperability is a series of workflows in a trenchcoat, and this post finally takes the trenchcoat off. A color-coded map shows which provider workflows went digital, which are fragmented, and which still run on fax. Video Content Antitrust’s System of Record Problem (Sep 3): The FTC’s investigation into Epic prompted a ninety-minute webinar, now posted with chapters and a smoothed transcript. We get into why market definition, missing B2B share data, and the SSNIP test leave antitrust poorly suited to systems of record, plus why information blocking may be doing more than any pending lawsuit. The Information Exchange: Cerner Milking Edition (Sep 18): This was so fucking fun. Ryan Tucker, Ryan Brickner, Brad Thorson, and I try an Around the Horn format, complete with points, penalties, and a mute button. We debate whether Oracle Health is dead, who would actually buy Cerner (IBM enters the chat), p(Doom), and why the front desk still hands you a clipboard. Regulatory Ask Not What Your Network Can Do (Sep 23): CDC’s RFI on public health data intermediaries lists use cases already served, unevenly, by eCR, lab reporting, IZ Gateway, and syndromic surveillance. The real opportunity sits in one question about AI: a network that can handle the next emergency without another interface project. Court cases Particle v. Epic: The Naughty Schoolteacher (Sep 4): After a summer-long vigil, the answer on Epic’s early summary judgment bid is two paragraphs and a remedial assignment. Particle advances to the next grade, and market definition gets another year of discovery. The Epic Discovery Files (Sep 8): Texas’s motions to compel arrive with a 251-page appendix of requests, objections, and meet-and-confer letters with Cravath. Inside: Epic using generative AI for document review, denied interoperability requests in scope, and Noerr-Pennington raised against lobbying discovery. Epic v. Health Gorilla: “Working as Designed” (Sep 9): Epic wants nothing to do with the data breach MDL, and explaining why puts fresh discovery on the public docket. The spiciest allegation: Health Gorilla told GuardDog to scrub its law firm business from its website instead of cutting off access. Veeva v. Epic: Legal Bypass Surgery (Sep 15): Veeva asks the Wisconsin Supreme Court to skip the Court of Appeals, while law professors and three policy groups line up as amici. Meanwhile, Epic’s lawyers apologize for another round of citation errors, including a quote that never existed. Texas v. Epic: Behind the Black Bars (Sep 17): The court portal served up Epic’s unredacted filings, revealing a $5 million document review budget and the AI workflow behind it. Also inside: the 200-plus company names Texas wants searched, and one very expensive Zoom invitation. OpenEvidence v. Doximity: Consequences Will Follow (Sep 25): OpenEvidence tells the court it will not comply with a discovery order, and its own lawyers at Quinn Emanuel say they won’t defend the choice. Add years of Slack reported unrecoverable, and Rule 37 sanctions come into view. Health Tech Keeps Choosing Violence (Sep 28): Doximity moves to end OpenEvidence’s case, Epic asks Texas to show its work, and a sleepy Audacious Inquiry patent fight sprouts antitrust and information blocking counterclaims. The main event is a long-sealed Cognizant v. Infosys ruling that hints where system of record antitrust claims can survive. EHRs One Verb for Oracle Health (Sep 14): Oracle’s earnings call quantifies every data center to the decimal point, while Oracle Health gets a single verb: “accelerate.” Panning the few healthcare mentions turns up an agentic care management system, a research-to-care ledger play, and the question of whether healthcare gets Larry’s patience. Epic’s Forretress Under Siege (Sep 30): Judy Faulkner tells a panel Epic paused hundreds of projects to harden its software and calls it a “shame,” while a spokesperson insists the roadmap hasn’t changed. Project Glasswing, a Pokémon-branded QAN sprint, and a trove of Jodel grievances reconcile the two Epics and preview the Jevons paradox coming for all software. Industry Analysis Scanning for a Network (Sep 1): Scan.com raises $220M to build the imaging network labs never got, speedrunning Zocdoc’s consumer-to-B2B pivot. Its wedge to network density may be the most American one available: personal injury litigation. The Front Desk Wants the Damn Whole Building (Sep 16): Hello Patient buys Converse Health, pushing its AI front desk into referrals, chart work, and prior auth. The copilot categories keep blurring, and your distribution partner is still your final boss. Cross-industry Comparisons A Different Patchwork Quilt (Sep 10): Healthcare loves to envy open banking, but the US version has no mandate, a toll booth at Chase, and data quality problems of its own. The grass isn’t greener; it’s another American patchwork quilt, and perhaps a worse one. Hail, Benihydra (Sep 21): Salesforce brings its platform into Claude, Slack, and its own agent, inviting the interfaces that might replace it. Cut off one head and more grow back, so long as the records underneath stay put. Living on A Trade Secret Prayer (Sep 22): Six credit unions are suing Fiserv, the Epic of core banking, by claiming their own member records as trade secrets. Banking has no Cures Act, so its lawyers reach for legal alchemy that healthcare has already tried. Other News None this month External Media Nabla Accelerate NYC: I kicked off fall conference season at Nabla’s Accelerate event in New York, where Delphine Groll opened by asking the room to picture the company it wants to become and the one it doesn’t. I liked her framework of bureaucracy, fear, and ego as the blockers. I also love vendor conferences/events in general - different vibe than industry biggies. Healthcare 101 with Nikhil Krishnan: I briefly guest lectured Out-Of-Pocket’s Healthcare 101 class. Appreciated Nikhil’s takeaways cover whether AI doctors can query HIEs, why healthcare’s data-liberation rules beat most industries’, and the hi-res graphic is in the comments. HCN: Epic Probed by the FTC: I joined the HCN guys to talk through the FTC’s investigation into Epic. Cedric’s new hairdo was an unexpected plot twist. The episode also covers MFN drug pricing, healthcare M&A and Eli Lilly’s acquisition streak. Fall Conferences: At eHealth Exchange’s Annual Meeting in Austin on Oct 27, I’ll moderate a panel on the tensions between AI, HIEs, and timely patient access with Jean Ross (Primary Record), Therasa Bell (Kno2), Byron Crowe (Doctronic), and Michael Marchant (Freenome). Here’s the rest of my schedule if you want to meet up: CommonWell (Redwood Shores, CA): Oct 13-14 Will be participating in a fun Jeopardy event Open@Epic (Madison, WI): Oct 20-23 Will be enjoying Verona, Willy Street, and other local adventures eHealth Exchange and Sequoia Project (Austin, TX): Oct 27-29 Yeehaw HLTH (Vegas): Nov 15-18 Groundhog Day, Venetian Edition RSNA (Chicago): Nov 30-Dec 2 See me at “Governing AI in Breast Imaging: What Health Systems Are Actually Doing” Digital Health Counsel 2026 AI Summit (Seattle): December 2-3 Will likely be speaking to a bunch of lawyers about information blocking Posts I Liked ChatGPT’s Epic integration: game changer or nothing burger?: Joshua Liu, MD offers five thoughts on OpenAI’s Epic launch, starting from the point that it rides the same open APIs available to anyone. He argues read-only access leaves ordering to Art and the ambient startups, and asks why HCA is piloting it alongside Commure. He’s sorta a must-follow at this point - consistently excellent, thought-provoking takes. Epic, Lilly, and the Discovery pass: Seth Chaney reads Epic’s first major Discovery deal (with Eli Lilly), as well as its revised developer terms on commercial displays, as the pipe finally opening between EHRs and pharma. Life sciences and health continue to collide. Scott Rossignol on EHR payer platforms and ePA fees: Scott argues the top ambulatory EHR vendors are turning the prior auth mandate into a per-member-per-year toll on payers, for an API whose operating cost has nothing to do with covered lives. His fix is two lines of regulatory text: put the CRD/DTR/PAS certification criteria in the Base EHR definition, and bring payer-facing ePA connectivity under § 170.404’s cost-based fee rules. It’s a good solution. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
Supreme Court denies Arizona’s bid to delay start of takeover of healthcare in state prisons
The U.S. Supreme Court rejected a bid by Arizona to block the start of a court-ordered takeover of healthcare operations in its prisons after the state was found to have provided inadequate care to incarcerated people and dragged its feet...
Caesars Entertainment Investor Alert: Kahn Swick & Foti, LLC Investigates Adequacy of Price and Process in Proposed Sale of Caesars Entertainment, Inc.
Former Attorney General of Louisiana Charles C. Foti, Jr., Esq. and the law firm of Kahn Swick & Foti, LLC (“KSF”) are investigating the proposed sale of Cae...
Man with two swords threatens officers during Eaton Rapids mental health crisis
A man carrying two swords was taken into custody Wednesday morning in Eaton Rapids after police said he threatened officers while appearing to experience a mental health crisis.
RRH marks one year of free genetic screening program that identifies health risks
13WHAM ABC Rochester provides local news, weather forecasts, traffic updates, health reports, notices of events and items of interest in the community, local sports and entertainment programming for Rochester and nearby towns and communities including Greece, Victor, Pittsford, Penfield, Henrietta, Webster, Irondequoit, Fairport, Chili, Gates, Rush, Wheatland, Canandaigua, Farmington, Spencerport and Hilton.
Framework Desktop with Ryzen AI Max+ Pro 495 Gets Official Pre-Order Date
After teasing the AMD Ryzen AI Max+ Pro 495 upgrade to the Framework Destkop mini PC, Framework has officially announced that pre-orders for the SFF desktop will start on Wednesday, 30 September. The announcement came in a post on the OEM's official X account, where it also confirmed that, as is...
Exciting forward closing in on Liverpool as major deal agreed
An exciting forward is closing in joining Liverpool's first-team very soon. One thing Andoni Iraola has a shortage of is adequate options at senior level in the no.9 position.With the injury of Hugo E...
Aid organization warns of public health emergency as hospitals aren't able to provide adequate care
Alabama Department of Public Health improperly reimbursed $28M in federal vaccine program, audit finds
$27.94 million of the ADPH’s reimbursements over a five-year period had inadequate documentation or were unrelated to contract purposes.
Ebola deaths in Congo top 500 as frontline health workers threaten to strike
Health professionals demand payment and better conditions, citing inadequate supplies and poor salaries.
Coverage and Reimbursement Roadmap for Women’s Health Innovation
Women's health has long been underserved by a coverage system built around inadequate research, insufficient billing codes, and payers that have been slow to re
Bond breakout? Big effects of bad data. Immigration and thermostatic politics & dad-chat is coming for dad-books.
Thank you for opening your Chartbook email. Anna Airy, A Shell Forge at a National Projectile Factory, Hackney Marshes, London, 1918 Bond breakout - John Authers Across the developed markets, bond markets are staging a slow-motion car wreck. Looking at the drastic moves in the US, Japan, the UK and France, Barclays’ Ajay Rajadhyaksha commented: “Last week, long bonds broke. Not in one country. In all of them. Simultaneously. Four countries. Four different political systems. Four different central banks. But the same trade — “get me out of duration!”” Each country has its own contributing political problems, but the uniformity of the shift out of long-term bonds with high duration makes clear that something broader is afoot. For Rajadhyaksha, it is “simple and uncomfortable.” The developed world “has too much debt, too little fiscal discipline, and no political appetite for fixing either.” If there’s a trigger, it has been the Iran war and the resulting shock to oil supply. Source: Bloomberg G7 countries are now borrowing at rates that were enjoyed by EM in the early 2020s For contributing subscribers only. Subscribe Trade between China and Russia has grown in recent years For contributing subscribers only. Subscribe Big effects of bad data A decade ago nearly nine in ten Americans, when approached, agreed to fill out the Current Population Survey, which is administered to about 60,000 households each month and asks about, among other things, employment. Fewer than seven in ten do so now (see chart 1). For the Consumer Expenditure Survey, which tries to capture 3,700 households monthly, the response rate is down from 68% to 40%. … When the information becomes less reliable, investment decisions get more difficult to make. Some may be delayed, creating a potential drag on the economy. A new working paper by Nicholas Bloom of Stanford University, Erica Groshen, former head of the Bureau of Labour Statistics (BLS) now at Cornell University, and Duncan Hobbs and Michael Strain of the American Enterprise Institute, a think-tank, hazards an estimate. Preserving trust in “the integrity and quality of official statistics”, the authors claim, generates economic benefits of about $25 for every $1 spent on the BLS, the agency with an annual budget of $700m that is responsible for many of these data. To arrive at their conclusion the quartet analysed an ignoble episode in the BLS’s recent history. On August 1st 2025 Donald Trump sacked Erika McEntarfer, appointed as the agency’s commissioner by his predecessor, Joe Biden. The president alleged, without evidence, that the BLS’s steep downward revision to recent jobs numbers had been “RIGGED in order to make the Republicans, and ME, look bad”. In fact, it was the wanton dismissal that looked bad in the eyes of many observers. In the following seven days there was a 50% leap, relative to the week before, in the average value of the index of Economic Policy Uncertainty (EPU), which tracks the number of articles mentioning such uncertainty that are published daily in American newspapers. This was a discernible jump even when compared to the chaos caused by Mr Trump’s trade war in April 2025 and his real one in Iran in the past two months (see chart 2). Based on Mr Bloom’s earlier study with other colleagues of the EPU’s impact on business investment, industrial production and employment, the authors estimate that the jump reduced American GDP by over $100bn (0.3%) and non-farm payrolls by 168,000 (0.1%). Source: The Economist Immigration and thermostatic politics (Sarah O’Connor in the FT) A strange thing happened a year and a half ago. No sooner had Americans elected Donald Trump as president on an explicitly anti-immigration platform than US public opinion began to swing much more favourably towards immigration. … to political scientists who study “thermostatic” politics, this development is no surprise at all. Public opinion often moves against the prevailing party, especially if they are perceived to have gone “too far” in one direction. The phenomenon was first explored in the 1990s with reference to fiscal policy, but in recent years it has been particularly evident in the realm of immigration policy. While these swings in opinion polls can make it seem as if people don’t know their own minds, they can be a useful democratic check on governments by sending bright flashing warning lights when policies stray too far from the public’s comfort zone. The problem comes when politicians misinterpret those signals. When people tell pollsters they want less immigration, or think it is bad for the country overall (or the converse), they are often expressing an opinion about how things appear to be going in that moment relative to their preferences, rather than a deep shift in their underlying views. According to Alexander Kustov, a political scientist, most Americans’ views are quite stable and moderate: they support immigration that is controlled and in the national interest, and oppose flows that are disorderly or under-enforced. In the US, he argues the Trump administration over-interpreted dissatisfaction with high immigration under Joe Biden, and implemented policies that went too far for many voters. “People don’t necessarily change their idea about their ideal immigration policy, but they can react to what the government is currently doing,” he told me. “A lot of people are not happy with what the Trump administration are doing — right now we’re not talking about border enforcement, we’re talking about people not just getting harassed, but killed.” But similarly, he added, pro-immigration advocates would be making a mistake to interpret the recent, more favourable swing towards immigration as a deep-seated ideological shift in attitudes. The recent history of UK immigration policy offers another cautionary tale. After the 2016 Brexit referendum, public concern about immigration fell. This was partly because net migration statistics declined, but also because people felt a sense of catharsis and control, says Sunder Katwala, director of British Future, a think-tank. By 2019, the public ranked immigration as only the ninth biggest issue of concern, according to Ipsos polling. But when the Conservative government liberalised visa routes for students and care workers between 2019 and 2022, that helped net migration to surge. And so, too, did public concern. Today’s Labour government has implemented another sharply restrictive turn in immigration policy. As Kustov and researcher Caitlyn Yates argue, thermostatic public opinion should be a useful check on politicians. Instead it seems to have helped to magnify the pendulum swing in the UK. The government over-interprets and overreacts to a change in public opinion, which reacts in turn, prompting a sudden swing the other way. Source: Financial Times HEY READERS, THANK YOU for opening the Chartbook email. I hope it brightens your day. I enjoy putting out the newsletter, but tbh, what keeps this flow going is the generosity of those readers who clicked the subscription button. If you are persuaded to click, please consider the annual subscription of $50. It is both better value for you and a much better deal for me, as it involves only one credit card charge. Why feed the payments companies if we don’t have to. Subscribe Anna Airy, Shop for Machining 15-Inch Shells: Singer Manufacturing Company, Clydebank, Glasgow, 1918 Racing for a vaccine … we have been here before! The deadly Ebola outbreak in two African countries driven by a virus species with no vaccine has triggered an urgent search for a potential jab, in a test of troubled global efforts to avert threats posed by emerging diseases. A World Health Organization advisory group is due to would meet on Tuesday to recommend candidate jabs to prioritise for clinical trials, the global health body said. It will assess data including an analysis by the Coalition for Epidemic Preparedness Innovations (Cepi), which was set up after failures in the international response to a previous Ebola crisis. The latest Ebola outbreak in Democratic Republic of Congo and Uganda has infected hundreds of people and killed more than 80, health authorities say. Cepi’s reaction will be a crucial indicator of its progress towards its wider goal of producing vaccines for pandemic threats in just 100 days, despite steep cuts to international health funding. “If there was ever a time that we could show the world why Cepi is needed and show the world why the 100-day mission is needed, it’s now,” Nicole Lurie, the organisation’s executive director for preparedness and response, told the FT. “We’re happy to accept that responsibility, but obviously we need help from partners — particularly financial help in the long run.” DR Congo and Uganda would make the final decision on whether to press ahead with any vaccine candidates endorsed for clinical trials by the WHO experts, the global health body said. “Other ethical and community acceptability issues will be considered,” said the WHO, which declared the latest outbreak a public health emergency of international concern on Sunday. “This will be important to make sure that the trial, if it happens, will be adequately communicated to the population.” Lurie said Cepi had provided information from a survey of research teams and companies working on drugs that might be effective against the Bundibugyo virus behind the outbreak. The organisation hoped soon to announce partners in the quest for a jab, she added, although she declined to give a timescale for when one might be developed. Cepi’s Nicole Laurie said global health bodies were ‘getting some live-fire drills’ with hantavirus and the latest Ebola outbreak. The hunt for a vaccine should be helped by scientific advances including the use of artificial intelligence to find drugs active against viruses, Lurie said. Existing jabs against the Zaire Ebola virus responsible for many previous outbreaks might provide a basis for tackling the Bundibugyo species, she added. “We’ll see how far and how fast we can get,” Lurie said, adding that Cepi had done preliminary work recently on a possible jab for the rat-borne hantavirus responsible for a recent fatal outbreak on a cruise ship. “Both with hantavirus and now with Ebola, [we] are getting some live-fire drills.” Source: Michael Peel in the Financial Times Dad-chat is coming for dad-books. (By Pamela Paul and Jeffrey A. Trachtenberg in the WSJ) They were the go-to gifts for Father’s Day: a book about some little-known chapter of World War II, the sweeping narrative of a shipwreck, perhaps the latest presidential biography. These days, dad books are a dying breed. Nonfiction book sales have been in decline for the past four years, and are now the most challenged segment of the print book market. Publishers say certain types of books still fare well—including celebrity memoirs and religious titles. But in recent years, print sales in such categories as biography, current affairs and business and economics—what publishers refer to as “serious nonfiction” and which tend to resonate especially with men—have fallen considerably. Sales of nonfiction print titles were down nearly 8% through May 9 this year, and sales of books about politics and current affairs were down 19%, according to book tracker Circana BookScan. Publishing has long been subject to cyclical changes, with trends in format and genre taking over bookshelves in grand sweeps. (Remember the adult coloring-book craze? Or the stratospheric rise of romantasy?) But many in publishing believe the decline in serious nonfiction is more existential. “The trend couldn’t be clearer,” said Jonathan Karp, the former chief executive of Simon & Schuster and publisher of the new Simon Six imprint. “This is a sea change and people should wake up and realize we’re living in a new world.” One culprit for the shift: a new media diet for fans of more serious nonfiction. … Sixty-two percent of men and 54% of women consumed a podcast in the prior month, according to a recent survey by Edison Research at SSRS, up from 46% and 39%, respectively, in 2023. “When we have internal meetings to talk about this problem, it always comes around to podcasts,” said Jonathan Burnham, president and publisher of the Harper Group at HarperCollins Publishers. “The man who wants to read American history is now tuning into one of the many good podcasts about history that lends the quiet attention to a serious subject he’s looking for. It makes the idea of sitting down with a 700-page Ron Chernow book less appealing. You’ve scratched that itch.” Source: Wall Street Journal Remarkable report by Novara from the nationalist rally in London in mid May. Anna Airy, Leopard Moth and Plums, 1915 If you’ve scrolled this far, you know you want to click: Subscribe
Catching up with sleep health supplements: A roundup of the latest science
Sleep has moved from a lifestyle concern to a core measure of health, as inadequate sleep affects a substantial share of adults and often occurs alongside chronic stress, undermining health, well-being and performance across sleep-wake cycles and life domains.
As Medicaid cuts near, one free Chicago clinic pushes expansion
Chicago-based Community Health doesn’t take Medicaid, Medicare or other payment, so it is doubling down on a growth strategy to meet the expected influx of newly uninsured patients.
$160K in designer merchandise stolen from Rochester business, owner says
13WHAM ABC Rochester provides local news, weather forecasts, traffic updates, health reports, notices of events and items of interest in the community, local sports and entertainment programming for Rochester and nearby towns and communities including Greece, Victor, Pittsford, Penfield, Henrietta, Webster, Irondequoit, Fairport, Chili, Gates, Rush, Wheatland, Canandaigua, Farmington, Spencerport and Hilton.
Man sentenced in 2023 death of Glenwood South business owner David Millette
One of the victim's family members called the sentence a "gross inadequacy."
Months of pain, delayed care: An asylum seeker's health crisis in ICE custody
Mother held at SD facility says months of delayed and inadequate medical care have left her with serious kidney infection and worsening pain.
Arsenal v Burnley: Key stats and talking points
Arsenal can't seal the Premier League title on Monday night (20:00 BST), even with a win, after Man City's midweek victory pushed any celebrations back. Burnley, already relegated, have nothing at stake — yet they've shown they can still upset bigger plans. Arsenal have spent three seasons living with the sting of near misses, always measured against a relentless Manchester City side that has dominated the Premier League.
How are Giants fans feeling about last place?
After Tuesday’s loss, the Giants fell to last place in the division. How are Giants fans feeling about that?
Trump to campaign in deep-red states as GOP plays defense
The president is expected to hold rallies in Oklahoma and Alabama next week.
‘Game of the Tournament’ — Shannon Sharpe, Sports World React to England’s Stunning World Cup Win vs. Mexico
On paper, there should have been no contest. England has a star-studded team, and while Mexico were playing at the legendary Estadio Azteca in front of about 80,000 fans, the odds were stacked against them.
DOL Mental Health Parity Bulletin 2026: MHPAEA Compliance Best Practices
On September 8, 2026, the DOL's Employee Benefits Security Administration issued Field Assistance Bulletin No. 2026-03 to clarify MHPAEA compliance and nonquantitative treatment limitations. DOL enforcement will focus on blanket treatment exclusions, medical necessity/prior authorization processes, and network adequacy. Read our alert for a practical compliance roadmap.
Long deployments overwhelm a strained Navy mental health system, personnel say
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15 discouraging hours with Onimusha: Way of the Sword, and 10 brilliant ones with He Who Watches
In the last few weeks, while playing some video games that I might review, I emailed two cries for help. I sent the first to a rep for Capcom, confessing that the company’s samurai game Onimusha Way of the Sword (out today for PC and console) was crushing me. “Feels like I’m playing ‘hard’ mode, not ‘normal,’” I wrote. “And I don’t want to have to knock it down to “story”. I’m exploring, trying to level my gear, but these two-phase boss fights with no mid-fight checkpoints are brutal.” I wagered I was only about halfway through the game, if that. I wasn’t sure I could keep up with the steepening difficulty curve. Was I missing something? Then, on Monday, I took some photos of some puzzles that were baffling me in the mind-bending He Who Watches (out now on PC), wrote out lengthy descriptions of how I’d been trying to solve them and asked Bobby Vanden, the game’s solo developer, for a nudge in the right direction. I told Vanden I’d spent hours on these puzzles. “I’m stuck in triplicate,” I told him. Could he tell me if the solutions I was attempting were even on the right track? I didn’t mention that the puzzles—coupled with major time pressures from other work—were stressing me out so much that playing the game was giving me headaches. This double dose of panic was unusual. I’m used to managing a workload full of reporting and reviewing, used to a crowded schedule and the need to stay calm amid the bustle. But I was stressed about these games. No one was forcing me to review them, nor even play them. I’d simply found them interesting enough to start, hoped they’d be interesting enough to write about and I’d sunk hours into them assuming I’d made the right call. Suddenly, however, I felt trapped. I was emailing for a way out. Above: This guy took me about an hour to beat. The feedback I got from Capcom confirmed my fears. They didn’t say it, but I will: Onimusha Way of the Sword is not for me. It’s a brutally hard game in need of a normal difficulty level. It’s a game that spikes so severely during its abundant boss fights—yet offers such flawed ways to improve when outside of them—that it feels like a bait-and-switch. In the new Onimusha, you play as famed samurai Musashi Miyamoto, aided by a magical soul-absorbing gauntlet that is possessed by a lady who offers advice. (Way of the Sword is a continuation of Capcom’s long-dormant Onimusha series, but that set-up had me wondering if the company was cribbing from their ill-fated Bionic Commando reboot; read about “wife-arm” when you get a chance). Way of the Sword is partially set in 17th century Kyoto, an explorable city where Miyamoto can fight demons, help civilians and eventually rescue ghostly dogs. The city evolves over time, with new mini adventures and obtainable loot on offer, all feeding into systems that promise to upgrade your gear and sword-fighting skills. Upgrades, however, are so incremental as to be imperceptible, causing the exploration of Kyoto to feel like inconsequential busywork. From that hub, players can go on linear missions into forests and old temples, where they will encounter many of the game’s tough bosses. Combat in Way of the Sword is akin to many modern melee games. Players are asked to mix attacks with dodges and parries. They’re encouraged to deplete an enemy’s stamina bar in order to do greater damage to its health bar. The old Onimusha games’ signature move was the issen, a counter-attack so sudden it’s all but pre-emptive. You strike just as they begin to strike toward you, beating them to the cut. By definition, the issen is a high risk move, leaving you wide open to pain. It feels risky in the game, especially against bosses, who can maul you in just a few blows. A game might train you to perform an issen well by offering a variety of lesser enemies who are not as tough as the boss but get close. Or it might offer a toehold against bosses by saving or checkpointing the player’s progress when a boss’ first health bar has been destroyed and before the second health bar appears. It might offer the less skilled player a chance to over-level their character, should the player simply commit to playing through its optional sidequests. Way of the Sword does none of this. Fighting its trivially easy grunt enemies and then its ferociously adept bosses is like playing a game of chess where I’ve got a rook, while the opposing side is all pawns and five queens. Bosses simply don’t checkpoint. You may be able to clear a boss’ first phase without taking much damage. Good for you. Do it again, every time you fail the second phase. As for the the central Kyoto hub, I kept pace with all of its added side activities and never felt like I was overpowered. Bosses could still easily buckle me. The new Onimusha, I concluded, is just too discouraging to keep playing. The advice I got from Capcom had been well-intentioned. They reminded me of the game’s various systems. They alerted me to an optional assist that flashes recommended button inputs (basically: counter this move; dodge that move). It was a little helpful. So was dropping down to “story mode,” which I tried last night. Story mode turns on those button prompts by default. It makes countering and dodging way too easy, nearly automatic. I don’t consider myself a master of action games like these, but I’ve cleared the likes of God of War, Stellar Blade, Star Wars Jedi and others of sub-Sekiro difficulty and had a fun time doing so. Not here. Not yet. Unless they patch Onimusha: Way of the Sword and add a middle difficulty or just checkpoint the damn bosses when they’re between health bars, my streak of loving Capcom games released in 2026 will likely end at two. It’s a shame, because I was having a good time finding those ghostly dogs. And then there’s He Who Watches, a phenomenal first person puzzle game with Portal vibes, except instead of a portal gun you’ve got a magical bow that shoots one arrow that can activate switches or be used to drag blocks. The twist is an actual twist: you can also walk on walls and the ceiling, reorienting gravity as you do, thereby placing blocks onto those other surfaces. Walking on walls and ceilings to solve problems is really the best thing. Would that I could in reality. He Who Watches consists of locked-room challenges, each brief enough to only require about a minute to actually solving, though it will take five, 10, eventually 30 minutes to figure out said solutions. They are not obvious! It’s a game of layered mechanics and shocking solutions. For example, see if you can follow this: You can drag a block to a wall. Then you can walk on the wall, which now feels like the floor, and drag that block across the wall. Later, back on the floor, you might realize you can look up. The block is still on the wall, stuck to it. You can shoot your magic arrow to its underside. Doing so creates a tether, so that you can yank the block off the wall and carry it, as if it were a balloon, into the spot where you need it to be to solve the puzzle. Here, watch Vanden explain some of the game’s basics in this launch trailer: As with any great puzzle game, the solutions to He Who Watches’ puzzles elicit relief and amazement. Oh my god, that worked! I didn’t even think that could be possible! Learning to solve the game’s puzzles feels like learning magic. But, oh, does the game get hard. Its Steam reviews, mostly glowing, are full of players remarking how quickly He Who Watches made them sweat. Wrote one: “loving this one already although my brain is hurting!” Wrote another: “As you get further in the game it feels like you need an IQ level of at least 120+.” Vanden has shown some mercy. Each locked room puzzle includes an optional junior version of the puzzle, meant to teach you. Difficulty nevertheless ramps severely. By the time I was emailing Vanden for help, I was struggling to even clear one of the hint puzzles. When I messaged him, my stress was exacerbated by strange things I’d found in the game’s various hubs: suspicious passageways, odd blocks and some intriguing locked doors. These were hints of secrets, I realized, yet I sensed I needed to play further into the game to understand them. I was stuck, but I wanted to see the rest. Vanden offered to give me the exact solutions, to solve those three puzzles for me, but first he gave four nudges. Three were for the specific puzzles, but his best hint was for all and ultimately proved to be a terrific life lesson: go back a bit, he suggested. Do the puzzles right before those. They were teaching you something. Focus on what their lesson was. Don’t rush, in other words. Recognize what you’ve accomplished. Build off of that. I did so. I absorbed the lessons. I saw those three tough puzzles in a new light. I solved one the night after he wrote back, another the morning after. I left a third for another time. I didn’t need it and I wanted to plunge deeper into the game, closer to the moment when I was sure I could start unlocking those secret doors. My head stopped hurting, too. He Who Watches feels special. It’s got more challenges, and I’m undeterred. It’s also nice that its puzzles don’t have a surprise second health bar. Game File is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe Item 2: In brief… 🎮 Ilari Kuittinen, co-founder of Helsinki-based Housemarque (Super Stardust HD, Resogun, Returnal) has stepped down from his studio, after a 31-year run, saying he’s “ taking a rare and well-deserved breather.” Sony purchased Housemarque in 2021, and the studio released its newest game, Saros, earlier this year. Trend-watch: Sony-owned Insomniac saw its founder Ted Price retire in early 2025, after a 30-year run. Sony-owned Sucker Punch saw its co-founder Brian Fleming step down in late 2025, after a 28-year run. 👀 Savvy Games Group chief Brian Ward is stepping down from the Saudi-government-backed games conglomerate, Bloomberg reports. No word on a long-term successor yet, nor if this augurs any closer integration between Savvy and Electronic Arts. EA was purchased by a consortium led by Saudi’s sovereign wealth fund, in early August. 💿 Square Enix has denied a Japanese media report that the company was planning to go private. In very different Square Enix news, the company revealed that the physical version of Final Fantasy VII: Revelation, the April 2027 finale of its radical remakes of FFVII, will include just one disc in its case, requiring a download for the rest. The first two FFVII remakes in the trilogy shipped on two discs apiece. While Square hasn’t commented on the reason why, a feature here in Game File last month broke down the processes and costs for physical games. The expense of a second disc comes out of the game publisher’s cut of each copy. Square could be saving in excess of a dollar a copy with this move. 🟥 Grand Theft Auto IV’s 26-minute ’‘extended look” gameplay showcase that premiered on Netflix last week—and was exclusive to the platform for six hours—drew 31.1 million views in its first four days, the streamer announced. (Netflix calculates views as total viewed hours divided by runtime; excludes replays). Compared to YouTube: The version that later premiered on Rockstar Games’ YouTube channel is sitting at 22.6 million views after seven days (YouTube’s more liberal counting system tallies anyone who viewed even just the first few second.) Compared to other Netflix mega-events: Last year, Stranger Things season 5’s first four episodes, which debuted together, drew a record 59.6 million views in their first few days on Netflix. For more of a live event type of comparison, in 2024, the Jake Paul vs. Mike Tyson boxing match drew 65 million concurrent streams as it happened; Netflix didn’t release live numbers for the GTA premiere. ☁️ Microsoft is changing the way it charges for cloud gaming, from an all-you-can-play offer for Xbox Game Pass subscribers, to caps for the subscription’s tiers (15 hours per month at the Ultimate tier), with the option to buy more hours in bulk beyond that. The company also said it will sell batches of cloud gaming time to non-Game Pass subscribers, details TBA. Microsoft does not release figures for cloud game usage, but said its changes would impact 4% of Game Pass subscribers. That implies a small portion of its subscribers exceed the 15-hour monthly mark. Cloud gaming offers the promise of playing games without the need for console or PC hardware, as the graphics, sound and controls are all transmitted via a streaming connection. Microsoft notes that its cloud gaming service can be used for a range of things, including Xbox One players using it to play newer-gen Xbox Series games via streaming; and people playing games via streaming, sans any console, “in markets where consoles are less available or affordable.” (That latter use case could even be relevant in Xbox’s home market soon, as console prices keep rising.) Take Two Interactive chairman Strauss Zelnick recently told investors he expects game-streaming tech, which has been only lightly adopted by gamers for over a decade, to be widely used within three years. 🇺🇸 The Trump administration has published multiple agenda-driven web video games to the White House’s website. One called Build The Wall partially clones Tetris as it asks players to build a wall to stop a “zombie border siege.” While actual Tetris involves clearing lines and basically not building a wall, the Trump-backed game omits the line-clearing aspect (and omits the fun as well). On Instagram, Tetris’ official license holders reacted by stating: “At Tetris we believe in the power of connection and bringing people together, not dividing them. To our fans everywhere: we love you, we see you, and we’re grateful to have you in our community. P.S. The Tetris Company was not involved in the creation of ‘Build the Wall.’ P.P.S.: We take copyright infringement very seriously.” Item 3: The week ahead: Tuesday, September 8 Game releases: Mewgenics (consoles; already out on PC) is an engrossing tactical combat game (with cats). It is getting its console port right after the release of a Star Wars tactics game and ahead of the late September launch of a Fire Emblem–a bumper crop for the genre. Wanderburg (PC) is an auto-shooting game like Vampire Survivors, but you’re a castle on wheels Event: Nintendo airs a 30-minute Nintendo Direct (10am ET) focused on The Legend of Zelda’s 40th Anniversary. A full unveiling of the upcoming remake of The Legend of Zelda Ocarina of Time is expected. Will they also show footage from next year’s live action movie? Tease the next big 3D Zelda? Add Link to Mario Kart World? Shadow-drop a new Tingle game? Wednesday, September 9 Event: Nintendo again! On this day, they’re planning to air a 45-minute Nintendo Direct (10am ET) focused on games heading to Switch 2 this winter. Followed by about an hour of gameplay demoed by the company’s Treehouse team. The September Nintendo Directs are always some of the year’s biggest. The 2025 edition included announcements of several major 2026 Switch/Switch 2 games: Pokémon Pokopia, Mario Tennis Fever, Yoshi and the Mysterious Book, Fire Emblem Fortune’s Weave. Plus the return of the Virtual Boy. Friday, September 11 Game release: EA Sports NHL 27 (PlayStation, Xbox) is a hockey game. There are so few that an indie studio that had been making wacky sci-fi first-person shooters just announced that, hey, we’re going to fill a void and make a hockey game for PC.
Engrams Embedding Entendre: Codesign for Efficient DRAM/SSD Offloading
Engram extends standard token embeddings with learned multi-token lookups. Recurring local patterns retrieve vectors directly, reducing the need to reconstruct them through attention and feed-forward layers. With Engram model architecture optimization, it allows for lower HBM capacity to be needed for models at the same quality. This does not mean there won’t be an insane demand for HBM but it just means that model architecture will continue to innovate around constraints. This model architecture design is naturally codesigned for parameter offloading: each token accesses a few embedding rows whose addresses depend on token IDs, not hidden states. The runtime can prefetch those rows from host DRAM while earlier layers compute, keeping the table outside HBM without transferring entire weight matrices. Our Memory model contains our latest estimates of quarter by quarter HBM, DRAM, & NAND supply and demand. Offloading frees HBM for model weights and KV cache, potentially supporting larger batches or more concurrent sessions. When DRAM becomes the next constraint, NVMe offers another tier. Recommendation systems already cache frequently or recently accessed embedding rows in faster memory while backing colder rows with SSDs. After NVIDIA roadmap had to change due to massively despec’ing Rubin Ultra from 1024GB to now ~200GB of HBM per chip, model architecture optimizations like emgram maybe helpful. Our DeepSeek-V4.1-Flash configuration uses roughly 189 GiB of memory for Engram. We replace it with a memory-mapped (mmap) file and measure serving performance with offload to SSD. Later on in our report, we will show our Engram offloading experiments along with the official InferenceX agentic inference serving results on Engram models like DeepSeekv4.1 Flash across all 6 NVIDIA GPU SKUs along with MI355X. Unsurprisingly, the CUDA Moat is still mogging MI355X on the ultra popular DeepSeekV4.1 Flash model. We also show how even on high capacity HBM SKUs, offloading emgrams to DRAM could result in even better performance for most of the pareto than keeping the emgram in HBM. Our benchmark has been widely reproduced, validated and/or supported by almost every major buyer of compute from Google Cloud to Microsoft Azure to Oracle, to Meta and many more. Furthermore, it has the support of the ML community including from vLLM, LMCache, SGLang, PyTorch, Huggingface and the support of major labs like OpenAI, MiniMax, ZAI, Qwen, Moonshot Kimi, etc. Star the InferenceX GitHub repository if you find the open-source benchmark and data useful!. InferenceX is the only inference benchmark in the world to have TPUv7, Jalapeño, Nvidia Rubin NVL72, AMD, and soon, SambaNova and Trainium. Due to how realistic AgentX scenario is to real world agentic inference workloads, AMD has committed to collaborating on MI455X UALoE72 too. DeepSeek did not release the original paper’s two trained Engram models. We replicated its setup on fineweb-edu using the released code and training hyperparameters, at an estimated 6E18 FLOPs per run. We observed the same U-shape scaling: Engram improved performance over pure MoE baselines. We also reproduced DeepSeek’s results, where earlier-layer representations with Engram resembled those of later layers. Like the original Engram paper, it is possible to probe Engram’s gate scores to see what n-grams DeepSeek-V4.1-Flash makes the most use of. Our gate scan finds names, code fragments, relational phrasing, and boilerplate. These examples prioritize interesting-ness over gate strength. One unexpected result was Wright : Ace Attorney. These examples suggest learned memory optimizes the training objective, not a judgment of which facts deserve storage. Licenses, bibliography fragments, API scaffolding, and website furniture can provide prediction shortcuts, so the value of additional Engram capacity may depend on what survives data preparation. This does not show that table capacity is “wasted”: the evaluation-corpus scan establishes neither training exposure nor the capacity occupied by each category. For offloading, strong gates do not identify cache-hot rows. Low gates do not automatically save reads either: computing the gate requires the retrieved key and undoes the performance gain of a fused kernel. Skipping reads would require a separate usefulness predictor before retrieval. In the original paper’s inference-time ablation, factual-knowledge benchmarks retained just 29–44% of their original performance, while reading comprehension retained 81–93%. This is due to the training–inference mismatch. The resulting degradation therefore measures this trained model’s dependence on Engram, not the performance difference between models trained with and without it. In our ablations, suppressing Engram worsens token likelihood across all evaluated domains, especially encyclopedia text and several code corpora. Surprisingly, GSM8K accuracy stays within measured run-to-run variation and removing Engram has no effect. Engram is not a detachable dictionary beside an unchanged MoE. Removing it changes downstream features and expert selection. We tested whether rerouting hurts or compensates by holding tokens fixed in a teacher-forced experiment on CRUXEval, a code-reasoning benchmark of small Python functions where the model predicts a function’s output from its code and an input, and scoring the reference answer. Removing Engram raised answer loss from 0.2848 to 0.3093 bits/token. Forcing the ablated model to use the original Engram-on expert choices made it worse still, at 0.3375 bits/token. Rerouting partially compensates for the missing memory. Memory features and expert selection work together, rather than following a clean “memory stores facts; experts reason” division. On the same CRUXeval, removing Engram during either phase reduced accuracy and increased generated tokens; removing it throughout produced the largest changes. Keeping Engram for prefill leads to more correct answers than keeping for decode likely due to semantically richer KV cache transferred to decode workers, allowing it to mitigate some of the performance loss. Engram’s table is large, but each lookup is small. DeepSeek-V4.1-Flash requests 24 rows at each of two Engram layers, about 12.4 KiB per processed token position across the model, or 3.1 KiB per GPU when split across four GPUs. Currently as of Day 7 since Model Release, MI355X is still 2-4x worse performance per dollar compared to B200 even when normalized by Mi355X’s lower TCO. Our full total cost of ownership breakdown comes from our AI Cloud TCO Model along with monthly market surveys of over 100+ gpu clouds & gpu cloud customers. On the Day 0 release of DeepSeekv4.1 Flash, NVIDIA vLLM works out of the box with zero issues across all 6 SKUs: H100, H200, B200, B300, GB200, GB300! This was thanks to the amazing work by the NVIDIA & Interact teams! In comparison, AMD vLLM did not work on day 0 for DeepSeekv4.1 Flash.Source: SemiAnalysis InferenceX AMD’s vLLM documentation points to using vllm/vllm-openai-rocm:deepseekv41-flash-0909, but from hour 0 of the model release to hour 23, AMD has not publicly released the image. AMD claims, “SPEED IS THE MOAT,” yet it has still not released it by the 23rd hour. We wish that, going forward, the AMD team has a better process for hour 0 model releases. Eventually when they did publicly release for “day 0” image support, performance-wise, it is currently up to 14.8x worse perf per dollar than H200 and up to 42x worse perf per dollar than B200/B300. The power of the CUDA MOAT is NVIDIA’s collaboration with its massive 6 million-developer community ecosystem including most of the vLLM & SGLang & Tokenspeed maintainers which means that CUDA is optimized on day 0. Overall, AMD did make significant improvements but the performance per dollar is still currently 2-4x worse than B200. AgentX Engram DRAM Offloading Improving Performance The HBM and DRAM offload use the same GPU kernel to select and dequantize rows. With HBM, it reads GPU memory; with Unified Virtual Addressing (UVA), it reads pinned host memory directly. Both support full decode graphs. Moving the table into HBM accelerates only the sparse lookup, leaving decoder computation and communication unchanged, resulting in little overall benefit while consuming memory otherwise available to KV cache. Another benefit of Engram offloaded to DRAM which means you can reduce the communication overhead by using less HBM GPUs per replica. For example, when enabling Engram offloading on B300, we are able to switch from TP4 to now TP2 which improves the pareto curve by up to 1.6x. When iso-model quality, less HBM is required as the engrams could be offloaded to host DRAM. Thus HBM bandwidth matters way more than HBM capacity. For inference workloads where memory bandwidth matters the most, 4-hi HBM provides the best $/bandwidth and therefore lowest cost per token. If China continues to make more and more revolutionary model architecture innovations, soon it could potentially 0Hi HBM stacks. [ ](https://newsletter.semianalysis.com/p/long-live-the-short-king-why-4-hi) [ Long Live the Short King: Why 4-hi HBM Wins ](https://newsletter.semianalysis.com/p/long-live-the-short-king-why-4-hi) Myron Xie, Bryan Shan, and 3 others · Sep 13 [ Read full story ](https://newsletter.semianalysis.com/p/long-live-the-short-king-why-4-hi) Moreover, on B300 and week-0 stack, moving the Engram table back to HBM did not improve results and stay within run-to-run variance. This is a result of the work optimizing DRAM offload, such as async, and overlap. SSD Offloading On B200, we created a unoptimized vLLM fork and stored the Engram tables in memory-mapped files on local SSDs. File backing lets the OS reclaim table pages when other applications need RAM. Pages already cached in memory can be served without reading the SSD again. Furthermore, note that we were unable to turn on GDS The unoptimized SSD implementation changes how rows reach the GPU. It copies row IDs to the CPU, deduplicates them, gathers the requested rows into pinned buffers, copies those rows back to the GPU and dequantizes them. This work runs between segments of the GPU execution graph. Native UVA performs row selection and dequantization directly on the GPU, avoiding the CPU round trip. A warm filesystem cache removes physical SSD reads, but leaves the coordination, row gathering and transfers. This is why a file already cached in RAM can still perform worse than a pinned DRAM table. The comparison measures the whole serving path; it does not separate the time spent on each of these operations. B200 DRAM dominates both measured SSD serving curves in total tokens per dollar and P90 interactivity. Near 125 tokens/s/user, DRAM delivers 121 million total tokens per dollar versus 52 million for SSD. For production serving, SSD offloading is likely not worth the tradeoff. On the B200 configurations we measured, SSD offloading loses on both measures: every observed SSD point has a DRAM alternative that delivers higher P90 interactivity and more total tokens per dollar. The only points where Cheaper storage does not automatically produce a cheaper inference service. Moving Engram to SSD leaves the same four expensive GPUs and the rest of the server in place. Reclaiming RAM only creates an economic benefit if it enables a cheaper server configuration or additional useful capacity. The current unoptimized path provides neither benefit, and the filesystem cache still consumes RAM when table pages are resident. Next we will look at the mechanisms and specific implementation of ngrams from DeepSeekv4.1 Flash, LongCat, Qwen3.8 Flash Next.
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Science Vs on the 49ers Substation: Anatomy of a Hatchet Job
In August, Pablo Torre Finds Out and Science Vs released an episode about my theory that electromagnetic fields from the electrical substation beside the 49ers facility may be contributing to the team’s run of soft-tissue injuries. As the originator of the theory, I was also a subject of the episode. I sat was interviewed by Wendy Zukerman and Rose Rimler of Sciene Vs. I sent them research, connected them with scientists, and spent hours digging through the City of Santa Clara’s and Silicon Valley Power’s records to help clarify critical details. Both Wendy and Rose came off as affable and professional, showing curiosity during the interviews, with Wendy going out of her way to question the “conspiracy theory” framing itself. Then they titled the episode We Solve the 49ers Viral Conspiracy Theory. I was familiar enough with their catalog that I never expected them to agree with my theory, but I did expect them to give it a fair hearing and to deliver their findings honestly. On both counts they came up short. They were not directly dishonest in anything they said, but rather in what they left out, in how what remained was cut, and in the picture painted by those two things in combination. They asked me to recorded the interview on my phone for better audio quality, and I held on to my copy for reference later. That turned out to be a fortuitous decision. Here is the raw audio of my first interview, unedited*. Only my side was recorded, so their questions aren’t on it, but you can generally infer them from the answers, and every claim I make below about what I said can be checked against my statements in this clip. (Note: Wendy had connection trouble at the beginning of the interview and was cutting in and out, which accounts for the false starts.) 0:00 -1:19:13 Audio playback is not supported on your browser. Please upgrade. Science Vs is a fun show. It is pitched at roughly a high-school understanding of science, for an audience that is skeptical, Snopes-oriented, and worried about misinformation. Take a claim circulating online, interview a supporter of the claim, interview consensus scientists, and then tell people which side of the line it lands on. I have listened to their episodes on raw milk, seed oils, 5G and other contested issues in the wellness space. I have problems with all of them, but each at least made an honest attempt to represent the actual range of scientific opinion by talking to credentialed scientists with differing perspectives. Dissenting researchers were heard from, answered, and often given a chance to respond. This episode did not do that. This article is not a relitigation of the science. I have written extensively about that already. This post is for the record. It is simply an accounting of what was wrong with their episode. Contents Is there a power plant next to the 49ers practice facility? — the clearest single example of getting something objectively wrong For the record — a high-level overview of all of the problems with their investigation Draw your own conclusions — why they had to make this episode at all What they left out about childhood leukemia — the exposure threshold, and playing games with statistics to minimize sick children What they left out about the mechanism — the body of literature they refused to cover, and evidence for the mechanism used against it The scientists Science Vs interviewed and did not air — four credential scientists who support myhe theory, recorded and cut, or not even called How they misrepresented me and my case — an answer severed from its question, and three telling edits How you would actually study the injuries — it doesn’t actually matter which team is the most injured, overall The theory: magnetic fields, oxidative stress, and collagen Since the episode never states my theory, here it is below. Those who are familiar with my work can skip this section. Electrical equipment produces magnetic fields, and those fields induce faint electrical currents in anything that passes through them, including people. My argument goes further than induced current. Mitochondria — the structures that generate a cell’s energy — run on continuous flows of electrons and protons, and those flows carry faint electromagnetic fields of their own. Maxwell’s principle of superposition shows that when two fields share the same space, they add together. An external field does not need to be strong to alter an internal field, it only needs to be present. The electron transport chain inside the mitochondria leaks a small fraction of its electrons by design, and those become reactive oxygen species — free radicals, which healthy cells use as signals. External magnetic fields cause the rate of leakage to change, increasing free radicals. When free radicals accumulate faster than the cell’s antioxidant systems can clear them, the result is oxidative stress. Oxidative stress is a recognized driver of chronic illness, including cardiovascular disease, neurodegeneration, diabetes and cancer, and it is in every medical school curriculum. One of its ordinary effects in connective tissue is that it switches on matrix metalloproteinases — MMPs, the enzymes that break collagen apart — while suppressing new collagen synthesis. Tendons are made of collagen. An athlete loading his soft tissue heavily six days a week is already creating oxidative stress in the tendons, so the addition of magnetic field exposure compounds the damage and inhibits repair, making him more susceptible to injury when enormous force lands on a tendon in a fraction of a second. That is the theory. We know that EMF causes oxidative stress, and we know that oxidative stress degrades collagen. The only thing missing is a study showing that direct connection. I have never claimed certainty that the substation is contributing to the elevated injury rate. I do believe it is likely, and I believe it warrants caution, and that a revenue machine like a major NFL team can easily afford to remove the exposure out of precaution. Is there a power plant next to the 49ers practice facility? Here is the clearest single instance of the problem with this episode. It requires no knowledge of electromagnetic fields at all. This story first came to me through Jon Feliciano, a former 49er, in an interview on Willard & Dibs on 95.7 The Game. Asked about why the 49ers are always injured, he said players used to joke that it was the power plant behind the practice fields. Wendy Zukerman corrects him on air. “It’s important to say that it’s not a power plant near the 49ers site.” Torre then asks her to explain the difference between a substation and a power plant. Her answer: a power plant generates electricity and transmits it to a substation, which converts the voltage into something your house can use and sends it on to your home or your business. There are two problems with that. The first is that there is a power plant on that site. The Gianera Generating Station is a natural-gas-fired peaker plant owned by Silicon Valley Power, and it has been there since 1986. I have published aerial photographs of the location from 1987 in which the gas plant is the only thing standing, before the practice facility was even there. I even mentioned the gas plant in my first interview. (Feliciano has since gone on record about this issue, and it is clear he had the substation in mind rather than the gas plant.) The second is that her definition describes a distribution substation, and the facility beside the 49ers is not that. It is the Northern Receiving Station, which takes in bulk power from outside the city’s grid and delivers it to distribution substations. Silicon Valley Power’s own map distinguishes receiving stations from substations, and Rose Rimler even reads the label out loud in the episode when she walks through that map on air. A few minutes before the map segment, Zukerman tells Torre: “like I said, we fact check everything.” Well, maybe not everything. I made a mistake On the morning of July 6th, at 10:20, I sent Rose and Wendy two studies. During the interview I had been asked which human studies show oxidative stress from electromagnetic fields, and I had not been able to name one on the spot. Rose emailed asking for the studies, I quickly searched for a couple, and I wrote that I thought these were the most relevant from that search. Unfortunately, I was busy and did not read either one closely at first. I picked them because they were topically relevant — one on substation workers, one on power plant workers. Neither were great studies, and their problems go past the ones raised in the episode. That was careless on my part. There is context that did not make the episode, though. Before that email I had been on a Zoom call with Rose talking about EMF and oxidative stress, and I pointed her to Dr. Henry Lai at the University of Washington, who has spent years aggregating the literature on this question. His tallies show that roughly 90% of studies since the late 1990s find oxidative effects from electromagnetic field exposure — hundreds of studies, systematically counted. Rose told me she was already aware of his work. So when she asked for studies, I understood her to have the aggregate view already and that she would report anything within that context. Not reading those two carefully was still a mistake, but the larger mistake was assuming the episode would be based on a thorough review of the actual body of literature, rather than on whatever I happened to send that morning. The second email At 1:49 that same afternoon — three hours and twenty-nine minutes after the first — I sent them a second email that I had been preparing for a while. It was a structured document in six numbered sections, written in response to a request they had made two weeks earlier, laying out my entire argument with citations attached to every link in the chain. The episode aired on August 13th, five weeks later, and not a single item from the second email is in it. Here is how it opens: The full email is included at the bottom of this post in Appendix B. Nearly 1,500 words in total. It contains two named mechanisms with the physics behind them. Occupational studies in humans. The literature on oxidative stress and collagen. A section addressing the strongest counter-evidence against my own theory, which I raised myself. And a closing section stating plainly what the theory cannot yet show. My entire argument, in writing, with detailed citations for every claim, provided to them five weeks before broadcast, and none of it made it into the episode. That is the single largest omission, but it is not an isolated one. The whole episode is riddled with similar problems, and the conclusion they came to is not merely a difference of opinion about the scientific evidence. Through omission and through strategic editing, Science Vs misinformed its audience — about what the evidence shows, about what I argued, and about who they spoke to. That is a notable outcome for a show whose stated purpose is correcting misinformation. For the record I am not going to tell you that Science Vs set out to discredit me, or that they had come to their conclusion before they reported the story, or that they used misleading editing to make me look like a man retreating from his own theory. I cannot know what was in anyone’s head, and I am not going to pretend otherwise, either. What I can tell you is what is on the record. They asked me for evidence and aired the weakest thing I sent. They interviewed three scientists who supported my theory and aired none of them. They discussed childhood leukemia without ever saying the exposure level at which it appears. And they took an answer I gave weeks before Ken Karipidis, the one EMF scientist who was put on air, was interviewed, and placed it directly after his critique, where it comes off as a major concession. A friend of mine who has worked as a journalist for thirty years read that last one and called it sleazy. I agree with her. Those are just the four issues that are impossible to defend as pure editorial decision, but they are not the only issues. The most glaring issues stem from what they left out: The exposure level at which the childhood leukemia association actually appears — three to four milligauss, a number the episode never states despite it being much lower than what I measured. The mechanism itself: The episode gets as far as “oxidative stress could weaken collagen,” which leaves it sounding like speculation, rather than a known pathway. The second email, and all the studies in it. Dr. Paul Héroux at McGill, whose work my proposed mechanism rests on, whose contact details I supplied, and who was never called. Dr. Beatrice Golomb at UC San Diego, who runs a research group on oxidative stress and mitochondrial function and has specific expdertice in collagen, interviewed and not aired. Dr. David Carpenter at Albany, the most prominent academic voice on the harm from magnetic field exposure, interviewed and not aired. Dr. Joel Moskowitz at Berkeley, interviewed and not even credited. The specific, testable condition I put in writing that would make me abandon the theory. My own unprompted statement of the theory’s evidentiary gap. My caveats about my own measurements. My ranking of EMF as one factor among several rather than the only one. The new equipment installed at those facilities between 2010 and 2014, and the sharp rise in system load from 2013 onward. But that is not all. What they kept, they selectively edited to serve a narrative that was not served by the raw transcripts of the interviews. A description of thousands of commercial routers in a workplace, reduced to the Wi-Fi in your house. My own acknowledgment, multiple times, that "I'm not a scientist" clipped in an episode that spends considerable energy pointing out that I am not a scientist. And a qualification I volunteered about my own measurements, cut from my answer and delivered later by their EMF expert as a correction. Together their edit produce a portrait of a wellness guy with Wi-Fi phobia and two bad studies, backing away from his theory the moment a “real” scientist looked at it. A practice facility where nothing changed because no new substation was built. Injuries written off as random because the 49ers were not quite the single most injured team in the league over the period in question. That portrait is false even though almost no individual statement made in the episode is. Draw your own conclusions At the top of the episode, Pablo Torre says his show had been flooded with requests to investigate the substation — that it was the thing they were asked to look into over and over again. Neither show went hunting for this story. It arrived from their own audience, in volume, and it could not be waved off. A thread I posted on X reached twenty-two million people. A guy with a gaussmeter and a brand-new Substack obligated a Pultizer prize winning program to spend an hour on a question about player health, that is considered fringe enough that most media operations won’t touch it. Pablo Torre Finds Out could not ignore it. So Science Vs came in and ran a “debunking” operation instead of an investigation. Everything below is what had to be left on the cutting room floor to deliver the “debunking”. They could not ignore it. So they tried debunked it instead. The demand was strong enough to force an episode, and since the episodes release the 49ers have sustained more injuries, including season ending ones, and interest has only grown. Demand from fans and playets is strong enough to force a better investigation from someone else. An omission is not a lie until you find out what was omitted. What follows is the detailed record so you can see the full picture. Draw your own conclusions. I have drawn mine. I am going to keep publishing. A note about Pablo Torre Finds Out After the episode aired I posted publicly, calling out Pablo Torre Finds Out for concerns I had about the integrity of their investigation, and about an interview directly with Pablo Torre which had been offered but never happened. I have since spoken with a producer at PTFO. The offer had rested on a misunderstanding about where things stood between us, and it fell away as the Science Vs part of the production widened past the science. He apologized for the miscommunication and I accepted. The producer also confirmed to me that they did essentially hand off the entire investigation to Science Vs for narrative purposes — so Pablo would be genuinely curious or potentially surprised by their findings — while still taking responsibility for what went out under their name. I appreciated the candor and the accountability, and I am comfortable with where we left things. So this post is not about PTFO. My disagreement is with Science Vs. What they left out about childhood leukemia Childhood leukemia appears at three milligauss. They gave no number at all. 1. They built an EMF ruler, then discussed childhood cancer without it. The sequence on air went like this: First I measured almost 9 mG, then I measured up to 50 milligauss. Torre reacts with concern — “that sounds high.” Cut to Karipidis: the public limit is 2,000 milligauss. Torre reacts again — “What happens at 2,000?” Karipidis explains that nothing happens at 2,000, that safety factors are built in. Then: at more than 50,000 milligauss you get flickers of light in the retina, and higher still, nerve stimulation. The listener now has a ruler (their ruler) to measure these numbers with. Fifty is nothing by their ruler. Then the episode turns to childhood leukemia and states, accurately, that there is a real association — but tellingly, they never give the exposure level at which that association appears. Childhood leukemia appears at three milligauss. They conveniently left that out. The pooled analyses that produced the World Health Organization’s carcinogen classification found roughly a doubling of childhood leukemia risk above three to four milligauss. That is the number that belongs in that segment, and it is more than ten times below the reading that had just been dismissed as trivial. I gave them that number myself, on tape, in the interview. Describing my own threshold, I said my comfort level for long-term chronic exposure is three to four milligauss, but preferably one. 2. Six children in thirteen million. The episode reports that these fields might explain one to four percent of childhood leukemias, then reframes it as a German estimate of perhaps six cases among thirteen million children. Torre, to his credit, is uncomfortable. What never gets explained is why that number is small. Almost no children lives above three milligauss in Europe. Fewer than two children in a hundred, in the Italian data. So even if the risk to those children doubles, the number of additional cases across an entire country stays small — not because the hazard is small, but because hardly anyone is exposed to it. Count the whole population and the few who are exposed disappear. And the reason hardly anyone is exposed is that siting rules keep housing away from transmission lines. In Europe, at least. The Dutch government has a standing precautionary policy against building new homes in any zone where the annual average magnetic field exceeds 4 milligauss — the same number the episode never mentioned. Denmark and Norway treat 4 milligauss as the level that triggers a look at mitigation. That is five hundred times below the ICNIRP figure quoted on air. The United States has no federal equivalent. That is evidence of infrastructure siting policy working. It is not evidence that there is no hazard. It is evidence that we already act as though there is one. If you listen to the raw audio you will hear that my proposed solution is EMF exposure is to build better infrastructure. What they left out about the mechanism 3. They accused me of cherry-picking, and then cherry-picked themselves. On air, Zukerman tells Torre that people who worry about electromagnetic fields dismiss the studies showing null results and collect the ones showing harm, and that this is why you have to be careful not to cherry-pick. They had two papers I had rattled off in a hurry, and a second email containing a carefully chosen set. They ran the two weakest, graded them on air, and presented the result as the state of the evidence for not only my theory, but the whole question of oxidative stress from magnetic fields. That is cherry-picking from my emails. The bigger picture is what they did with the literature as a whole. Zukerman acknowledges it exists, dismisses it, and disposes of it in a single stroke. You can go online right now, she tells Torre, and find scores of studies showing these fields increase oxidative stress. The issue, she says, is that they are not studies in people. Many of them are in people. The occupational studies in my second email are in people. That email had been in her inbox for five weeks. She waved off the literature on a factual claim that the documents in her possession contradict. (I have written separately about the evidentiary standard at work here). The effect was that they essentially baited me: ask the subject to supply the evidence, take the weakest thing he sends, and let that stand as a proxy for the whole argument. Wendy has been doing this show for ten years and clearly knows how to extract what she needs for her desired narrative. 4. They presented the collagen-improvement research as a gotcha, but I had already addressed it. The episode treats the existence of studies showing that EMF can improve collagen as a surprise that undercuts me, but I had pre-emptively addressed that five weeks earlier in the email they ignored. Those studies use measured, high-intensity pulsed dosing. The mechanism by which they work is oxidative signalling. The cell reads a controlled rise in reactive oxygen species as a warning, upregulates its antioxidant defenses, mounts a repair response, and the therapy stops before the system is overwhelmed. The key point is that it induces an oxidative response, which means those studies are actually evidence for my proposed mechanism, not against it. A field that produces a therapeutic effect cannot be biologically inert (which is the implication when they say “Nothing happens at 2,000 milligauss). Chronic ambient exposure is the same pathway with no off switch, and it is most consequential during the evening and while sleeping, when the body is in repair mode and the exposure does not stop. Section 5 of my email is titled What about the study showing improved collagen synthesis. I raised the counter-evidence myself, explained why I did not think it refuted the theory, and wrote that I was disappointed the question had not come up in the interview. That is worth holding against the cherry-picking charge in the item above: the studies they presented as inconvenient for me were studies I had gone out of my way to put in front of them. 5. Section 1 of my email stated a critical argument that was never put to the expert directly responsible for it. My email says the exposure limits exist to prevent acute effects and do not address chronic exposure at all, and that my dispute is with the entire framework. Zukerman gestures at this once. After Karipidis gives the 2,000 milligauss figure, she tells Torre that I would object because those levels do not capture “more subtle effects.” That is not my argument, and “subtle” is doing a lot of work here. My argument is that the limits are built to prevent acute effects — nerves firing, muscles twitching, etc — and were not designed to address chronic exposure at all. In fact, ICNIRP’s own documents state as much themselves. Mine is a structural objection to what the standard measures, reduced as a concern about subtlety, it becomes a matter of degree, rather than a categorical difference. They interviewed Ken Karipidis, vice chair of ICNIRP — the body that writes those limits. He was asked what the limit is, but he was never asked how it applies to chronic exposure. The scientists Science Vs interviewed and did not air 6. They interviewed four officials of the standards body. The episode credits roughly a dozen researchers. Four of them are associated with ICNIRP. Ken Karipidis is the vice chair. Rodney Croft chaired ICNIRP from 2020 to 2024 and led the development of its current guidelines. Dan Baaken is ICNIRP’s scientific secretary. Frank de Vocht sits on the Main Commission. One of them speaks in the episode. Their institution’s position is more than adequately represented — the 2,000 milligauss figure, the safety factors, the assurance that nothing happens below the line. 7. The four who were left out. Dr. Beatrice Golomb is Professor of Medicine at UC San Diego — a physics undergraduate degree, a PhD in biology, an MD. She directs a research group whose stated focus is the relationship between oxidative stress, mitochondrial function and health. That is the mechanism the episode spent its first half dismissing. Her published work includes the fluoroquinolone case series behind the FDA’s black box warning on an antibiotic class that ruptures tendons, where the accepted mechanism is oxidative stress and mitochondrial toxicity — the back half of my chain, already on a drug label. She is in the credits. She is not in the episode. She has told me she finds my theory biologically plausible, and that she has a recording of her interview. Dr. David Carpenter directed the Institute for Health and the Environment at the University at Albany for decades and is the most prominent academic voice arguing these fields cause harm. Childhood leukemia is the reason these fields carry a WHO classification at all, and Carpenter is the person you call if you want that case made by someone who has spent a career on it. He is in the credits. He is not in the episode. He has told me that when he was interviewed they could not have been less interested in what he had to say. Dr. Joel Moskowitz directs the Center for Family and Community Health at UC Berkeley’s School of Public Health. He told me directly that they interviewed him and that he thought it went well. He does not appear in the episode, and unlike Golomb and Carpenter, he does not even appear in the credits. Dr. Paul Héroux at McGill is the researcher whose work provides the foundation for the oxidative stress mechanism my theory rests on. I gave Rose his email address and phone number. He was never interviewed. They never even called him. 8. “He’s not a scientist.” The episode leans hard on the fact that I am not a credentialed scientist. Zukerman says it. Torre repeats it. “At all.” Having built a segment on that, they then left out the physicist-biologist-physician, the professor of public health, the director of a university environmental health institute, and the McGill researcher whose work the primary mechanism comes from. They spent the episode telling their audience I am not a scientist, and then kept four actual scientists who support the theory off because their argument does not survive otherwise. How they misrepresented me and my case 9. They played my words as a response to an interview I had never heard. Near the end of the hour, Zukerman says she went to me and told me the evidence was lacking. Then she plays me saying I am not wedded to it being an EMF, that I have staked my reputation on it needing more study, and that I am not certain of anything. That segment was placed immediately after Karipidis had finished taking the cherry-picked papers apart. It plays as a man folding under expert scrutiny. Commenters have used it against me since, but it is incorrect. Here is the sequence as it happened. I was interviewed. Karipidis was interviewed weeks later. I was never told what he said, or even who he was. I was never asked to respond to it. I did not know his name until the episode aired. That is not a simple editing decision. That is a quote from one interview, moved to follow a critique from a different interview it was not a response to, so that it would land as a concession. A friend of mine who has spent thirty years as a journalist read that sequence and called it sleazy. She is right. The full passage is reproduced in Appendix A, and it is worth reading. What airs is the preamble. Four paragraphs later I say “to directly answer your question” — and that answer, about what would change my mind if the team relocated, is not in the episode. Neither is the sentence two paragraphs on, where I say the EMF might turn out to be ten percent of the problem. I will say the underlying point again, though, because I meant it and I still do. I am not wedded to my theory that magnetic fields from the substation are contributing to the 49ers injuries. I could be wrong. What I am wedded to is the process of scientific inquiry, and the fact that we should be cautious around these exposures and we need more independently funded studies. 10. Three telling edits. They cut “I’m not a scientist” mid-sentence. What I said: “...and I am not certain of anything. I’m not a scientist. To me, I find the mechanisms compelling. I will go back to the fact that I got into this not because of the 49ers, but because of clients I was working with who suffer from EDS...” What aired: “...and that I am not certain of anything. I’m not.” The clip ends on the first two words of the sentence in which I say I am not a scientist, in an episode that spends considerable energy establishing that I am not a scientist. The full sequence is in Appendix A. They cut my own description of my work. Asked what I do, I said I run a wellness business, that I am focused on writing software to help people navigate environmental stressors, that environmental health is my focus, and that I also do independent journalism and research. What aired is the wellness business and the environmental health, with the software and the journalism removed from my own answer. The software engineering does come up later — narrated by them, as a hacker who grew up to write firmware — but my current work, in my own words, arrives as “wellness guy.” Thousands of commercial routers became home Wi-Fi. What I described: working at a wireless networking company surrounded by thousands of Wi-Fi routers, and a stress-induced health collapse afterward that working in that environment contributed to. What aired: Wi-Fi, the kind you have at home — reinforced by a clip of Christian McCaffrey talking about turning his router off at night. Three cuts, and every one of them makes me seem less credible. That is not a coincidence. 11. I gave them my own caveats and the test that would disprove me. In the first email I wrote that a well-designed chronic, ambient-level exposure study in tendon showing no collagen degradation, run over many months, would undercut my confidence in the theory. That is a specific, testable condition, stated in advance and in writing. There was a second interview, weeks later, which was not used in the episode, but in that I asked again for the falsification criterion to be included. What the episode presents instead is a man saying “we need more study,” which reads as a hedge, an open-ended request for the benefit of the doubt. It is the opposite of a hedge. Section 6 of my second email says, unprompted, that as far as I am aware there is not a single study showing EMF-driven oxidative stress degrading collagen in a human in vivo or in human tendon in a lab. I wrote that because it is true and because it is the first thing anyone should check. Under their standard it becomes the hinge of the entire first half, framed as something they had to surface without my cooperation. I had handed it to them five weeks earlier. And in the interview I said that my 25 to 50 milligauss readings were taken at knee level, and that these fields attenuate quickly, so by the time it reaches your head it is not that high anymore. That did not air either. The qualification arrives later, from Karipidis, as a correction. How you would actually study the injuries 12. They measured the wrong thing. The episode spends its final act on whether the 49ers are the most injured team in the NFL, finds no clean ranking, and lands on “injuries are random”. That is the wrong test. You would define the exposure — measured field levels at the facility — and the outcome narrowly: soft-tissue injuries, not a single MSK injury count that a broken finger and a ruptured Achilles both land in. Then you would compare the 49ers to themselves before and after the exposure changed, and compare that change against every other team over the same window. That controls for league-wide shifts in rules, turf and training load. It is a difference-in-differences design, and it is standard. I sent them that argument on July 28th, in writing, along with the fact that in eleven of the past twelve seasons the 49ers had finished top ten in Adjusted Games Lost. And by the episode’s own reporting, the 49ers are second in games lost to injury over the past decade, with FTN’s Aaron Schatz confirming that once you adjust for starters they come out second worst in the league — after having been one of the healthiest teams for years before that. A finding like that is where an investigation starts, not where it stops. 13. I did a lot of substation research for the episode that was never aired. I had reported that the substation next to the facility was expanded in 2014. That was wrong, and Rose Rimler and I sorted it out together. They gave me credit on air, which I appreciated, but framed it as a concession on my part to something they had found. In fact I had been investigating it myself, was uncertain before they asked, but was waiting for clarification from Silicon Valley Power. The uncertainty centered around a substation named “Esparanca” that was proposed right behind the facilities as part of the stadium construction, but now appears to never have been built. I spent days in Silicon Valley Power’s records, and did eventually reach Silicon Valley Power for confirmation and indentified the mistake myself. I also gave them highly detailed documents on what we do know about those facilities: new equipment installed between 2010 and 2014, and load growth across the system with an inflection around 2013–2014, with the Northern Receiving Station carrying the highest capacity in the system and sitting closest to the data center corridor. None of that is in the episode. I have a separate piece about it coming out soon. *I cut 2 seconds from the raw audio to remove personal information that had no connection to anything in the episode. Appendix A: the passage the clip was taken from This is the sequence from my first interview, in full. The episode uses one fragment of it. It’s tricky because my understanding is that there’s something like a 15-year half-life on collagen remodeling issues. They’re going to get a new crop of players. What I really need, though, is for the injuries to be broken down so we can see the soft tissue injuries. Right now, they’re categorized as MSK injuries, but let’s say we can actually identify them more specifically. Is that right? He was able to do that? Oh, cool. I wasn’t able to find that information. Interesting — I didn’t know that data existed. I tried so hard to get it, and I didn’t know it was available. Maybe you could connect me with that person. That would be amazing. I’m not wedded to it being an EMF, honestly. I’m not. I would say that, to a certain extent, I’ve staked my reputation on the fact that it needs more study. It’s important to look into it, and I am not certain of anything. I’m not a scientist. To me, I find the mechanisms compelling. I will go back to the fact that I got into this not because of the 49ers, but because of clients I was working with who suffer from EDS, Ehlers-Danlos Syndrome, a tendon hypermobility issue. This condition is documented to be partially caused by oxidative stress. I’ve worked with them to mitigate their EMF exposure and have seen people improve. I think it’s a bigger story. In a way, the 49ers represent an occupational cluster with specific exposure risks. If someone would conduct a study on this, I believe we could learn a lot. Perhaps we would discover that it’s like, okay, maybe it’s 10% of the problem. I don’t know the exact number, but I think either way, conducting the study would provide valuable insights. To directly answer your question, it’s challenging for me because it’s part of a bigger story. If the 49ers move and stop having injuries, I might conclude that it was related to the substation. However, if they move and still experience injuries, I would want to analyze the nature of those injuries. Are they primarily soft tissue injuries? I don’t think it’s necessarily a case closed, but the story might lose traction at that point regardless. Three things are worth noting. The aired fragment stops immediately before the sentence in which I say I am not a scientist — the cut described in item 10. It also stops four paragraphs before the words “to directly answer your question.” What the episode plays is the throat-clearing. The actual answer, about what would change my mind, never airs. And two paragraphs in, I say the EMF might turn out to be ten percent of the problem. That is the ranking the episode says I never gave. Appendix B: the full email, July 6th, 1:39 PM Hi Rose, You asked me to send you some studies a couple of weeks ago. I apologize for the delay. I have been incredibly busy. I also wanted to give you a chance to dig in yourself, and get your own perspective before I influenced you too much with mine. That said, I do want to make sure that the actual argument is abundantly clear, so here it is! One note before I begin, there are really two separate questions here: Does the substation cause the soft-tissue injuries? That was my specific claim, and what the podcast is about. Is the theory biologically sound? Can 50/60 Hz fields at these levels do anything biological below the safety limits? Question two is why people have been calling me a conspiracy theorist. The regulatory and advisory bodies (ICNIRP, etc) maintain that anything below their exposure limits is biologically inert, and that position is broadly accepted within the mainstream, but the actual science paints a different picture. To defend my theory I’ve had to defend a much larger claim: that the advisory bodies have the biology wrong. I can’t honestly answer question 1 without first addressing that. Here’s is a simplified outline of my theory, with links to studies: 1. Advisory body thresholds for biological effects The ELF magnetic-field limits (ICNIRP’s ~2,000 mG public / 10,000 mG occupational) exist to prevent acute effects from exposure. If a magnetic field is strong enough, it makes nerves fire and muscles contract. Muscles twitch. You can see faint flashes of light in your vision. People can even feel tingling or even a shock. That happens due to Faraday’s law, which states that a time-varying magnetic field induces an electric field inside the body via the creation of Eddy currents.The standards assume that those currents do nothing below the twitch threshold. They do not consider chronic effects at all. My argument is that they are biologically active and do have chronic effects. 2. There are multipe ELF-EMF mechanisms for inducing oxidative stress. This is basic biophysics. Below are the two primary mechanisms. Simplest first. Dr. Paul Héroux of McGill has the most intuitive explanation, which rests on Maxwell’s principle of superposition: because Maxwell’s equations are linear, two sets of electromagnetic waves sharing the same space simply add together. In the interview I pictured a pebble dropped into a pond, sending out clean ripples. Then a boat motors past at distance, sending larger waves, and where they meet the ripples, the two add together and the original pattern gets distorted. In our cells, the mitochondria run on continuous currents of electrons and protons that carry their own faint electromagnetic fields. An external field from a substation, by the principle of superposition, adds to those internal currents and shifts the pattern. The electron transport chain in the mitochondria leaks a fraction of its electrons by design as reactive oxygen species (ROS), which act as signalling molecules in a healthy cell. Distorting that field increases that electron leakage, creating oxidative stress. A tiny electromagnetic interference results in a large downstream effect. https://www.sciencedirect.com/science/article/pii/S2405844025006474 The more complex pathway is Dimitris Panagopoulos’s Ion Forced-Oscillation / Voltage-Gated Ion Channel (IFO-VGIC) mechanism. Weak, polarized, low-frequency fields force the ions (calcium, potassium, sodium) next to an ion channel’s voltage sensor to oscillate; because that force scales with the inverse cube of the distance involved, fields far below the stimulation threshold can still force the channel open, disrupting the cell’s ion balance and driving ROS overproduction (Nitric oxide and superoxide interact and produce peroxynitrite, a highly unstable cytotoxin that breaks down into free radicals). https://www.researchgate.net/publication/366088934 https://www.spandidos-publications.com/ijo/59/5/92 https://www.mdpi.com/1422-0067/22/18/10041 https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1585441/full https://pmc.ncbi.nlm.nih.gov/articles/PMC3772193/ 3. Evidence of oxidative stress, in vivo, in humans from ELF-EMF There are many studies, and the strongest are occupational, which applies to the 49ers situation. 115 power-plant workers vs. 145 office controls. Serum malondialdehyde (MDA, the standard lipid-peroxidation marker), superoxide dismutase, and catalase were all significantly higher in the exposed group, and the markers rose with increasing field exposure. https://journals.sagepub.com/doi/abs/10.3233/WOR-203244 A follow-up where they reversed the oxidative stress in power plant workers. A double-blind randomized controlled trial: 91 power-plant workers given vitamin E, vitamin C, both, or placebo for 90 days. The antioxidant groups showed reduced lipid peroxidation and raised antioxidant capacity versus controls. https://pubmed.ncbi.nlm.nih.gov/32191586/ A spot-welder study: 46 welders occupationally exposed at 50 Hz, showed significantly altered red-blood-cell antioxidant enzyme activity and concluded ELF-MF “might act as an oxidative stressor… even at the recommended levels of exposure.” https://pubmed.ncbi.nlm.nih.gov/18504600/ A substation-specific study found oxidative stress and DNA damage https://pubmed.ncbi.nlm.nih.gov/24460415/ 4. Oxidative stress degrades collagen This half isn’t controversial at all. Oxidative stress activates the matrix metalloproteinases (MMPs) that break collagen down and suppresses its synthesis. Here are three example studies: Siwik et al. 2001: Oxidative stress raises MMPs and lowers collagen synthesis in cardiac fibroblasts. https://pubmed.ncbi.nlm.nih.gov/11121376/ Fisher et al. 2009: Collagen fragmentation drives oxidative stress and elevates MMP-1 in aged human skin. https://pmc.ncbi.nlm.nih.gov/articles/PMC2631323/ Varani et al. 2006: Decreased collagen production in oxidatively aged skin. https://pubmed.ncbi.nlm.nih.gov/16723701/ 5. What about the study showing improved collagen synthesis I’m glad you asked this question, and I’m bummed we didn’t get to it in the interview because it is a great question, and very important to understand. Superficially it may appear to be a refutation of my theory, but I would argue that it actually supports the underlying argument. That study used a short, high-intensity pulsed dose: therapeutic-PEMF, the same type of field used clinically to stimulate bone and tissue healing. The reason this works is because it triggers the very same biological pathways that can lead to oxidative stress. The exposure still stimulates ROS production, but done at a controlled dosage, for a limited duration it has a different effect. The cell reads the ROS as a warning signal and it upregulates its antioxidant defenses, and mounts a repair/proliferation response. The therapy is then stopped before the cell gets overwhelmed. That is essentially a hormetic response: a small dose of a stressor producing a beneficial adaptation. Two things follow: At the very least, this means the field is biologically active, which by itself undercuts the regulatory claim that these fields are inert below their thresholds. There is a wealth of literature on PEMF (pulsed EMF) bone regeneration and calcium channel signalling (which is the second mechanims in section one). Here is one. https://www.nature.com/articles/srep13856 At best, it leads us straight to my actual concern, which is that under chronic, chaotic and unregulated exposure, the cell’s antioxidant capacity gets overwhelmed, resulting in oxidative stress. There are plentiful examples of things that are beneficial at controlled doses, but harmful at uncontrolled doses. Excecise is one obvious, uncontroversial example. Botox is perhaps a more interesting example. 6. What about a study that shows EMF causing collagen degradation in humans? As far as I am aware there is not a single study showing EMF-driven oxidative stress degrading collagen in a human, in vivo, or in human tendon in a lab. There are studies involving isolated fibroblasts though, which secrete collagen. The most relevant one showed that human fetal scleral fibroblasts exposed to 50 Hz ELF-EMF showed a significant decrease in collagen synthesis and that MMP-2 expression was upregulated, which is the exact mechanism I described in section 2. https://pmc.ncbi.nlm.nih.gov/articles/PMC3626379/ That’s it! Thanks again for the interview. Best, Peter Anthony Cowan Environmental Health · Wellness Tech · Researcher & Journalist Publisher & Editor, Living Energy Bio: petercowan.comSocial: X · Instagram · TikTokApp: sunlightis.lifePhone: [redacted]
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Pioneer of China NewCo model sued in US over trade secret misuse, double-dealing
A legal feud unfolding in New York is putting a spotlight on the work of a business development veteran who is credited for pioneering one of biopharma’s hottest dealmaking mechanism: the China “NewCo” model. In a lawsuit originally filed in New York state court and recently moved to federal court, China’s Lepu Medical Technology has alleged that biopharma business development consultant Su Zhang, who was hired to help shop its GLP-1 weight-loss candidates to Western partners, engaged in corporate double-dealing and trade secret leaks. According to the complaint, while acting as Lepu’s primary dealmaking liaison for a group of obesity and metabolic disease drug candidates, Zhang was secretly double-dipping as the acting chief business officer for a direct competitor, BrightGene Pharmaceutical. “She never adequately disclosed the role, never sought Lepu’s consent, and never proposed any safeguard,” Lepu alleged in its complaint, which was filed in July after Zhang’s consulting firm, CoDevCo, sought certain transaction-based success fees from its angry customer through an arbitration process in Singapore. Lepu, the parent company of Lepu Biopharma, has asked Zhang to pay back its $500,000 retainer and disgorge all benefits she received during the alleged breaches of fiduciary duty, plus other damages and relief. The company has also requested the court grant injunctions to protect Lepu’s trade secrets. The ill-fated partnership officially kicked off in December 2024, when Lepu tapped CoDevCo as its “exclusive business development mechanism” to identify collaborators for the company’s drug candidates. According to Lepu’s complaint, Zhang personally negotiated and signed the agreement as managing director for CoDevCo, which used her home address. Before the Lepu deal, Zhang made a name following a short stint as the global head of business development for Hengrui Pharmaceuticals. It was during her tenure that Hengrui signed a landmark deal granting exclusive rights for a portfolio of GLP-1 assets to Hercules, which was at that time newly established by a group of private equity and venture capital firms. In addition to the regular upfront and milestone payments, Hengrui also gained an equity stake in Hercules, which later became Kailera Therapeutics. The Hengrui-Hercules deal opened a new paradigm, where a Chinese biopharma company spins off certain early-stage assets to investors for further development through the creation of a new company abroad. The “NewCo” model quickly came into vogue as it allows Western investors to access high-potential assets originating from China at an early stage while giving the Chinese licensors an opportunity to reap long-term benefits through equity stakes in the new firms. The NewCo model proved its value when Kailera staged a record-breaking $625 million IPO on Nasdaq this April, merely two years into the Hengrui deal. Related Kailera CEO 'knew we were in a good spot' before obesity biotech's record-breaking $625M IPO On her LinkedIn page, Zhang described her work at Hengrui as “[b]uilding team and capability from the ground up,” forming NewCo and major pharma partnerships worth billions of dollars. Lepu clearly wanted that kind of track record to help boost its own cardiometabolic portfolio, which includes a range of assets for obesity, Type 2 diabetes, fatty liver disease and muscle preservation during weight loss treatment. “Lepu’s pipeline is very valuable, but only if Lepu could secure the right international partner to expand into the overseas market during the available commercial window,” the company argued in its complaint. The Chinese biotech said it had little knowledge of U.S. laws, customs or business practices in the business development field, and therefore “needed to rely entirely” on the expertise of Zhang and her team as the firm’s first engagement of a U.S.-based BD consultant. “Zhang’s dominating influence on the business development strategy is further evidenced by the fact that she personally controlled the business-development communications on behalf of Lepu with potential partners,” Lepu said in its complaint. After entering the deal, Zhang introduced Lepu to her four associates. According to Lepu’s version of events, all of them were allegedly employed at different time points to perform similar jobs at other Chinese companies that Lepu described as its competitors, while having access to Lepu’s confidential information. As such, Lepu described Zhang’s team as “a roster of individuals whose primary professional loyalty, by virtue of their concurrent full-time employment, ran to Lepu’s competitors.” As well as the specific examples set out in the case, a look at Lepu’s deals over the period suggests Zhang may have been involved in at least one transaction. During their partnership, Lepu, through its subsidiary Shanghai Minwei Biotechnology, also out-licensed its GLP-1/GIP/FGF21 agonist MWN105 to a NewCo called Sidera Bio in the fall of 2025. The deal included an upfront and near-term payment of $35 million, up to $1.01 billion in milestones, and a 9.99% stake in the Danish startup. It seems likely that Zhang facilitated the Minwei deal given that Lepu is on record as having used CoDevCo as its “exclusive business development mechanism.” The big shock for Lepu came in the form of a news article on June 25, 2025. The article, reporting on phase 2 data for BrightGene’s GLP-1/GIP receptor agonist BGM0504, identified Zhang as acting chief business officer of the Lepu rival. Blindsided by her association with BrightGene, Lepu confronted Zhang in July 2025. “Lepu was given assurances that there was nothing to be concerned about and told that Zhang would explain the matter to Lepu,” Lepu alleged in its complaint. “Zhang never did.” Lepu claimed that Zhang had the motive and opportunity to steer potential prospective partners toward BrightGene or other competitors. Later, in February 2026, one of Zhang’s associates joined BrightGene as the vice president for global business development, according to the complaint. Around the same time, Lepu sent written demand letters asking Zhang to account for her BrightGene role, identify what confidential data were shared with the rival firm, and provide any conflict-of-interest or firewall policies during the engagement. According to Lepu, neither CoDevCo nor Zhang answered the questions in their responses. Related Novo vs. KBP: How a $1.3B deal turned into a fraud accusation and an international legal fight In a motion to dismiss filed with the U.S. District Court in the Eastern District of New York on Sept. 4, Zhang’s legal team argued that Lepu’s agreement was signed with CoDevCo, and that an employee of the contractor does not owe fiduciary duties to the client. In its complaint, Lepu said: “That CoDevCo was the contracting entity does not insulate Zhang from personal liability for duties she personally undertook and personally breached.” Taking the argument one step further, the defending party argued that the consulting agreement “does not create a fiduciary relationship even between CoDevCo and Lepu; instead, it identifies CoDevCo as an independent contractor retained to market Lepu’s business to potential western partners.” Although CoDevCo was Lepu’s exclusive business-development contractor, there were no terms stipulating that the consulting firm should serve only Lepu, Zhang’s lawyer noted. As to Lepu’s claims that Zhang misappropriated trade secrets, the defendant argued that Lepu authorized the use of the information so Zhang’s team could perform their service per the agreement. In a rebuttal filed on Sept. 11, Lepu’s lawyer set out why they believe the Chinese biotech satisfied New York law’s misappropriation definition by alleging that the defendant used a trade secret “in breach of a duty or through improper means.” As an alternative to dismissing the suit, the defendant suggested the action should be stayed pending outcomes from the arbitration of a separate case in Singapore. While NewCo pioneer Zhang is defending her business arrangements, momentum behind the NewCo trend has continued unabated into 2026. Through August, Chinese biotech assets have spurred 15 NewCo deals this year, according to local trade publication PharmaDJ.
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WHO urges targeted action to strengthen emergency workforce capacities for shared health risks across the Asia-Pacific region
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Business Restructuring Review Vol. 25 No. 3 May-June 2026
In This Issue Texas Bankruptcy Court Adopts Barnet Rule Requiring Foreign Debtor to Have U.S. Assets to Be Eligible for Chapter 15 Relief In In re Siu-Fung Ceramics Holdings Limited, No. 24-33299, 2026 WL 382424 (Bankr. S.D. Tex. Feb. 10, 2026), the court denied petitions for chapter 15 recognition of Hong Kong bankruptcy and liquidation proceedings commenced on behalf of an individual debtor and a group of companies that he owned or controlled. According to the court: (i) the corporate debtors' Hong Kong liquidation proceeding was not eligible for chapter 15 recognition because the attorney retainer upon which such relief was based was not funded until nine months after the chapter 15 petition date; and (ii) the individual debtor's Hong Kong bankruptcy case could not be recognized because the debtor's "center of main interests" on the chapter 15 petition date was not in Hong Kong, and he did not even maintain an "establishment" there. [read more …] Southern District of Texas Clarifies Post-Purdue Course for Consensual Third-Party Releases and Gatekeeping Provisions In In re Container Store Group, Inc., 676 B.R. 356 (S.D. Tex. 2026), appeal filed, No. 26-20166 (5th Cir. Apr. 14, 2026), cross appeal filed, No. 26-20166 (5th Cir. Apr. 24, 2026), the U.S. District Court for the Southern District of Texas addressed consensual third-party releases and gatekeeping provisions in the aftermath of the U.S. Supreme Court's ruling in Harrington v. Purdue Pharma L.P., 603 U.S. 204 (2024). Consistent with existing Fifth Circuit precedent, the court confirmed that, in appropriate circumstances, consent for third-party releases may be obtained through a creditor's failure to opt out of granting that consent. But, the court ruled, consent through an opt-out mechanism essentially can never be inferred for creditor classes that stand to receive no recovery under a chapter 11 plan and that are deemed to reject the plan by operation of applicable bankruptcy law. Instead, those classes must affirmatively opt in to any release. The court also narrowed and remanded the bankruptcy court's acceptance of a broad gatekeeping provision, ruling that such provisions must correspond to the restrictions established by Fifth Circuit precedent. [read more …] Delaware Bankruptcy Court: Initial Transferee Need Not Be Defendant in Fraudulent Transfer Avoidance and Recovery Litigation The Bankruptcy Code gives a bankruptcy trustee the power to avoid asset transfers that are either made with the intent to defraud creditors or that are "constructively" fraudulent because an insolvent debtor did not receive adequate value in exchange. The Bankruptcy Code also permits recovery of an avoided transfer from not only the initial recipient, but also from subsequent transferees. Courts disagree over whether a transfer must actually be avoided before the trustee can seek recovery from a subsequent transferee and whether the initial transferee must also be a defendant in the recovery litigation against a subsequent transferee. The U.S. Bankruptcy Court for the District of Delaware weighed in on this debate in Phillips v. SS Associates LLC (In re ONH AFC CS Investors, LLC), No. 23-10931 (CTG), 2026 WL 312892 (Bankr. D. Del. Feb. 4, 2026). The court adopted the majority view, ruling that the initial transferee need not be a defendant in avoidance and recovery litigation against a subsequent transferee, but that the trustee must establish the elements necessary to avoid the initial transfer as part of the recovery litigation. [read more …] New York Bankruptcy Court Weighs In on Adequate Assurance of Future Performance under Assigned Leases and Chapter 11 Plan Exculpation Provisions In order to assume and assign an executory contract or unexpired lease, a bankruptcy trustee must cure most defaults under the agreement and provide "adequate assurance" of the assignee's future performance. However, the Bankruptcy Code provides no guidance as to the meaning of "adequate assurance" other than with respect to shopping center leases. In In re Broadway Realty I Co. LLC, No. 25-11050, 2026 WL 147505 (Bankr. S.D.N.Y. Jan. 19, 2026), the U.S. Bankruptcy Court for the Southern District of New York examined this issue in connection with a proposed assignment of thousands of residential leases as part of a free-and-clear sale of debtors' properties. The court held that "adequate assurance" does not mean a guarantee of the assignee's future performance, but merely demonstration that the assignee has the ability to satisfy the underlying obligations. The bankruptcy court also ruled that an exculpation provision in the debtors' chapter 11 plan exonerating non-estate fiduciaries from liability for actions taken in connection with the chapter 11 case was unobjectionable, provided it was limited in scope to postpetition conduct and actions taken in connection with implementation of the plan after its effective date. [read more …] Newsworthy Corinne Ball (New York) (Hall of Fame), Bruce Bennett (Los Angeles), Carl E. Black (Cleveland), Jeffrey B. Ellman (Atlanta), Brad B. Erens (Chicago), Gregory M. Gordon (Dallas), Heather Lennox (Cleveland/New York), Joshua M. Mester (Los Angeles), and Kevyn D. Orr (Washington) were included in the 2026 edition of Lawdragon 500 Leading Bankruptcy and Restructuring Lawyers. The Daily Business Review selected Isel M. Perez (Miami) as an "On the Rise" winner for the Florida Legal Awards. The Florida Legal Awards annually recognize those who have made significant contributions to the legal industry in Florida. Dan T. Moss (Washington/New York) was inducted as a Fellow in the 37th Class of the American College of Bankruptcy at its Annual Meeting in March 2026 in San Antonio, Texas. Christine Borries (Munich) was ranked in the practice area Restructuring/Insolvency in the 2026 edition of Chambers Germany. The 2027 edition of The Best Lawyers in Singapore™ recognized Sushma Jobanputra (Singapore) in the practice area Insolvency & Reorganization. The restructuring transaction involving Eissmann Automotive North America, Inc. received the "2025 Turnaround of the Year (Large Company)" at the Turnaround Management Association (Detroit) Annual Awards Reception. T. Daniel Reynolds (Cleveland) and Nick Buchta (Cleveland) represented subsidiaries of Eissmann Group Automotive in connection with the parent company's German insolvency proceedings. Roger Dobson (Sydney) is among 40 Jones Day lawyers recognized by The Best Lawyers in Australia 2027 for his contributions in Banking and Finance Law; Distressed Investing & Debt Trading; Insolvency and Reorganization Law; Litigation. An article written by Corinne Ball (New York) titled "Ard Finance—A Global Enterprise Combining an LME With a Foreign Insolvency Proceeding and Chapter 15" was published in the April 21, 2026, edition of the New York Law Journal. An article written by Alex Sapp (New York) titled "Recent Developments in Section 510—Subordination" was published in the 2025 edition of the Norton Annual Survey on Bankruptcy Law. An article written by Brad B. Erens (Chicago) titled "New York Bankruptcy Court Approves Insider DIP Litigation Financing" was published on April 6, 2026, by Lexis Practical Guidance. An article written by Corinne Ball (New York), Dan T. Moss (Washington/New York), David S. Torborg (Washington), and Isel M. Perez (Miami) titled "New York District Court Affirms Narrow Scope of 'Public Policy Exception' in Chapter 15 Cases" was published on April 6, 2026, by Lexis Practical Guidance. An article written by Jeffrey B. Ellman (Atlanta) titled "Statutory Cap on Lease Rejection Damage Claims in Bankruptcy Applies to Solvent Debtors" was published on April 6, 2026, by Lexis Practical Guidance. An article written by Trisha L. Mowbray (Real Estate; Chicago) and Ryan Sims (Washington) titled "Chapter 11 Plan that Abridged Non-Debtor Lessee's Rights to Remain in Possession After Rejection Unconfirmable as Having Been Proposed in Bad Faith" was published on April 6, 2026, by Lexis Practical Guidance. Lawyer Spotlight: Ben Rosenblum Ben Rosenblum, a partner in the New York Office, represents debtors, creditors, and other parties in out-of-court restructurings and court-supervised proceedings, including chapter 11 cases, municipal bankruptcies, international insolvency matters, and stockbroker liquidations. His experience spans industries such as manufacturing, shipping, mining, aviation, energy, real estate, and telecommunications. Ben's notable debtor representations include Peabody Energy, the City of Detroit, Chrysler LLC, Spansion Japan, and Dana Corporation. Significant creditor representations include General Maritime Corporation, Calpine Corporation, American Home Mortgage, and Murray Energy. He currently represents creditors in Puerto Rico's restructuring. He also has extensive experience advising financial institutions on bankruptcy law as applied to derivatives.
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