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Culturally Relevant Cardiovascular Disease Prevention and Care Strategies
(Feature Impact) Driven by rising rates of obesity, diabetes, high blood pressure and other risk factors, cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the United States. googletag.cmd.push(function() { googletag.display('fixed-big-ad-top-asset'); }); Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation’s largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high-quality healthcare. A new scientific statement published in the American Heart Association’s flagship journal, “Circulation,” revealed how social, economic, cultural and environmental factors contribute to persistent disparities in cardiovascular health, calling for culturally tailored prevention strategies, equitable access to care and greater representation of Hispanic populations in cardiovascular research.“Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health,” said Johanna Contreras, M.D., M.Sc., FAHA, director of the Division of Heart Failure and medical director of the Hispanic Heart Center within the Mount Sinai Health System. “Yet Hispanic people remain underrepresented overall in the research that guides prevention and treatment strategies… Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives.”Hispanic Cardiovascular Health by the NumbersCardiovascular risk factors – obesity (nearly 46%), type 2 diabetes (15.5%) and high blood pressure (approximately 44%) – are prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.According to the report, only about 1 in 5 Hispanic adults achieves ideal cardiovascular health as defined by the American Heart Association’s original Life’s Simple 7 metrics. Updated analyses using the Life’s Essential 8 framework demonstrated persistent disparities for heart and brain health, as well as suboptimal dietary quality, sleep patterns and levels of physical activity.Social and Economic Barriers MatterBiology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, impact heart health. In fact, approximately 17% of Hispanics live below the federal poverty threshold, compared with 8.2% of white adults. googletag.cmd.push(function() { googletag.display('fixed-big-ad-middle-asset'); }); “Many Hispanic adults face obstacles that extend far beyond the doctor’s office,” Contreras said. “Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment.”Contreras emphasized the cultural values and practices of Hispanic people also influence how they perceive their health and healthcare options.“Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience,” Contreras said. “At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon.”An Action Plan for Improving Hispanic HealthThere are practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.“Reducing cardiovascular disease among Hispanic populations demands action at every level,” Contreras said, “from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health.”By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives. Learn more at Heart.org.Photo courtesy of Shutterstock googletag.cmd.push(function() { googletag.display('fixed-big-ad-bottom-asset'); });
Concern after Europeans endorse US science agenda
Germany’s biggest research funder has said it is “concerned” after Berlin, plus several other European countries, endorsed a controversial US-led science policy statement. On October 4, the White House announced that 16 countries, including Germany, the UK, Italy, Greece, Bulgaria, Cyprus, Poland, Japan and South Korea had backed the Kyoto Vision for a Golden Age of Science.The document, agreed on the margins of the annual Science and Technology in Society forum in Kyoto, which gathers science ministers from across the world, appears uncontroversial at first sight. It’s a one-page statement, without any concrete measures, that touches on reducing administrative burden on scientists, experimenting with new funding models and the use of “super intelligence” in science, the Trump administration’s preferred term for artificial intelligence. However, what’s controversial is that much of the language in the Kyoto Vision reflects Science: A New Golden Age, a major policy document released by the White House in July.That document attracted criticism for deriding universities as “legacy institutions” and suggesting money be diverted to new research labs. In a speech in Kyoto on October 4, Michael Kratsios, director of the White House Office for Science and Technology Policy and the report’s author, said that the US was seeking to “diversify the ways that we support research to meet our best scientists where and when they do their best work.” The worry is that the Trump administration may be using genuine dysfunctions in academia as a pretext to defund and disempower universities, which US vice president JD Vance has labelled “the enemy.” Many in Europe also want more experimentation and reform of how science is organised and funded, and agree with criticisms of academia made by Science: A New Golden Age. But some also fear that if the US pushes for reform partially in bad faith, it could politicise and undermine the whole agenda. Washington is currently trying to change federal funding rules so that political appointees can block and cancel scientific grants. It has cut grants mid-project on topics related to diversity and other politically forbidden areas. And last year, it threatened to cut Harvard University’s federal funding unless it admitted a “critical mass” of new faculty and students to create campus “viewpoint diversity.” “Particularly concerned”Because of this wider US political context, the Kyoto Vision’s otherwise innocuous sounding statement that “we encourage experimentation with new institutional models for science that provide varying levels of autonomy, resources and direction” has caused consternation in Europe, particularly from some of Germany’s biggest science organisations. A spokesperson for the German Research Foundation (DFG), the country’s biggest funder, said that it would “closely monitor whether the current US administration uses the Kyoto Vision to restructure research funding to the detriment of research institutions such as universities and their autonomy.” The DFG was “particularly concerned” with the statement’s references to Science: A New Golden Age, they continued. A spokesperson for the German Rectors’ Conference, which represents the country’s universities, said that the reference to “new institutional models” raises “questions on the underlying understanding of academic freedom and autonomy.” Research funding must “guided first and foremost by scientific not political principles,” they went on. Dampen criticismEuropean endorsement of the Kyoto Vision might dampen domestic criticism of the Trump administration’s science policy, some in the US fear, by suggesting international support. “What we saw from Germany, Japan, the UK and other countries, is an impulse that the administration has exploited with our own science reform movement, a belief they can use dialogue to make things better,” said Cole Donovan, director of science policy at the campaigning group Stand Up for Science. “In practice, the administration has done the opposite.” Not a binding statementThere’s been so much concern in Germany that the country’s federal Ministry of Research, Technology and Space put out a statement defending its endorsement of the Kyoto Vision, which it has posted on its website. Related articlesIs metascience being co-opted?European researchers sound the alarm that Trump rule changes will hit cooperationThe US ‘golden age’ science strategy: what Europeans need to know The ministry said that it “should be regarded as a basis for discussion and does not constitute a binding statement.” Backing the statement gives Germany the chance to raise “issues and concerns” with the US during upcoming talks on science and technology scheduled for November. “Although these intentions appear, in principle, to be worthy of support, they will be scrutinised and examined more closely as the process continues,” the statement continues. Super intelligence?A ministry spokesperson confirmed to Science|Business that Germany had broadly endorsed the Kyoto Vision.However, they said Berlin had not agreed to final changes in the statement to refer to AI as super intelligence. In September, facing protests against data centres and polling that suggests US citizens are far more concerned than excited by the technology, Trump issued an executive order that attempts to rebrand AI as super intelligence, following polling on social media.The name change is to “reflect the transformative capabilities of these technologies and the limitless opportunities they create for the American people,” the order says. EU askedThe UK and Italian science ministries did not respond to a request for comment on their endorsement of the Kyoto Vision. Although most EU countries did not endorse the statement, it’s not clear which states the US asked. The White House Office for Science and Technology Policy did not return a request for comment. A European Commission official, speaking under condition of anonymity, said that the US had approached the EU, but too late for the EU to quiz all its member states on whether Brussels should endorse the statement.
Mental and Behavioral Health Profiles – Memorial Regional Hospital
Growing up in the Caribbean, Jenny Boodlal-Sookraj, MSW, witnessed firsthand how stigma often prevented people from seeking mental health support. That experience inspired her to pursue a career in social work, where she is committed to reducing stigma, promoting awareness and empowering individuals to seek the support they need. As a social worker and case […]
Pilot Project Aids Cancer Survivors in Achieving Healthy Weight and Reducing Recurrent Risk
New program will help patients improve fitness and manage weight after cancer treatment
Google's Android update tackles motion sickness, accessibility, and more
The new features coming to Android are aimed at reducing motion sickness, helping blind users navigate their surroundings, and more.
LMH Health, KU and others form Astra Health with goals of reducing costs, expanding access
LMH Health, the KU Health System and three other Kansas health systems have joined forces to form Astra Health, a collaboration aiming to improve care, reduce costs and better serve rural communities.
WHO recognizes healthy, innovative cities across the Western Pacific Region
Nine Healthy City champions from across the World Health Organization (WHO) Western Pacific Region received special recognition at an awarding ceremony during the 11th Global Conference of the Alliance for Healthy Cities in Sydney, Australia.The WHO Regional Office for the Western Pacific has presented the Healthy Cities Recognition Awards every two years since 2004 to celebrate innovative and impactful city-led initiatives that improve the health and well-being of urban populations.Eight cities received awards for their best practices, and one National Forum received the WHO Regional Director’s Special Award in recognition of its long-standing leadership in advancing the Healthy Cities movement.Awardees were selected through a rigorous evaluation process and recognized for demonstrating measurable, innovative and sustainable approaches to health challenges faced by cities.Remarking on the significance of the awards, Dr Huong Tran, Director of the Division of Health Promotion, Disease Prevention and Control at the Regional Office, said that, “There is no single blueprint for a healthy city. What works in one context may need to be adapted to another. But by sharing our experiences, including what worked, what was challenging, and what we learnt along the way, we can help one another move faster and further.”Award-winning cities and initiativesThis year's awards recognize outstanding city-led initiatives that have demonstrated measurable impact, innovation and sustainability in advancing health initiatives for urban populations.Baguio City (Philippines) – Data for equity: informing action, improving healthDr Donnabel Tubera-Panes, City Epidemiologist – Medical Officer IV of the Health Services Office accepted the award on behalf of Baguio City. Photo credit: Maria BoyadgisBaguio City was recognized for developing a pioneering Livability Index that provides village-level data across all 128 barangays (villages), enabling evidence-based planning and more equitable allocation of resources. By integrating community participation and institutionalizing the index within city planning and budgeting processes, the city has demonstrated how data can drive action to reduce health and social inequities.Eunpyeong-gu (Seoul, Republic of Korea) – Communities living in vulnerable situations: advancing health equity through community engagementVice Mayor Honourable Ahn Hyoung Jun accepted the award on behalf of Eunpyeong-gu. Photo credit: Maria BoyadgisEunpyeong-gu was recognized for its inclusive health equity programme supporting vulnerable populations, including isolated older adults and LGBTQI+ communities. Through peer-led community networks, social cooperatives and inclusive service design, the district has strengthened access to care, promoted social inclusion and advanced community ownership of health initiatives.Madiun City (Indonesia) – Adapting and mitigating climate-related crises: building heat resilience and preventing flood-related health risksMs Yuni Dwi Purwani, Secretary General of the National Forum for Indonesian Healthy Cities/Regencies, accepted the award on behalf of Madiun City. Photo credit: Maria BoyadgisMadiun City was recognized for its SUPERMIE (Sustainable Public Environmental Management Initiative) – a community-based environmental governance model that addresses urban flooding, climate resilience and environmental sustainability. The initiative contributed to reductions in flood-prone areas, greenhouse gas emissions, diarrhoeal disease and dengue fever, while at the same time improving food security through neighbourhood food gardens. The programme has already been replicated in 15 cities and regencies across Indonesia.Macao Special Administrative Region (China) – Protecting communities from tobacco and alcohol-related harms: tackling commercial drivers of riskDr LO Iek Long, Director of the Health Bureau, Macao SAR, China accepted the award on behalf of Macao. Photo credit: Maria BoyadgisMacao SAR was recognized for implementing a comprehensive and integrated approach to tobacco and alcohol control. Through legislation, monitoring systems, enforcement, public awareness campaigns and multisectoral partnerships, the programme has strengthened protection against major risk factors for noncommunicable diseases and established a model that is highly transferable to other urban settings.Phnom Penh Capital City (Cambodia) – Safe, active and health-enabling transport: advancing health and reducing inequities in urban mobilityH.E. Khoung Sreng, Governor of Phnom Penh Capital City accepted the award on behalf of Phnom Penh Capital City. Photo credit: Maria BoyadgisPhnom Penh received the award for its Safe School Zone Project, which combines infrastructure improvements, speed management, enforcement, education and stakeholder engagement to protect children and communities. The initiative has demonstrated measurable reductions in crashes and vehicle speeds while providing a scalable model for safer urban mobility across the country.Quezon City (Philippines) – Transforming food environments: addressing policy, market and urban design drivers of health and nutritionMs Jirah Asa M. Sideco, Chief of the Nutrition Section of the Quezon City Health Department accepted the award on behalf of Quezon City. Photo credit: Maria BoyadgisQuezon City was recognized for its public food procurement policy that promotes healthier diets through government-run institutions and feeding programmes. Supported by strong policy frameworks and monitoring systems, the initiative improves access to nutritious food for vulnerable populations while serving as a benchmark for other local governments.Samarinda City (Indonesia) – Preventing violence and promoting gender equality: transforming urban systems, norms and spaces Mrs Rinda Wahyuni, Chairperson of Samarinda Healthy City Forum accepted the award on behalf of Samarinda City. Photo credit: Maria BoyadgisSamarinda City was recognized for its multisectoral approach to preventing violence and advancing gender equality. Responding to local evidence on violence against women and children, the city has positioned violence prevention as a public health priority, bringing together health services, schools, social welfare institutions, law enforcement, civil society and community leaders to strengthen prevention, reporting, survivor-centred support and legal protection. Through inclusive policies, community engagement and sustainable city financing, Samarinda has developed a locally owned and scalable model for creating safer, more equitable and inclusive urban communities.Singapore – Age-friendly cities: transforming systems to bridge generations for a healthier tomorrowDr Tan Weng Mooi, Director, Integrated Health Promotion, accepted the award on behalf of Singapore. Photo credit: Maria BoyadgisSingapore received recognition for its Healthy Precinct Framework, which translates national healthy ageing priorities into neighbourhood-level action. The initiative integrates preventive care, social support, service coordination and age-friendly environments while actively engaging older persons, caregivers and community organizations. Its expansion across multiple precincts demonstrates its scalability and long-term sustainability.WHO Regional Director’s Special AwardNational Forum for Indonesian Healthy Cities/Regencies (Indonesia)Ms Yuni Dwi Purwani, Secretary General of the National Forum for Indonesian Healthy Cities/Regencies, accepted the award on behalf of the National Forum. Photo credit: Maria BoyadgisThe WHO Regional Director's Special Award was presented to the National Forum for Indonesian Healthy Cities/Regencies (FKKSI) in recognition of its long-standing leadership in advancing the Healthy Cities movement across Indonesia. As a national platform bringing together local governments, communities, academia and civil society, FKKSI has played a critical role in promoting collaboration, capacity-building, knowledge exchange and advocacy. Its efforts have strengthened and institutionalized healthy urban development nationwide and established a model for multisectoral engagement in the Region. Healthy Cities for allThe 2026 Healthy Cities Recognition Awards highlight how cities can lead transformative action on health by addressing climate change, inequity, ageing, nutrition, mobility, social inclusion, violence prevention and the commercial determinants of health. The recognized initiatives demonstrate that local governments, communities and partners can work together to create healthier, safer and more resilient urban environments for everyone. As urban populations continue to grow across the Western Pacific Region, WHO remains committed to supporting cities in advancing health, equity and sustainable development through the Healthy Cities approach and the Alliance for Healthy Cities. ###Note to editorsSince 2004, the WHO Healthy Cities Recognition Awards have provided a platform for cities to share innovative and effective approaches to improving health and well-being. The awards recognize achievements in areas including climate resilience, healthy ageing, health equity, gender equality, tobacco and alcohol control, urban mobility, nutrition and data-driven governance. In 2026, more than 150 submissions were received from cities and local governments across the Western Pacific Region. The titles and affiliations of awardees are presented as they were at the time the photo was taken.______________For more information, or to arrange media interviews, contact: WHO Regional Office for the Western Pacific: wprocom@who.int
Gladys Knight 'easing into fewer' concerts after health concerns
Amid growing health concerns from family and fans after recent concerts, legendary singer Gladys Knight has announced she is reducing her tour schedule.
Doctors Should Keep an Eye on Your Mix of Medication. If They Don’t, You Should.
There’s a term for reducing unnecessary or harmful drugs: “deprescribing.” Especially as patients age, experts say, it’s important to regularly review the medications they’re taking.
UnityPoint Health-Finley reducing cardiac procedure hours
UnityPoint Health-Finley in Dubuque will be reducing cardiac procedure hours, citing a hiring struggles and a lack of demand in recent years.
Star Stable Entertainment reduces workforce by 20% to secure long-term future of its multiplayer horse adventure RPG
Interim CEO says by "reducing operating costs and refocusing resources," Star Stable will be in the "best possible position to adapt and grow"
Gene Editing Is Giving Crops a Way to Tell Farmers When They’re Feeling Stressed
From glowing plants to purple leaves, the signals empower farmers to quickly detect diseases and pests, reducing the need for widespread chemical use.
Could quitting ultra-processed food boost mental health?
A preliminary study led by UC San Francisco adds to growing evidence that reducing ultra-processed food may improve symptoms of depression. Published in JAMA Psychiatry, the study is believed to be the ...
The Scientists Who Want to Steer Hurricanes
Over the weekend, Hawaii was lashed by Hurricane Lala, which has washed away homes, left more than 125,000 people without power, shut down two of the state’s busiest airports, threatened dangerous flash flooding and, at time of writing, has killed one person. What if we could’ve steered the storm away from Hawaii, into the vast expanse of the empty Pacific Ocean that lies all around the islands—where no one could get hurt? This scenario might sound like the stuff of science fiction. But earlier this year, a peer-reviewed study published by the Public Library of Science found that it might be possible, and sooner than we think. The study was titled: “Weather Jiu-Jitsu: Prospects for atmospheric nudging to defuse the impact of catastrophic weather extremes.” According to the paper, the controversial practice of cloud seeding could enable human beings to make hurricanes change direction. The potential results could be astounding: The authors suggested that Hurricane Sandy, which in New York City alone killed 44 people and caused $19 billion of damage in 2012, could’ve been diverted by 200 miles, missing the metropolis entirely. Cloud seeding, which first succeeded in the U.S. in 1946, is a practice whereby small particles—for example, dry ice, silver iodide, or salt—are dropped into clouds, causing moisture to condense into precipitation. In the 1960s, the U.S. government launched Project Stormfury, an experiment that saw Navy pilots flying into the heart of a hurricane, dodging winds over a hundred miles per hour, to cloud-seed inside it, in the hope of reducing the storm’s power. “The seeding,” the theory went, “would stimulate the formation of a new eyewall that would surround the existing eyewall. The new eyewall would contract, strangling the old eyewall and reducing the intensity of the hurricane.”
Doctors say radical plan to merge Scotland's health boards should be scrapped
BMA Scotland says there is no evidence that reducing the number of health boards from 14 to two will improve patient care.
How AI is quietly reshaping chemical sciences
From reducing administrative workload to navigating ‘alien intelligence,’ this month’s column takes a practical look at integrating LLMs and LWMs in the lab
Intel Panther Lake Teardown, 18A, BSPD, GAAFET, SemiAnalysis STEEL
Panther Lake debuts the first commercial implementation of backside power delivery (BSPDN), introduces Intel’s first iteration of gate-all-around (GAA) transistors, and showcases their advanced packaging capabilities with its Foveros-S assembly. With Panther Lake, Intel’s manufacturing arc has shifted from nebulous roadmaps to shipped silicon, a significant milestone on their long road back to competitive semiconductor manufacturing. To evaluate the extent of Intel’s comeback, we tore down Panther Lake. The SemiAnalysis STEEL teardown lab breaks down advanced datacenter and AI hardware. To learn more about our pipeline or to commission a teardown, contact sales@semianalysis.com. WE’RE HIRING: Architecture, floorplan, packaging, manufacturing, and labs experts. Opportunities from system to transistor and everywhere in between. Check out our Careers page. Our teardown traces 18A from its four-sheet RibbonFETs (Intel’s marketing name for GAAFETs) and gate stacks through contacts, frontside and backside wiring, and the bonded carrier. We explain how these material and integration choices improve gate control and reduce resistance, while adding capacitance, thermal resistance, and process complexity. Our measurements put Panther Lake’s 18A compute logic and TSMC N3E GPU logic at similar logic density. However, 18A does not lead TSMC N3P, N2 or Samsung SF2 in peak density. Panther Lake’s CPU cores are incremental updates, and the high-end GPU still uses TSMC N3E. Panther Lake assembles one compute tile, one GPU tile, and one I/O tile atop a passive base tile using Intel’s Foveros-S advanced packaging. Both compute tile variants use Intel 18A. The Xe3 GPU options are a 4-core GT1 tile on Intel 3 and a larger 12-core GT2 tile on TSMC N3E. Both I/O tile variants use TSMC N6. [1], [2] Our analysis centers on the PTL-U compute tile, both the 4-core and 12-core GPU tiles, as well as the 12-lane I/O tile. In conventional chips, power and signal are routed through the same frontside metal stack towards the device frontend. Power rails consume scarce routing resources near the transistors, while tall via stacks carry VDD and VSS from the coarse upper wires to local rails. Backside power delivery (BSPD) moves the main power network behind the transistor layer, to the backside, separating it from frontside signal routing. We covered BSPD and its impacts in 2024. [3], [4], [5] Intel’s BSPD implementation, branded as “PowerVia”, routes power through dedicated backside metals to nano-TSVs, which connect those rails to local source/drain (S/D) contacts. Implementing that separation requires Intel to build the interconnect stacks from both sides of the wafer. The frontside comprises the M0-M14 signal stack, while the backside comprises the BM0-BM5 power stack. M0 and BM0 are closest to the transistors. The nano-TSVs connect the two sides, but Intel patterns and etches each via from the front after forming the contacts. A narrow via runs from the side of the contact deep into the silicon substrate. Intel then completes the frontside signal metal stack, bonds the wafer to a carrier, flips it and removes the original substrate until the buried via tips are exposed. The backside metal stack is then deposited directly on the revealed vias. The nano-TSV and backside-via profiles taper in opposite directions because Intel forms them from opposite sides of the wafer. The transistor structures form the FEOL. Local contacts and nano-TSVs connect them to the wiring. M0 begins the frontside interconnect stack. The silicon carrier remains attached above the frontside interconnects. It supports the device wafer during substrate removal and backside processing and remains part of the finished chip’s thermal path. PowerVia removes the main power distribution from the congested frontside metals, routing supply through shorter and wider backside wires. Its lateral landing still occupies area in the standard cell, so it recovers less cell area than a direct backside contact. [3] Nano-TSVs beside the logic devices carry VDD or VSS from the backside power network, while signal connections continue upward through the frontside metals. Backside Interconnects Samsung SF2 data is included for comparison to Panther Lake’s within this article. SF2 is the incumbent GAA foundry node but lacks BSPD, serving as a useful reference to evaluate 18A. A full teardown of Samsung’s S26 products, processed on SF2, will be shared soon.Nanosheet-cut EDS comparison. The PowerVia supply path runs from the backside Cu rails through Mo-lined W nano-TSVs to the local transistor contacts. In this cross section, the tapered connection spans roughly 150 nm from the contact level to BM0. The Ta liner confines Cu and promotes adhesion to the surrounding stack; the AlOₓ etch stop controls the next dielectric etch above the rail. Dielectric beneath the ribbons electrically separates the devices from the backside wiring and removes the conducting silicon body below the channel. [6] AlOₓ serves as an etchstop (ES), enabling endpointing and protecting the underlying layers. Low-volatility aluminum fluoride reaction products resist the fluorinated plasma, allowing a thin AlOₓ film to protect the metal while the surrounding low-k dielectric is removed. [6], [7]. While the BM0 and layers above the M1 lines show double AlOx layers, Our SMIC N+3 teardown showed single AlOₓ layers. SMIC uses a simpler local AlOₓ substack, while the remaining cap and etch sequence provide the required landing protection. So why double layers? The closely spaced AlOₓ doublets provide two protected endpoints in the etch sequence. Intel documents an AlOₓ/SiN/AlOₓ stack that explains the benefit. The main dielectric plasma etch stops on the first AlOₓ film; a selective wet clear opens that film; a second plasma etch removes the intermediate SiN and stops on the second AlOₓ film. The final wet clear exposes the metal landing surface. SiN is the intermediate dielectric in Intel’s published example. [8] The second stop protects the metal through a cap breakthrough. Wide openings can etch faster than narrow ones, and etch depth varies across the wafer. Metal under an early-clearing opening would otherwise be exposed while other openings still need more etching. Staged protection widens the process window and reduces metal erosion, corrosion and void formation. [8] TSMC documents AlN/AlOₓ/SiOC/AlOₓ above Cu, with AlN blocking Cu diffusion, and a simpler AlN/SiOC/AlOₓ variant that omits one AlOx film. [9] Levels with different opening sizes, aspect ratios, pattern densities and cap materials need different etch margins. A double AlOx stop is useful where another protected endpoint justifies the added processing. The extra film adds formation, selective opening and cleaning steps, plus another set of interfaces to control adhesion, moisture, and stress. These blanket films are opened through the existing via pattern, so each film does not require another lithography mask. AlOₓ adds parasitic capacitance when it replaces lower-k dielectric; two thin AlOₓ films can nevertheless contain less AlOₓ than one thick film. Total thickness, placement, and theintermediate dielectric determine the electrical cost. Deposition chemistry also changes AlOx permittivity and residual hydroxyl content, which can oxidize the underlying metal. [7], [8], [10], [11] The backside stack separates into relatively fine BM0-BM2 wiring near the devices and coarser BM3-BM5 power distribution. The largest pitch increase occurs between BM2 and BM3. BM0’s pitch closely matches the logic-row height, fitting local power delivery to the cell rows. Higher levels aggregate current through larger conductors: routing density becomes less important than low resistance and current capacity as the network approaches the package. This hierarchy provides wide power wiring for the power delivery network without consuming scarce frontside signal-routing resources. [3] The SemiAnalysis STEEL teardown lab breaks down advanced datacenter and AI hardware. To learn more about our pipeline or to commission a teardown, contact sales@semianalysis.com. WE’RE HIRING: Architecture, floorplan, packaging, manufacturing, and labs experts. Opportunities from system to transistor and everywhere in between. Check out our Careers page. Frontside Interconnects Intel 18A combines Mo-lined W contacts and nano-TSVs with a separate backside Cu power network. Samsung SF2 keeps power on the frontside, using Ti-based contact interfaces and Ta-based barriers and Co liners around Cu wiring. In 18A standard-cell rows, backside power rails supply the devices through nano-TSVs within the cells, freeing frontside routing resources. Samsung’s M0 accommodates both power and signal connections. From the device toward M0, the connection runs through a Ti-based S/D interface, W contact fill, a Mo-lined W via, and the Cu M0 wire. Mo supplies a conductive nucleation and adhesion layer for W, replacing the resistive TiN liner used in conventional W integration. This increases the effective conduction volume within the feature while retaining W fill and its established polishing, cleaning and etching processes. Intel’s Mo/W patent describes this integration tradeoff. The nano-TSV uses the same Mo-lined W construction in the backside supply path. [12] The move from TiN to Mo is an incremental change. While a full Co or Mo fill can also reduce the volume lost to liners in very small features, it requires new integration schemes that increase complexity and risk. Cu remains attractive for wider wires due to its low resistance. As wires and vias shrink, the diffusion barrier consumes an increasing fraction of their cross-section. [12], [12], [14] Intel uses Co/Ru liners at M0-M1, Co at M2-M4, and Nb at M5-M9. The lower-level liners help Cu adhere and reduce void formation during trench fills. Applied Materials’ Endura has new thermal control that facilitate wetting process, so the thin film continuity is good enough that good capillary pressure will drive Cu atoms to the via bottom without voiding. Intel’s choice to use Nb is particularly interesting. Intel’s Nb patent describes a conductive diffusion barrier intended to reduce the barrier’s contribution to resistance relative to conventional Ta-based barriers, particularly at via bottoms where all current crosses the barrier. The patent pairs Nb in coarser levels with the option of lower-cost PVD processing. [15], [16] The upper metal layers support thicker barriers formed through physical vapor deposition (PVD) despite its worse coverage and uniformity. Meanwhile, the lower metal layers require thinner barriers deposited through conformal atomic layer deposition (ALD). Co/Ru adds another material interface and requires controlled deposition and Cu fill. Changing liners and barriers by metal layer allows Intel to optimize interconnect resistance, process complexity, and reliability. [15, 16] RibbonFET, Intel’s name for its gate-all-around FETs (GAAFETs), replaces the FinFET’s vertical fins with four stacked horizontal silicon nanosheets, allowing the gate to surround the channel on every side. The path to GAAFET begins with the planar transistor. A planar MOSFET places the gate above the channel between its source and drain. Pairing an NMOS with a PMOS transistor creates a CMOS inverter, in which the NMOS pulls the output low for a high input, and the PMOS pulls it high for a low input. The gate must retain electrostatic control of the channel to ensure clean switching. As gate lengths shrank, the drain began to compete with the gate for that control, increasing off-state leakage. Electrostatic control was restored through an architectural evolution that raised the channel into a vertical fin and wrapping the gate around three sides. Called “FinFET”, this new architecture packed more effective channel width into a smaller footprint. Further scaling made it harder to maintain both drive current and leakage within smaller cells, and reintroduced the same problems planar MOSFETs faced. Nanosheet GAAFETs close the fourth side by replacing the vertical fin with a stack of horizontal nanosheets, each surrounded by the gate. The tighter electrostatic control suppresses leakage at shorter gate lengths while stacking adds effective channel width within the cell footprint. In a FinFET process, channel width changes in discrete steps as designers must add or remove whole fins. Nanosheet width can instead be adjusted continuously within the process’s design rules. Wider sheets increase drive current, while narrower sheets reduce capacitance at the cost of drive current. Intel 18A uses stacks of four nanosheets each and varies their widths across logic and SRAM. At the process level, adding more sheets to each stack increases effective channel width and drive current, but complicates fabrication. RibbonFET vs MBCFET Samsung began GAAFET production in 2022 with SF3E, following with SF3 and now SF2. Its ‘MBCFET’ provides a useful structural comparison with Intel’s first RibbonFET implementation. [17] STEEL is digging deeper into SF2, used in the Exynos 2600, and TSMC’s GAAFET N2, used in Apple’s A20 Pro, in upcoming newsletter articles. We’re throwing some teasers on X. Let’s compare Samsung SF2’s MBCFET with Intel 18A’s RibbonFET. Subscribe Even to the untrained eye, Intel’s extra nanosheet is obvious. Intel stacks four ribbons to Samsung’s three. Samsung’s sheets are much wider in these fields, so both sheet count and width matter to the available channel perimeter. Sheet width also changes which silicon surfaces carry current. On conventional (001) silicon, wide nanosheets emphasize the broad top and bottom surfaces, favoring electron transport; the larger sidewall contribution in a narrow sheet favors hole transport. Thinner sheets improve gate control but increase confinement and scattering. This makes width and thickness part of the NMOS/PMOS balance, alongside strain and threshold voltage. [18], [19] GAAFET designs like 18A use different work-function-metal (WFM) stacks for NMOS and PMOS. Around each ribbon, a thin SiOx interfacial layer separates the silicon channel from the HfOx high-k dielectric, with La providing dipole tuning and the WFM wrapping the dielectric. NMOS uses a TiAl-based stack, while PMOS uses TiN WFM. W fills the remaining gate trench, providing a lower-resistivity path where the work-function layers are no longer needed. In this field, the PMOS stacks leave room for W between ribbons, while the NMOS stacks occupy more of those gaps. A silicon-based dielectric marks the P/N boundary, allowing the PMOS and NMOS gates, sharing the same gate trench, to be processed sequentially. Fast logic paths, retention circuits, and SRAM need a family of threshold options. Changing threshold without substantially changing device dimensions, capacitance or fabrication complexity is valuable. FinFET processes typically use different work-function-metal stacks. In a four-ribbon GAA stack, the narrow sheet-to-sheet gap limits how much WFM can fit around each channel. La in the gate dielectric creates interfacial dipoles at the SiOx/HfOx boundary, shifting effective work function and tuning threshold voltage. This gives Intel another control alongside its NMOS and PMOS WFM stacks. Low-threshold devices improve critical-path drive; higher thresholds reduce leakage elsewhere. Dipole tuning is especially useful in GAA because it changes threshold without consuming the narrow intersheet gap with thicker WFM. Precise control of La incorporation, diffusion and interface quality has long been a challenge, limiting viability in high volume production but is now seen from every leading-edge foundry. Intel’s patent describes depositing a dipole-forming oxide above HfOx and annealing it toward the interfacial oxide before completing the work-function and fill metals. This separates threshold tuning from the space available for metal. Newer research addresses the thermal cost: imec’s 2026 dipole-middle research inserts the shifter between two HfOx depositions, shortening the diffusion path while protecting SiOx during patterning. [20], [21]Matched-cut EDS, Intel 18A (left) vs. Samsung SF2 (right). Intel retains raised source/drain epi beneath its contacts, while Samsung recesses W deep into the epi to form a V-shaped Ti-lined interface. The deeper contact increases metal-to-semiconductor area and shortens the current path from the lower sheets, reducing contact and spreading resistance. It also removes epi volume and brings the contact etch closer to the channel ends. Retaining more epi preserves the material available for strain transfer, especially from SiGe into PMOS. These geometries balance contact access against stress engineering and etch margin. [22], [23] Samsung stacks three sheets to Intel’s four ribbons, and both processes use sheet width to tune drive strength. In our Samsung cross-sections, widths range roughly from 19 to 30 nm in the NPU rows and 37 to 50 nm in the CU cell. The Samsung nanosheets taper, with the widest sheet at the bottom and the narrowest at the top. Both processes use HfOx gate dielectric and Ti-based work-function stacks, with Al in the NMOS stack. In the Samsung devices shown here, the dielectric and WFM occupy the intersheet gaps, leaving W above the top sheet. Intel’s PMOS stack leaves more room between ribbons, and W fills those gaps while the thicker NMOS stack leaves W mainly in the upper trench. Gate-stack EDS maps. The W between Intel’s PMOS ribbons provides a conductive path close to the lower gates. Where WFM fills the entire gap, the gate still surrounds the channel, but voltage reaches it through the more resistive work-function films. Thinner WFM and dipole tuning preserve room for low-resistivity fill; Mo and Ru are alternative fill metals being developed for further scaling. [24] A masked, sequential WFM flow explains the different gate heights and inter-nanosheet fill. The proposed sequence below shows how separate NMOS and PMOS work-function steps produce that geometry. Enabled by the BSPDN process, Intel replaces the dense-logic silicon subfin with dielectric, removing the parasitic conduction path below the ribbons and reducing substrate-related capacitance. A retained silicon body as in classical, non-SOI, planar and FinFET designs needs junction and punchthrough-stop engineering to suppress leakage. Dielectric isolation makes that leakage less sensitive to the subfin doping profile but adds removal and fill steps. It also weakens the direct thermal path through silicon, making the contacts, metal stacks and package more important for heat extraction. [24], [26] Fluorine is concentrated around selected Intel device structures in the maps. WF6 is a standard precursor for W nucleation and fill, while barrier films protect adjacent dielectrics from fluorine attack. Low-fluorine W processes reduce the residual-F burden. Chloride-based precursors avoid introducing F during W deposition, but require control of chlorine attack, nucleation and fill quality. The integration target is a continuous, low-resistance W path with a thin protective liner and minimal chemical damage to the surrounding stack. [20], [27], [28] The SemiAnalysis STEEL teardown lab breaks down advanced datacenter and AI hardware. To learn more about our pipeline or to commission a teardown, contact sales@semianalysis.com. WE’RE HIRING: Architecture, floorplan, packaging, manufacturing, and labs experts. Opportunities from system to transistor and everywhere in between. Check out our Careers page. We measured cell height, gate pitch, metal geometry, and ribbon dimensions at the XTEM sites shown below. The tables group these dimensions by site and device polarity. Our “sheet cuts” cross the silicon channel and show the ribbons end-on. “gate cuts” run along the channel through successive gates. The 18A logic cell dimensions point to a five-track logic library while the N3E and Intel 3 cell dimensions evidence a seven-track logic library. The DDR-PHY uses wider M0 wires and much larger spacing than core logic. That trades routing density for lower wire resistance and weaker coupling between neighboring nets. The geometry suits the current delivery and coupling requirements of analog, clock, and I/O circuitry. PowerVia lets 18A combine a compact cell height with wider M0 geometry by moving the main power rails off the signal-routing tracks. That relaxes local wire scaling while preserving a small cell footprint. Cell height and gate pitch set the geometric density; pin access and routability determine how much of it a real block can use. [29] The biggest takeaway from our gate-pitch measurements is that Intel 18A compute logic and TSMC N3E GPU logic have similar density in the Bohr representative-cell model. The 18A example is 18.6% denser than the Intel 3 GPU example. Gate pitches are nearly identical across the three sites, so cell height drives most of the difference. The Bohr model combines a four-transistor NAND2 spanning three gate pitches and a 32-transistor scan flip-flop (SFF) spanning nineteen pitches, weighting their densities 60:40. The sensitivity column shows how independently changing cell height and gate pitch by ±1 nm changes the result. This compares representative cell geometries; whole-die density also depends on cell mix and placement. The 18A P-core gives M0 substantially more metal cross section than the N3E vector engine. Treating each profile as a trapezoid gives 2.63 times the area per line and 1.84 times the area after normalization by routing pitch. The larger section reduces the geometric contribution to line resistance and lowers current density for a given current. Taller and wider wires also add capacitance, so circuit delay depends on the balance of resistance and capacitance. The DDR-PHY has less metal area per routing width than the 18A core fields, while remaining above N3E. [30] Area = height × (top CD + bottom CD) / 2, including liners. Area/pitch normalizes by routing width. Taper is the symmetric sidewall angle from vertical, with the largest angle belonging to the DDR-PHY. Compute tile The measurements show how ribbon dimensions and gate-stack geometry vary across the compute tile and between NMOS and PMOS to balance channel drive, gate load and the space needed for the dielectric/WFM stack across logic, SRAM and the DDR-PHY. Width mainly changes available channel perimeter; thickness also changes electrostatic control and carrier confinement. Gate-stack thickness then determines the space left for low-resistivity fill P-core and LP E-core logic Both the P-core and LP E-core use multiple nanosheet widths. Widths are measured on high-magnification XTEMs while wider-field images demonstrate additional width choices within the LP E-core. Multiple widths are expected even within an LP E-core. Timing-critical paths, buffers and cells with different fanout need different drive strengths. The lower-magnification fields show this width diversity beyond the sites quantified in the table. L2 and L3 SRAM GAA gives SRAM designers another way to balance the pull-up (PU), pass-gate (PG), and pull-down (PD) transistors. FinFET bitcells set device strength through fin count while GAA adds nanosheet width as a sizing knob. In a 6T SRAM cell, a strong pull-down relative to the pass-gate limits read disturbance, while a strong pass-gate relative to the pull-up improves writability. During a write, the pass-gate and write driver pull the node storing “1” below the inverter trip point. During a read, the pull-down holds the node storing “0” low. Bias, threshold voltage, mismatch and assist circuitry set the remaining margin. FinFET high-current cells commonly use a PU:PG:PD fin-count pattern of 1:2:2, a device-sizing ratio rather than a current ratio. Ribbon width lets Intel balance SRAM strengths without adding whole fins. The L2 cell uses its narrowest ribbons for PU and widest for PD, improving writability and read stability respectively. Intel’s disclosed HCC operates without assist; its denser HDC uses negative-bitline write assist. Pulling the selected bitline briefly below ground increases pass-gate overdrive so it can overpower the pull-up at lower supply voltage. That buys density and low voltage writability at the cost of boosting circuitry, switching energy, and additional voltage stress that must be controlled. [31], [32] Four rectangular ribbons give the perimeter = 8 × (width + thickness), before corner rounding. PG/PU is 1.49 and PD/PG is 1.16. The L3 structures closely resemble L2 in layout and cell height. Fewer L3 nanosheet widths are tabulated because fewer high-magnification images were available. DDR PHY The DDR-PHY trades density for controlled analog behavior and reliable off-chip signaling. It contains drivers, receivers, delay circuits, and calibration logic that set drive strength, sampling time, and voltage margin. Repeated four-sheet devices with similar widths fit the use of regular transistor units for matching and programmable drive. Its wider local wiring provides room for current delivery and separation of sensitive signals, while consuming more area than a dense core-logic grid. The layout serves the memory channel’s electrical requirements as well as digital logic density. [33] The SemiAnalysis STEEL teardown lab breaks down advanced datacenter and AI hardware. To learn more about our pipeline or to commission a teardown, contact sales@semianalysis.com. WE’RE HIRING: Architecture, floorplan, packaging, manufacturing, and labs experts. Opportunities from system to transistor and everywhere in between. Check out our Careers page. Intel 3 GPU devices Vector engine logic Intel 3’s XVE logic uses two-fin PMOS and NMOS devices with power rails in M0. Its cell height and M0 pitch give a seven-track geometry, two tracks more than the 18A logic. One-fin groups also appear among the two-fin devices. Intel 3 L2 SRAM The Intel 3 L2 SRAM uses the familiar HCC sizing pattern: one PU fin, two PG fins, and two PD fins. N3E GPU devices Vector engine logic The N3E XVE field contains repeated two-fin devices with seven-track cell geometry. N3E remains a FinFET process, giving Panther Lake a direct FinFET-to-RibbonFET comparison. N3E L2 SRAM The N3E L2 SRAM uses the same PU:PG:PD fin-count pattern of 1:2:2. Panther Lake-U follows Lunar Lake’s floorplan quite closely. Both pair 4 P-cores with 4 LP E-cores and NPU, media and display engines in similar locations. Lunar Lake also uses Xe2, the direct predecessor to Panther Lake’s Xe3 GPU. This makes Lunar Lake the most direct basis for our comparisons. Arrow Lake differs in core count and uses the older Xe-LPG GPU architecture, so we only use it where it offers a more direct component-level comparison. Compute tile Panther Lake compute-tile floorplans remain sparse even months after launch. Intel 18A’s backside metal and dielectric stack must be removed without damaging the underlying structures before a clean transistor-level floorplan can be imaged. Most published die shots hide or heavily process the background, but we are quite proud of the die shot we achieved and are excited to show the work we have done. We measured the areas of the key components on the compute tile and compared them with their Lunar Lake predecessors on TSMC N3B. These help us to capture changes in block area and compare the two chips across process nodes and designs. Our total tile areas exclude the scribe-line area. The compute-plus-GPU subtotal below uses the PTL-U compute tile and GT1 GPU; it excludes the I/O tile and passive base. Individual block areas use the boundaries marked on the floorplans The compute-plus-GPU row is recomputed from the displayed PTL-U and GT1 areas. Component rows use their stated per-region counts and are not an additive partition of the whole tile. The P-core area remains almost unchanged between Lunar Lake and Panther Lake, despite L2 capacity increasing from 2.5 MiB to 3 MiB. Arrow Lake uses the same Lion Cove core as Lunar Lake but also has a 3 MiB L2. Cougar Cove fits 20% more L2 into the same P-core area. The larger private cache keeps more of each core’s working set close to its execution units, reducing access to shared L3 and DRAM. Extra capacity adds storage leakage and lookup energy, so designers balance it against avoided lower-level accesses. The shared P-core L3 cache also shrank by 14.8%. [2] Cougar Cove combines a similar footprint with Intel’s reported power-efficiency improvements. RibbonFET’s tighter channel control reduces leakage, while PowerVia reduces supply droop and allows tighter voltage guardbands. [1] Darkmont’s four-core LP E-core cluster is 5.0% smaller than Skymont’s on Lunar Lake, with most of the reduction in its L2 regions. The 1 MiB region shrank by 8.4% and the 1.5 MiB region by 14.9%. The tag arrays also use one fewer visible row. Tags identify which memory addresses the data array holds, so rearranging them changes the cache’s layout and wiring without requiring less data capacity. [2] The LP E-cores share one L2. This pools capacity and avoids duplicating all the cache machinery, but the four cores contend for its banks and bandwidth. Their separate cluster also keeps light work away from the performance cluster and its L3, allowing that larger domain to sleep. [1], [2] Cache area includes more than the storage cells. Tags identify each line, decoders select rows, sense amplifiers read the small bitline signal, and wires connect to the banks. Splitting an array into smaller sections shortens wordlines and bitlines, improving access speed, but duplicates peripheral circuits. Panther Lake’s smaller cache regions therefore reflect the complete memory implementation, including how much of each region is devoted to storage. [34] Unlike Meteor Lake and Arrow Lake, Panther Lake has no separate SoC tile. The NPU, LP E-cores, memory controllers, PHYs, media and display engines now share the compute tile. This removes an active die and keeps CPU memory traffic on one die. The cost is moving PHY and I/O-related circuitry onto 18A: drivers, receivers and analog circuits must still meet external voltage, loading and signal-integrity requirements, so their area does not shrink like dense digital logic. [1], [2] The biggest shrink comes from the NPU, which occupies 36.9% less area. NPU 5 consolidates the same total INT8 MAC count into half as many neural compute engines. Each of the three NCEs has a larger MAC array to make the complete NCE envelope 22.6% larger than an NPU 4 engine. Consolidation also halves the number of scratchpads and SHAVE DSPs, from 12 to 6. The MAC array handles matrix multiplication and convolution, while SHAVE executes vector and custom operations that fit the array poorly. [1], [2], [35] The paired floorplans identify each NCE envelope and its scratchpad, MAC, and SHAVE regions. Each measured MAC polygon is counted once per NCE in the area accounting below. The scratchpads store weights, activations, and intermediate results near the MAC arrays, allowing repeated use without fetching them again from DRAM. Halving their number delivers the largest measured area saving but leaves less local storage for the same total MAC count. Layers that no longer fit locally require smaller working tiles or more transfers of intermediate data. The benefit depends on keeping the enlarged arrays busy while managing that tighter storage budget. [36] NPU 5 also adds native FP8. Using half the operand width of FP16 reduces storage and transfer demand, helping workloads fit the smaller local memory budget. Lower precision and format-dependent range make scaling and model validation part of deployment. Hardware activation functions further reduce work that would otherwise occupy the programmable DSPs. [1], [2] Microsoft requires an NPU to deliver at least 40 TOPS for Copilot+ PCs. Both Lunar Lake and Panther Lake meet this threshold, but Panther Lake uses significantly less silicon. GPU tiles Panther Lake is Intel’s first product with Xe3, its latest GPU architecture. It offers two different GPU tiles: a smaller GT1 tile with 4 Xe3 cores on Intel 3 and a larger GT2 tile with 12 Xe3 cores on TSMC N3E. Panther Lake allows us to compare the same GPU architecture across both Intel 3 and TSMC N3E. Wildcat Lake adds a third Xe3 implementation on Intel 18A. A future newsletter will detail Xe3 and its implementation differences across all three process nodes. GT2 scales Xe3 to a different physical layout, with render slices arranged vertically instead of GT1’s horizontal arrangement. Slice placement sets the distances to shared cache banks and the D2D interface. Those wires consume area and add delay, so scaling the number of Xe cores also requires a new balance of cache placement, routing and timing. [1] What’s immediately obvious is that the GT2 tile on TSMC N3E has much smaller Xe cores than GT1. These block areas include logic, caches, and routing. An Xe core on the GT1 tile is ~69% larger than one on Lunar Lake, and ~55% larger than one on GT2. Intel 3 therefore uses substantially more area per Xe core. The block-area gap exceeds the measured logic and SRAM density gaps, bringing routing, timing targets, cell mix, and floorplan allocation into the comparison. The measured vector/matrix engine region is almost unchanged between Lunar Lake and Panther Lake’s GT2 tile. Xe3 retains eight 512-bit vector engines and eight 2048-bit XMX engines per core. Its gains also come from feeding those engines more effectively: more resident threads hide stalls, and variable register allocation lets shaders trade registers per thread against the number of threads kept active. [1] The shared L1/SLM capacity increased by 33% from 192 KiB to 256 KiB, while its area increased only 5%, raising effective density by 27%. L1 retains reused cache lines, while software-managed SLM lets a thread group share data locally. Both reduce traffic to more distant memory. Allocating more SLM per group can also limit how many groups reside on a core at once. [1], [37] The GT1 tile carries 4 MiB of L2 against 16 MiB on the GT2 tile. GT1 divides its L2 cache into four 1 MiB banks, while GT2 uses eight 2 MiB banks. Each bank contains 128 macros, but each N3E macro stores 16 KiB, twice the Intel 3 macro’s 8 KiB capacity. The N3E macro is only 54% larger while holding twice as many bits, giving it 30% higher density: ~23.7 Mbit/mm² versus 18.3 Mbit/mm². Including bank-level circuitry, the gap widens to ~16.9 Mbit/mm² on GT2 versus ~10.4 Mbit/mm² on GT1. GT2 gains density with its macros storing more bits per unit area, and those macros occupy more of each cache bank. Larger macros spread decoder and sense-amplifier overhead across more storage, while a more compact bank layout reduces the share spent on control and routing. The compromise is longer wordlines and bitlines that carry more capacitance. [34] I/O tile Panther Lake uses two I/O tile variants, both fabricated on TSMC N6. The smaller one provides 4 PCIe 5.0 and 8 PCIe 4.0 lanes and serves lower-tier systems as well as those without a discrete GPU, while the larger one adds 8 PCIe 5.0 lanes, bringing the total to 20 lanes, for discrete-GPU connectivity. Panther Lake SKUs with the larger 10- or 12-Xe GPUs use the smaller I/O tile. [38] The smaller I/O tile adds a PCIe 4.0 block and a Thunderbolt block to Lunar Lake’s I/O layout, providing four additional PCIe 4.0 lanes and another Thunderbolt 4 port. Its repeated N6 blocks retain nearly identical areas and layouts. Reusing these proven PHYs and controllers avoids porting and requalifying external interfaces on 18A, where faster digital logic offers less benefit to circuits constrained by the off-chip link. [38] SemiAnalysis’s teardown lab (STEEL) dives deep into the world’s advanced datacenter and AI hardware. To learn more about our pipeline or to commission a teardown, contact sales@semianalysis.com. We’re hiring technical experts from system to transistor and everywhere in between. Check out our Careers page. Panther Lake offers scalability and modularity through its disaggregated packaging that partition compute, GPU, and I/O silicon into separate tiles allowing for a suite of tile configurations. This partitioning makes the package part of Intel’s node economics as it determines how much leading-edge wafer area each product consumes, which functions can remain on other processes, and how much configuration freedom Intel can offer from a shared set of tiles. Furthermore, fabricating the compute and GPU tiles separately confines the new 18A process to the compute tile and allows graphics and I/O to use other, more established, and more cost-effective processes. For Panther Lake, the GPU and I/O tiles are assembled alongside the compute tile on a passive silicon base using Foveros-S. Intel’s current technology brief lists a nominal 36 µm pitch for Foveros-S. Through-silicon vias (TSVs) in the base connect the fine wiring above to the larger package connections below. The functional tiles sit side by side on that passive base in a 2.5D configuration. [39] Our cross-section through the compute and GPU tiles shows the package’s wiring hierarchy. Microbumps connect each active tile to the passive silicon base; its fine redistribution layer (RDL) carries the short, dense tile-to-tile links. TSVs carry connections through the base to the package substrate, which fans them out to the much coarser motherboard solder joints. The base supplies interconnect, while computation remains in the active tiles above it. [39] At the compute-tile edge, the higher-magnification inset shows a local microbump spacing of approximately 25.24 µm and a feature width of 12.33 µm. These local spacings are finer than Intel’s nominal Foveros-S value. The X-ray fields further confirm tighter neighboring bumps, consistent across every die-to-die area found on each tile. Additional X-ray analysis is offered after the paywall. Putting the memory controller beside the CPU removes the D2D transfer that CPU memory requests required in Meteor Lake and Arrow Lake. This avoids the extra transmitter, receiver, and link traversal, saving interface energy and latency. Panther Lake’s separate GPU still crosses a D2D link to reach DRAM, so its larger local caches also help contain package traffic. [1], [40] Smaller dies are less likely to contain a random fatal defect, and screening them before assembly prevents one bad tile from consuming a complete package of good silicon. Reuse also spreads design and qualification work across more products. Against those gains, Intel pays for the passive base, D2D circuits, extra bonding and test steps, and losses during assembly. Cost per working product across the portfolio captures the combined effect of wafer yield, reuse, test, and assembly. [29] Wildcat Lake packaging Intel launched Core Series 3, formerly Wildcat Lake, on 16 April 2026 for value mobile and edge systems. Wildcat Lake keeps 18A but removes the passive base and combines more functions on one die to simplify the package. The two products therefore reveal two distinct ways to commercialize the same leading-edge process. [41] Wildcat Lake’s 18A die combines up to two Cougar Cove P-cores, four Darkmont LP E-cores, two Xe3 cores and a smaller NPU. A separate platform-controller die supplies I/O, connected through UCIe, Intel’s first processor implementation of the standard. Consolidating graphics remove a tile boundary and the passive base, reducing assembly complexity for a modest-bandwidth value product. It also ties CPU and graphics scaling to the same die, giving up Panther Lake’s ability to swap in a much larger GPU. [42], [43] In July 2021, Intel CEO Pat Gelsinger set out an ambitious process roadmap aimed at regaining performance leadership by 2025, later described as five nodes in four years. Five years and one CEO later, Intel’s comeback story is not as unambiguously positive as Pat may have hoped. [44], [45] Intel once set the pace for process technology, bringing high-k metal gate technology and FinFETs into volume production years ahead of the rest of the industry. Its 22 nm FinFET process reached consumers with Ivy Bridge in 2012. [46] Intel’s integrated device manufacturing (IDM) model allowed its architects and process engineers to co-optimize products and processes. Starting with Sandy Bridge, Intel dominated x86, while AMD struggled with Bulldozer. That lead faltered at 14 nm and broke at 10 nm. Intel targeted a massive 2.7× density increase, but the node arrived years late and required several revisions before it could support Intel’s full lineup. This delay forced Intel to stretch 14 nm across six generations, while TSMC moved ahead in process technology and AMD recovered in x86. By 2019, Intel was still shipping 14 nm across most of its product stack, with its 10 nm client ramp focused on Ice Lake mobile processors. Meanwhile, TSMC was shipping N7 and N7+, and AMD’s Zen 2 compute chiplets used N7 to raise core counts and improve efficiency. Intel’s process failures were central to its decline, but unsound business decisions furthered their downward slide. Product delays compounded product mistakes, pushing client, server, and FPGA roadmaps off schedule. Several attempts to enter AI (Nervana and Gaudi) and networking (Tofino) also failed to establish lasting businesses. Intel’s recovery has focused on consumer CPUs and advanced packaging. Tiger Lake, Alder Lake, Lunar Lake and now Panther Lake have restored Intel’s consumer roadmap. On the process side, Intel 4 shipped with Meteor Lake, Intel 3 with Granite Rapids and Sierra Forest, and Intel 18A with Panther Lake. Intel has also made advanced packaging part of its foundry offering. However, Intel is still playing catch-up in servers. Several Xeon generations arrived years late and trailed contemporary AMD and Arm server CPUs in performance, efficiency, and core count. The process roadmap is back, but Intel does not hold the same process-technology leadership position it held prior to 10 nm. The introduction of gate-all-around nanosheets and backside power delivery are two of the biggest changes to transistor integration in a decade. Intel took on both changes at once: 18A paired its first RibbonFET with PowerVia in Panther Lake. Panther Lake is a substantial manufacturing milestone. Our cross-sections show how RibbonFET and PowerVia reshape local contacts and wiring, while the floorplans show where architectural consolidation and process choices save area. A sustained competitive lead depends on product performance, cost, yield, and the next implementation. The SemiAnalysis STEEL teardown lab breaks down advanced datacenter and AI hardware. To learn more about our pipeline or to commission a teardown, contact sales@semianalysis.com. WE’RE HIRING: Architecture, floorplan, packaging, manufacturing, and labs experts. Opportunities from system to transistor and everywhere in between. Check out our Careers page.. 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Gov. Bob Ferguson targets H.R. 1 fallout for Apple Health Medicaid in executive order
Gov. Bob Ferguson signed an executive order Thursday aimed at reducing the effects of H.R. 1, a federal law he said cuts health care and food assistance.
How myth-busting science changed cerebral palsy
Research from Adelaide continues to play a major role in changing the world's understanding of cerebral palsy, tracing its causes back to genetics and reducing costly litigation against obstetricians. ...
Yale School of Medicine On the Science of Childhood Anxiety, Say, Anxiety Disorders Are the Most Common Mental Health Challenges In Youth
Credit: Matt Bradbury October 5, 2026 - By Isabella Backman - Anxiety disorders are the most common mental health challenges in youth. Left untreated, they can disrupt the lives of both children and their families. The good news is that with intervention, most children will overcome these conditions. Across Yale School of Medicine, scientists are working to understand anxiety at every level, from common anxious behaviors to molecular biomarkers in the brain. They are using their findings to develop and disseminate new evidence-based treatments for childhood anxiety. Today, the go-to treatment for childhood anxiety disorders is cognitive behavioral therapy (CBT). This is a form of psychotherapy that teaches children skills for confronting anxious thoughts and helps them practice managing situations that cause anxiety. While it is the gold-standard treatment backed by considerable scientific evidence, up to 50% of children will not see sufficient benefit from CBT alone. Wendy Silverman, PhD, Alfred A. Messer Professor in the Child Study Center, co-directs the Anxiety and Mood Disorders Program alongside Eli Lebowitz, PhD, associate professor in the Child Study Center. One of their main interests is learning how to improve outcomes beyond CBT. “We’re developing cutting-edge, research-based knowledge that can reduce the suffering that anxiety causes children and their families,” says Silverman. Changing parent behavior YSM experts are investigating how to improve CBT outcomes for children by involving the parents. Silverman’s research has uncovered two main components of parent intervention that improve childhood anxiety: not enabling children to completely avoid the things that make them anxious and taking steps to enhance their autonomy. Parents may unintentionally reinforce their child’s anxiety by allowing them to avoid what makes them anxious. They also may unintentionally limit the children’s sense of autonomy by being overly intrusive. “One of the things that we take pride in is that we’ve focused on trying to understand what parents need to do, and to test our ideas and see if changing the parents’ behaviors is enhancing the effects of CBT,” Silverman says. “Our findings thus far suggest that they do." As much as CBT can be helpful, it can also be challenging to get one’s child to do the necessary steps for CBT to work. This is one important reason why Lebowitz created a novel intervention program for parents named Supportive Parenting for Anxious Childhood Emotions (SPACE). Existing intervention programs often teach parents to act as therapists for their child, such as training them on how to practice breathing exercises. “It makes sense, but this doesn’t work very well in practice,” says Lebowitz. “And part of the reason, I think, is that it’s not easy to get your kid to do things, especially if they’re not excited about doing it.” SPACE is unique because it focuses entirely on parent involvement and changing parental behavior—children are not involved in the sessions. For example, parents learn how to use supportive messages that convey confidence that their child can tolerate and manage distress. “It might sound like a parent saying to a child, ‘I get that this is really hard for you, but I know that you can handle it,’” Lebowitz says. The program also works with parents to identify the ways in which they are accommodating anxious behaviors. “We’ll pick one thing that parents are doing that is an accommodation and help them make a detailed plan for how they’re going to change that,” Lebowitz explains. Treating Anxiety in Children and Adolescents Much of the existing research on SPACE has focused on parents of children under age 14. Ongoing studies are now exploring its use with parents of older teens. “Both anxiety and accommodation can interfere with normative developmental shifts during the teen years, including increased autonomy and individuation from parents,” says Rebecca Etkin, PhD, associate research scientist in the Child Study Center. “In this sense, SPACE may be particularly well-suited for anxious teens and their parents. We want to see whether it is effective during this distinct developmental window.” Unfortunately, many families in need of CBT face barriers, including limited availability of services and geographic constraints. One way to improve access is digital interventions. Silverman and her team are developing an evidence-based digitized intervention program for parents that they can access directly from their computer or smart phone. “The work we’re doing will be one of the very few parent interventions that is digitized and importantly tested for effectiveness,” she says. Creating interventions for anxiety-related challenges Silverman and Lebowitz recently received a generous gift to develop and test other interventions that help parents reduce other child anxiety-related behavioral and emotional difficulties, such as restrictive eating and unexplained somatic symptoms. One of these projects in particular focuses on understanding the risks of social media and its potential benefits, including offering a sense of connection. “A lot of research has focused on the idea that social media is harmful and the less of it the better,” says Lebowitz. “But we actually see is that this is not quite right—there are negatives, but there are also positives. So, we’re trying to get a little bit more nuanced of a picture.” The team is working with teens with social anxiety and their parents over an extended period to better understand their social media habits and how their anxiety levels affect engagement with different platforms. The teens will answer questions sent to an app on their phones about mood and social media usage in an effort to capture emotional responses as they unfold. “We hope to develop interventions that can help make the best of social media while protecting against the more problematic effects,” Lebowitz says. The brain’s role in anxiety Researchers are also testing therapies to address anxiety at the neurological and molecular levels. In collaboration with Dylan Gee, PhD, professor of psychology in Yale's Faculty of Arts and Sciences, and Hilary Blumberg, MD, John and Hope Furth Professor of Psychiatric Neuroscience at Yale School of Medicine, Lebowitz and Silverman are using brain imaging to identify changes in a child’s brain before and after parents enroll in SPACE. In one study, children viewed anxiety-inducing images while undergoing magnetic resonance imaging (MRI); the researchers conducted scans with and without the children’s parents nearby. Before SPACE, children’s brains were better able to activate the regulatory circuitry needed to turn off an anxious response when their parents were nearby. But after SPACE, children could activate this circuitry even without the parent around. “As parents work on gradually reducing some of their accommodations, you can see a child get better at regulating their own fear system in the brain,” Lebowitz says. “It’s remarkable.” Research into the molecular underpinnings of anxiety can also inform new childhood anxiety treatments. In a recent study, Lebowitz, Silverman, and Flora Vaccarino, MD, Harris Professor in the Child Study Center, discovered that a protein known as fibroblast growth factor 2 (FGF2) could be protective from the toxic effects of stress. FGF2 levels in children and their parents were linked to the children’s risk of developing anxiety and depression, the study showed. The findings could help explain why some children who are exposed to early life trauma such as poverty or abuse are more prone to developing mental health disorders. And FGF2 could be a target for treatment. “This is very novel because it starts to give a clue to what is the molecular chain that connects those lived experiences to the actual psychological outcomes,” Lebowitz says. New ways to study and treat childhood anxiety Michael Crowley, PhD, associate professor in the Child Study Center, collaborates with Silverman and Lebowitz to study the role that attention plays in development and maintenance of childhood anxiety. There is a large body of research that shows that anxious children, like anxious adults, are prone to focus on threatening stimuli such as angry faces compared with neutral faces. This has led to innovative interventions that involve attention retraining. The idea is that if experts train children to look away from threatening stimuli, it may reduce their anxiety—especially children with social anxiety who are most prone to attend to threats. The researchers have just completed a clinical trial for attention retraining with 10- to 14-year-olds with social anxiety disorders and are currently analyzing the findings. Besides this innovative attention retraining research, as Crowly notes, “I like to design tasks that are engaging to kids,” Crowley says. “My goal is to assess something without the kids knowing what we are assessing.” With this goal in mind, Crowley has created a virtual game, named Boom, to study threat processing in children with anxiety disorders. The game is similar to that of hot potato—the child and three digital players take turns virtually passing a ball to each other’s gloves. At some point, the ball turns into a bomb, and as the bomb lands in each player’s glove, the outline of the glove turns yellow. The goal is to avoid having the bomb go off in your glove. What isn’t obvious is that the game is designed to measure different types of threatening stimuli, both ambiguous and direct. In the game, the direct threat occurs as the bomb is traveling towards your glove. The ambiguous threat is the yellow outlined glove as it is unknown where the bomb will travel next. While children play the game, Crowley’s team measures their brain activity using electroencephalography (EEG). The researchers have discovered that in kids with anxiety, the brain reacts more strongly to ambiguous threats than it does in their peers, but less strongly to direct threats. They believe that the initial abnormally large brain response to not knowing where the bomb is going impairs the brain's ability to properly respond when the threat is actually traveling the child’s way. “The brains of children with anxiety are unable to differentiate between threats you need to do something about and those that are not your problem.” Michael Crowley, PhD, develops innovative games for studying anxiety in children and adolescents.Credit: Matt Bradbury Based on these insights, Crowley hopes to study whether interventions like attention training could restore appropriate threat processing. Crowley’s team is also working on a test called the Balloon Risk Avoidance Task, which evaluates risk-taking and avoidance behaviors. It features a digital balloon that is full of air and about to burst. Kids have six seconds to let air out of the balloon. The more air they let out, the less risk they face that the balloon will pop. But at the same time, the balloon becomes less valuable as it deflates. “The more air you keep in the balloon, the more points you get,” Crowley explains. So far, the researchers have found that when the balloons pop unexpectedly, teens with social anxiety show distinct brain responses. Studying these responses can help psychologists understand the underlying pathways driving the various manifestations of anxiety. The genetics of anxiety When Thomas Fernandez, MD, associate professor in the Child Study Center and of psychiatry, was still in training, there was a lot of excitement about understanding the genetics associated with autism spectrum disorder. Since then, scientists have identified around 250 genes associated with autism. The genetic contribution to anxiety disorders, on the other hand, has historically received less attention. Anxiety is less heritable than autism, but the genetic contribution for anxiety disorders that emerge in childhood may be higher than for anxiety disorders overall. While scientists estimate the heritability of anxiety disorders in general to be around 30% to 50%, some studies suggest higher heritability for certain childhood-onset anxiety presentations. “I saw firsthand how researchers in the field went about finding vulnerability genes for autism,” Fernandez says. “So, we’re using a very similar playbook for childhood anxiety.” “I saw firsthand how researchers in the field went about finding vulnerability genes for autism. So, we’re using a very similar playbook for childhood anxiety.” Thomas Fernandez, MD Associate Professor In the Child Study Center and in Psychiatry Now, Fernandez and Emily Olfson, MD, PhD, assistant professor in the Child Study Center, are studying children and their parents to identify genetic changes that are present in the child but not the parents, known as “de novo mutations.” “All of us have some de novo mutations—maybe about 50 to 100 sprinkled throughout the genome,” Olfson says. “But when they occur within the coding regions of genes, they can be really disruptive.” Previous research shows that people with autism have higher rates of damaging de novo mutations than the general population. In 2022, Olfson, Lebowitz, Silverman, and Fernandez published a study on 68 children and their families that found that children with anxiety had similarly high levels of these mutations. Studying de novo mutations can help point the researchers to where they should be looking for genes associated with anxiety. “The end game is using the genes to steer us toward the right part of biology that we can then target to come up with better treatments,” Fernandez says. Building on those findings, the team is now studying more families to better understand how these de novo mutations, along with other genetic and environmental factors, shape pediatric anxiety disorders. They recently received a National Institutes of Health grant to enroll 750 new families over the next five years. Olfson is the principal investigator, with co-investigators Lebowitz, Fernandez, Silverman, and Shuangge Steven Ma, PhD, department chair and professor of biostatistics at Yale School of Public Health. Neurodevelopment, Risk Genes, and Mental Health Conditions - The Olfson Lab Joel Gelernter, MD, Foundations Fund Professor of Psychiatry, is interested in how different anxiety disorders differ genomically. “We are studying social phobia, panic disorder, and generalized anxiety disorder, working to understand why people differ in their risk to these specific anxiety disorders and evaluating various risk factors,” he says. Gelernter was recently involved in one of the largest studies to date of the genomics underlying anxiety disorder. The study included around 122,000 people with anxiety disorders and around 730,000 without. It found that some genetic differences associated with anxiety were linked to signaling that helps reduce overactivity in the nervous system. Many anxiety medications available today work by targeting this process. “It’s nice when the biology that you get out of a large genome-wide study ratifies things that we already know because that can help increase confidence in further findings from the study,” Gelernter says. Uncovering the neurobiology of psychiatric disorders John Krystal, MD, Robert L. McNeil, Jr. Professor of Translational Research and chair of the Department of Psychiatry, is interested in the neurobiology of psychiatric disorders, including post-traumatic stress disorder (PTSD), of which anxiety is a major symptom. In the late 1980s, Krystal’s team discovered that the drug yohimbine activated symptoms in patients with PTSD. “This was the first time we could link a specific biological mechanism to the symptoms of PTSD,” Krystal says. At the time, he adds, this finding was highly controversial. “A lot of people felt that PTSD was a purely psychological syndrome that didn’t have an underlying biology.” Since then, Krystal has dived deep into understanding the neurobiology of PTSD to learn how to better treat it. His team is evaluating the use of ketamine and psychedelics. These would be among the first treatments to be developed specifically for PTSD. They may also be applicable for other disorders including anxiety disorders, Krystal adds. An important gap in PTSD treatment is the absence of biological tests that inform how to best help patients manage their PTSD symptoms. A doctor doesn’t diagnose cancer based on how they feel. Rather, they use tests of the biology of the cancer to determine the best course of treatment. “And we can’t do that in any psychiatric disorder other than Alzheimer’s disease,” Krystal says. “But now we are building a foundation for this approach to the treatment of anxiety disorders for the first time.” Source: Yale School of Medicine
David Petraeus: George W. Bush, Political Courage, and the Surge in Iraq
In the wake of the September 11 attacks, President George W. Bush launched what he called the War on Terror. It began with the invasion of Afghanistan in late 2001, which quickly toppled the Taliban and expelled al-Qaeda from its most crucial sanctuary. Then, in early 2003, American forces—with the support of foreign allies like the United Kingdom, Australia, and Poland—attacked Iraq, toppling Saddam Hussein’s regime and installing an occupation force in hopes of quickly transforming the country into a free and democratic state. Instead, the post-regime coalition authority made significant missteps, and a devastating insurgency erupted. And despite President Bush’s 2004 reelection, the war quickly lost popular support among the American public. In early 2007, Bush appointed General David Petraeus, who had already served in Iraq as a two- and three-star general, to lead allied forces in Iraq, which heralded a sea change in American strategy known as “the surge.” As part of our coverage looking back on 9/11 and the world it created, General Petraeus tells the inside story of one of the most consequential moments in the War on Terror. The general’s essay today is both a crucial history and a profile in political courage. It demands reflection as we take stock of the last 25 years. —The Editors By the end of 2006, the war in Iraq was failing. There is no useful purpose in softening that judgment with the passage of time. The bombing of the al-Askari mosque in Samarra by terrorists that February had accelerated sectarian violence and pulled Iraq into an increasingly vicious Sunni-Shia civil war. Al-Qaeda in Iraq and Sunni insurgent groups controlled substantial areas, Shi’ite militias operated with growing impunity in other parts of the country, and the Iraqi security forces were no longer capable of arresting the downward spiral. The strategy of transitioning security responsibilities to Iraqi forces, consolidating American troops on large bases, and progressively reducing the U.S. presence had clearly been invalidated by the escalating violence. The numbers conveyed the horror imperfectly but unmistakably. In December 2006, an average of 53 Iraqi civilians were killed by violence every 24 hours in Baghdad alone. Washington, meanwhile, was approaching its own breaking point. Public support for the war had fallen dramatically, President George W. Bush’s Republican Party had just lost control of both houses of Congress, and the bipartisan Iraq Study Group—of which future defense secretary Robert Gates was a member—had recommended a course that anticipated a substantially reduced American combat role. Many senior military leaders were deeply skeptical of sending substantial additional forces, advocating instead for an accelerated transition to Iraqi forces, the deployment of additional trainers and advisers, or other more modest measures with an eye to withdrawing U.S. forces. Virtually every political incentive pointed toward reducing America’s commitment. President Bush chose instead to increase it, a decision that remains, in my view, one of the most courageous presidential decisions of the 21st century.
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Countries race to provide oral health care for all in 100-Day Sprint across Asia
Twenty Asian countries and areas across the WHO Western Pacific and South-East Asia regions vowed to strengthen essential oral health benefits as part of a “100-Day Sprint” initiative, during the 16th Asian Chief Dental Officers Meeting held from 27 to 29 September in Kota Kinabalu, Malaysia. The meeting marked the midpoint of the 100-day sprint bolstering support for countries to develop essential oral health benefit packages that can be integrated into national universal health coverage plans. Convened by the two WHO regional offices and the Malaysian Ministry of Health as the Secretariat, the meeting brought together national oral health leaders from 20 Asian countries, staff from all levels of WHO, WHO collaborating centres and other development partners. Participating countries and areas included: Bangladesh, Bhutan, Brunei Darussalam, Cambodia, China, Hong Kong (SAR) China, India, Indonesia, Japan, Lao People’s Democratic Republic, Malaysia, Maldives, Mongolia, Nepal, the Philippines, Singapore, Sri Lanka, Thailand, Timor-Leste and Viet Nam. Participants reviewed progress and refined proposals using the WHO Service Package Delivery and Implementation (SPDI) Platform. Countries conducted bottleneck analyses across four key areas: service delivery, workforce, access to essential medicines and health products, and health financing. They identified practical actions to address implementation challenges and refined proposed revisions to their national oral health benefit packages. “There is no health without oral health. Through the 100-Day Sprint, countries are advancing the implementation of the Western Pacific regional implementation plan on oral health and strengthening progress towards universal health coverage,” noted WHO Regional Director for the Western Pacific Dr Saia Ma'u Piukala. Participants identified bottlenecks and proposed workable solutions to strengthen access to essential oral health care through primary health care, sharing experiences and discussing how best to translate policy commitments into feasible and sustainable action at the country level. Malaysian Minister of Health Datuk Seri Dr Dzulkefly Ahmad highlighted the importance of prevention and primary health-care approaches to improve oral health: “Oral diseases can have lifelong consequences, yet many are preventable. By integrating essential oral health care into primary health care and promoting prevention in schools and communities, we can improve oral health across the life course.”The WHO team led by Dr Huong Tran, Director of the Division of Health Promotion, Disease Prevention and Control of the WHO Western Pacific Region and national oral health leads from over 20 Asian countries visited the SK Pekan Putatan School, Sabah for school oral health programme including flouride mouth rinsing. © WHO / V. ChaudharyDr Huong Tran, Director of the Division of Health Promotion, Disease Prevention and Control for the WHO Western Pacific Region, emphasized key collaborative roles WHO can play. “Oral diseases are the most common noncommunicable diseases, yet many can be prevented and treated through essential oral health services delivered at the primary health-care level,” she said. “By sharing experiences and using WHO tools such as the SPDI Platform, countries are accelerating progress towards universal health coverage for oral health.” “Integrating oral health into broader health services is essential for reducing inequities, expanding access and recognizing oral health as an integral component of overall health and well-being. The 100-Day Sprint provides an important opportunity to translate this commitment into practical action and ensure that quality oral health services reach all people, especially those most in need,” said Dr Suman Rijal, Director of the WHO South-East Asia regional Department of Healthier Populations and Noncommunicable Diseases. As host of the meeting, Malaysia showcased ongoing efforts to strengthen oral health care through primary health care and prevention-focused approaches, while providing a platform for countries across the two WHO regions to exchange experiences and accelerate progress towards universal health coverage for oral health. “WHO is encouraged by Malaysia's leadership in addressing the burden of oral diseases and advancing universal health coverage for oral health through practical, country-led action,” said Dr Rabi Abeyasinghe, WHO Representative to Malaysia, Brunei Darussalam and Singapore. Countries will continue to refine and figure costs for national oral health benefits during the remaining sessions of the 100 days. These efforts support implementation of the WHO Global strategy and action plan on oral health 2023–2030, while also helping to expand access to essential oral health services through stronger and more equitable health systems across the WHO Western Pacific and South-East Asia regions.______________For more information, or to arrange media interviews, contact: WHO Regional Office for the Western Pacific: wprocom@who.int WHO Regional Office for South-East Asia: SEMediaRelations@who.int
A film thinner than a human hair blocks electromagnetic waves—and hides heat!
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Plague is stoppable. The next health threat may not be.
The word plague is scary. Centuries ago, the Black Death killed tens of millions of people and changed the course of history. Plague still kills people around the world, and the word still evokes catastrophe. New fears of plague surfaced on October 2, when a lab worker in Irkutsk, Russia, died of pneumonia. Reports suggested that she may have contracted plague through a laboratory exposure. Understandably, people were alarmed. On October 7, the World Health Organization called for the Russian Federation to be transparent about what it knew. WHO issued an update on October 10. Russian authorities told WHO that testing did not identify plague and that investigations found no laboratory release. WHO said confidence in its risk assessment remained limited and that further clinical, epidemiological, and laboratory information was needed. The cause of the woman’s illness remains unknown, and WHO says a laboratory-associated exposure cannot be excluded. As I explained in a recent interview, this incident is very unlikely to lead to a pandemic. Plague is still active, including in the U.S., which sees a handful of cases each year. But it is a disease we can prevent and treat. Plague doesn’t spread readily, and it responds to antibiotics. The standard response—isolate the patient, trace contacts, and administer antibiotics and monitor for symptoms among contacts for seven days—works. We have even planned for antibiotic-resistant plague. At CDC, we developed a playbook for antibiotic-resistant plague and ran exercises on how to find and stop it. CDC guidance anticipates engineered resistance and recommends two different classes of antibiotics if there’s reason to suspect it. There is no evidence that resistance—or even confirmed plague—is involved in this incident. We have thought through how to address plague, but we’re not ready for the next major health threat that emerges from a lab or from animal spillover to humans. What should concern people is how little stands between the world and the next pathogen to get loose. Since peak COVID, epidemic preparedness has fallen off the political agenda, but the risk is greater than ever. More labs handle dangerous pathogens with more ways to make those pathogens deadlier, and more people live and work in close contact with animals. There are actions we can take now: We need better lab safety in every country. The number of labs that work with dangerous pathogens has increased worldwide over two decades, but there’s no enforceable international standard and no inspection regime; the Biological Weapons Convention, fifty years on, still has no verification mechanism. Labs that study dangerous germs need strong safety systems, training, and oversight. We need to reduce spillover events. Three in four emerging human infections start in animals, and there’s a lot we can do to reduce spillover risk, but the world is doing very little of it. Live-animal markets are one place to act. For instance, closing live-bird markets helped control H7N9 influenza in China. Reducing opportunities for people to encounter infected animals can prevent infections before they become outbreaks. In The Formula for Better Health, which is now out in paperback along with the hardcover, Kindle, and audiobook versions, I argue that labs do too many risky experiments with too many dangerous pathogens in too many institutions, and that every experiment should first answer one basic question: Is the likely benefit greater than the risk? Spillover risk can also be reduced: In the book, I discuss how Brazil cut its deforestation rate by 70% from 2004 to 2012 while increasing agricultural production and reducing risky contact between people and forest animals. We need faster detection and response. Delay costs lives. Strong surveillance, good labs, and trained responders can turn a single case into a small cluster of infections instead of an epidemic. Resolve to Save Lives has worked for nearly a decade to help countries find and stop outbreaks faster. The 7-1-7 target, which Resolve to Save Lives developed with partners in Uganda and elsewhere, provides a clear standard: detect within 7 days, notify within 1 day and complete all essential early response actions within 7 days. In Uganda’s Kasese district, for example, a review of a measles outbreak using 7-1-7 identified shortages of accessible funds, fuel, and vehicles that delayed the response. District leaders established funds they could access quickly. When, a few months later, the Crimean-Congo hemorrhagic fever appeared, the district detected it in three days, notified authorities in one, and mounted an effective response in two. Only one case was confirmed, and the patient survived. Because funds were available before the emergency, authorities were prepared and able to act. This kind of preparation can’t wait until the next crisis begins. Plague is an old disease we that know how to stop. The next threat may be harder to recognize, harder to treat, and easier to spread. Safer labs, less risk of spillover, and faster outbreak detection and response need sustained investment now, while we still have time to prevent the next emergency. Share
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Culturally Relevant Cardiovascular Disease Prevention and Care Strategies
(Feature Impact) Driven by rising rates of obesity, diabetes, high blood pressure and other risk factors, cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the United States.Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation’s largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high-quality healthcare. A new scientific statement published in the American Heart Association’s flagship journal, “Circulation,” revealed how social, economic, cultural and environmental factors contribute to persistent disparities in cardiovascular health, calling for culturally tailored prevention strategies, equitable access to care and greater representation of Hispanic populations in cardiovascular research.“Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health,” said Johanna Contreras, M.D., M.Sc., FAHA, director of the Division of Heart Failure and medical director of the Hispanic Heart Center within the Mount Sinai Health System. “Yet Hispanic people remain underrepresented overall in the research that guides prevention and treatment strategies… Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives.”Hispanic Cardiovascular Health by the NumbersCardiovascular risk factors – obesity (nearly 46%), type 2 diabetes (15.5%) and high blood pressure (approximately 44%) – are prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.According to the report, only about 1 in 5 Hispanic adults achieves ideal cardiovascular health as defined by the American Heart Association’s original Life’s Simple 7 metrics. Updated analyses using the Life’s Essential 8 framework demonstrated persistent disparities for heart and brain health, as well as suboptimal dietary quality, sleep patterns and levels of physical activity.Social and Economic Barriers MatterBiology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, impact heart health. In fact, approximately 17% of Hispanics live below the federal poverty threshold, compared with 8.2% of white adults.#placement_976606_0_i{width:100%;max-width:550px;margin:0 auto;}var rnd = window.rnd || Math.floor(Math.random()*10e6);var pid976606 = window.pid976606 || rnd;var plc976606 = window.plc976606 || 0;var abkw = window.abkw || '';var absrc = 'https://ads.empowerlocal.co/adserve/;ID=181918;size=0x0;setID=976606;type=js;sw='+screen.width+';sh='+screen.height+';spr='+window.devicePixelRatio+';kw='+abkw+';pid='+pid976606+';place='+(plc976606++)+';rnd='+rnd+';click=CLICK_MACRO_PLACEHOLDER';var _absrc = absrc.split("type=js"); absrc = _absrc[0] + 'type=js;referrer=' + encodeURIComponent(document.location.href) + _absrc[1];document.write('');“Many Hispanic adults face obstacles that extend far beyond the doctor’s office,” Contreras said. “Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment.”Contreras emphasized the cultural values and practices of Hispanic people also influence how they perceive their health and healthcare options.“Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience,” Contreras said. “At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon.”An Action Plan for Improving Hispanic HealthThere are practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.“Reducing cardiovascular disease among Hispanic populations demands action at every level,” Contreras said, “from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health.”By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives. Learn more at Heart.org.Photo courtesy of Shutterstock
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WHO joins Pre-COP31 to advance climate action that delivers for people’s health
The World Health Organization (WHO) is joining Pacific leaders, governments and partners at Pre-COP31 in Fiji from 5 to 8 October to advance health priorities in climate action and strengthen the Pacific voice ahead of the 31st Conference of the Parties (COP31) to the United Nations Framework Convention on Climate Change (UNFCCC).COP31, to be held next month in Antalya, Türkiye, marks an important step for global climate and health action. Health is one of the 10 priority themes of the COP31 Action Agenda, “Dynamic and Resilient Health Systems”, and a dedicated Health Day will take place on 9 November, the first day of COP31. The inclusion of health reflects growing global recognition that climate action and health are closely connected. The climate crisis is affecting population health globally. Across the WHO Western Pacific Region, which includes Pacific island countries and areas, the consequences of climate change include extreme heat, cyclones, floods, rising sea levels, food and water insecurity, infectious diseases and disruptions to essential health services. The Pacific in particular faces additional challenges. A recent review of 76 hospitals in 14 Pacific island countries found that 62% of health facilities are located within 500 metres of the sea or a river, leaving them particularly exposed to flooding, storm surges and sea-level rise.Bringing Pacific priorities to the global climate agendaThe Pacific Pre-COP31 provides an important opportunity for Pacific countries and partners to consolidate regional priorities and bring the experiences and leadership of Pacific communities into global climate discussions.Pacific countries have been advancing practical approaches to protect health in a changing climate, including strengthening climate-resilient health systems, improving preparedness for extreme weather events, building resilient health infrastructure and mobilizing climate finance for health. “This Pre-COP is an important moment for the Pacific, bringing global climate discussions to a region that has long been at the forefront of the climate crisis. It provides an opportunity for Pacific countries and areas to set their priorities, experiences and leadership on the global stage, and to ensure that the realities of Pacific communities are genuinely reflected in the decisions made on climate action,” said Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific.Throughout this week, WHO will co-convene and participate in high-level discussions and events focused on climate and health, climate resilience, adaptation, financing and implementation. “Climate finance is essential for resilient and healthy Pacific communities,” emphasized Dr Mark Jacobs, WHO Representative to the South Pacific and Director of Pacific Technical Support. “We must ensure that financing reaches the people, communities and essential services most exposed to climate risks, supporting locally defined priorities and investments.”WHO will work with partners to strengthen the integration of health considerations across climate policies and investments, including national climate plans and resilience initiatives.Health as a driver of climate actionAmid the risks to health and pressures on health systems, well-strategized and implemented climate action can deliver significant health benefits. Investments in clean energy, sustainable transport, resilient infrastructure, food systems and nature-based solutions have proven to reduce health risks while contributing to climate mitigation and adaptation.“Climate action is truly an investment in health. Cleaner energy, healthier food systems and climate-resilient health services can protect lives while building stronger communities. We now need to turn these opportunities into action and make health a core part of climate investments,” said Dr Sandro Demaio, Director and Head of Office, WHO Asia-Pacific Centre for Environment and Health in the Western Pacific Region. “These benefits demonstrate that climate action is not only about reducing future risks. It is also an opportunity to improve lives today while building healthier, safer and more resilient societies.”At COP31 next month, WHO will also support the Health Pavilion, which will bring together the global health community and partners to advance health and equity within climate negotiations. With COP31 poised to move health higher on the global climate agenda, WHO will continue working with countries and partners across the Western Pacific Region and globally to strengthen climate-resilient and low-carbon health systems, and ensure that climate action protects and improves people’s health.____________________Media contactsElizabeth Bennett, WHO Asia-Pacific Centre for Environment and Health in the Western Pacific Region, elizabeth.bennett@who.intJulia Dongwhan Shin, WHO Asia-Pacific Centre for Environment and Health in the Western Pacific Region, dong.shin@who.intWHO Western Pacific Communications, wprocom@who.int
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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!
Solomon Rotimi: How Our Science is Contributing to Reducing the Burden of Prostate Cancer
Solomon Rotimi: How Our Science is Contributing to Reducing the Burden of Prostate Cancer / cancer, Ernest Kaninjing, Ewan K. Cobran, Folakemi T. Odedina,
Clean Air Policies Help Kids Breathe and Think Better
New research finds that reducing air pollution can reverse harms to children’s health.
Countries race to provide oral health care for all in 100-Day Sprint across Asia
Twenty Asian countries and areas across the WHO Western Pacific and South-East Asia regions vowed to strengthen essential oral health benefits as part of a “100-Day Sprint” initiative, during the 16th Asian Chief Dental Officers Meeting held from 27 to 29 September in Kota Kinabalu, Malaysia. The meeting marked the midpoint of the 100-day sprint bolstering support for countries to develop essential oral health benefit packages that can be integrated into national universal health coverage plans. Convened by the two WHO regional offices and the Malaysian Ministry of Health as the Secretariat, the meeting brought together national oral health leaders from 20 Asian countries, staff from all levels of WHO, WHO collaborating centres and other development partners. Participating countries and areas included: Bangladesh, Bhutan, Brunei Darussalam, Cambodia, China, Hong Kong (SAR) China, India, Indonesia, Japan, Lao People’s Democratic Republic, Malaysia, Maldives, Mongolia, Nepal, the Philippines, Singapore, Sri Lanka, Thailand, Timor-Leste and Viet Nam. Participants reviewed progress and refined proposals using the WHO Service Package Delivery and Implementation (SPDI) Platform. Countries conducted bottleneck analyses across four key areas: service delivery, workforce, access to essential medicines and health products, and health financing. They identified practical actions to address implementation challenges and refined proposed revisions to their national oral health benefit packages. “There is no health without oral health. Through the 100-Day Sprint, countries are advancing the implementation of the Western Pacific regional implementation plan on oral health and strengthening progress towards universal health coverage,” noted WHO Regional Director for the Western Pacific Dr Saia Ma'u Piukala. Participants identified bottlenecks and proposed workable solutions to strengthen access to essential oral health care through primary health care, sharing experiences and discussing how best to translate policy commitments into feasible and sustainable action at the country level. Malaysian Minister of Health Datuk Seri Dr Dzulkefly Ahmad highlighted the importance of prevention and primary health-care approaches to improve oral health: “Oral diseases can have lifelong consequences, yet many are preventable. By integrating essential oral health care into primary health care and promoting prevention in schools and communities, we can improve oral health across the life course.”The WHO team led by Dr Huong Tran, Director of the Division of Health Promotion, Disease Prevention and Control of the WHO Western Pacific Region and national oral health leads from over 20 Asian countries visited the SK Pekan Putatan School, Sabah for school oral health programme including flouride mouth rinsing. © WHO / V. ChaudharyDr Huong Tran, Director of the Division of Health Promotion, Disease Prevention and Control for the WHO Western Pacific Region, emphasized key collaborative roles WHO can play. “Oral diseases are the most common noncommunicable diseases, yet many can be prevented and treated through essential oral health services delivered at the primary health-care level,” she said. “By sharing experiences and using WHO tools such as the SPDI Platform, countries are accelerating progress towards universal health coverage for oral health.” “Integrating oral health into broader health services is essential for reducing inequities, expanding access and recognizing oral health as an integral component of overall health and well-being. The 100-Day Sprint provides an important opportunity to translate this commitment into practical action and ensure that quality oral health services reach all people, especially those most in need,” said Dr Suman Rijal, Director of the WHO South-East Asia regional Department of Healthier Populations and Noncommunicable Diseases. As host of the meeting, Malaysia showcased ongoing efforts to strengthen oral health care through primary health care and prevention-focused approaches, while providing a platform for countries across the two WHO regions to exchange experiences and accelerate progress towards universal health coverage for oral health. “WHO is encouraged by Malaysia's leadership in addressing the burden of oral diseases and advancing universal health coverage for oral health through practical, country-led action,” said Dr Rabi Abeyasinghe, WHO Representative to Malaysia, Brunei Darussalam and Singapore. Countries will continue to refine and figure costs for national oral health benefits during the remaining sessions of the 100 days. These efforts support implementation of the WHO Global strategy and action plan on oral health 2023–2030, while also helping to expand access to essential oral health services through stronger and more equitable health systems across the WHO Western Pacific and South-East Asia regions.______________For more information, or to arrange media interviews, contact: WHO Regional Office for the Western Pacific: wprocom@who.int WHO Regional Office for South-East Asia: SEMediaRelations@who.int
From Boosting Mental Health to Reducing Dementia Risk, Here's Why Reading Is Extremely Good for You, According to Science
Mounting evidence suggests that regularly cozying up with a book can increase brain and mental health, improve literacy and math skills, and even slow cognitive decline. What's more, fiction seems to have the added benefit of introducing readers to others' perspectives
RFK Jr. packs health agencies with political appointees
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SENA Health Secures Series A Financing to Accelerate Growth and Expand AI and Technology Capabilities
SENA Health, a New Jersey-based AI-powered healthcare access and care coordination company, today announced it has secured Series A financing led by Rittenhouse Ventures. The funding will support the expansion of SENA's Clinical Command Center and global operations. SENA is dedicated to relentlessly reducing friction in healthcare by reducing the administrative burden for healthcare organizations, making it easier for patients to access care, and enabling providers and staff to focus on deliveri
Less Than 1% Of International Development Finance Targets Air Pollution
International development lenders committed $4.7 billion in 2024 to projects aimed explicitly at reducing air pollution, less than 1% of all international development finance, according to an annual analysis published Tuesday by the Clean Air Fund (CAF).
FDA approves tirzepatide for reducing cardiovascular risk in adults with type 2 diabetes
The popular drug, sold by Eli Lilly and Company under the brand name Mounjaro, has been at the center of many cardiology trials over the years. It is now the first dual GIP and GLP-1 hormone receptor agonist approved by the FDA for this indication.
A Hidden Cause of Aging May Spread From Deep Inside Your Bones
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Your gut may be making a molecule that raises Alzheimer’s risk
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Summer Sports Camp Sets Stage for School Year for 300 Youth
By Yanet Luna, Vitals contributor Who knew all that summer play could get kids ready for the upcoming school year? Regular physical activity can improve children’s academic performance, attention, memory and mental health, while reducing symptoms of depression, according to the Centers for Disease Control and Prevention. Programs that encourage physical activity, social connection and confidence-building can play an […]
Poll: Young voters think there is too much money in politics
A new poll out this morning reveals young American voters from all political backgrounds think there is too much money in politics. They also believe rich people and wealthy organizations have more influence on members of Congress than the individuals who vote for them. MS NOW contributor, author and pollster John Della Volpe joins Morning Joe to discuss the findings — along with Jeff Clements, the CEO of American Promise, a nonpartisan group focused on reducing the influence of money in politics, which commissioned the poll.
New Device at UToledo Health Helping Critically Ill Patients Get Off Ventilators Faster
The FDA-approved LungPacer AeroPace® System uses targeted neurostimulation to strengthen the diaphragm of ventilated ICU patients, helping them breathe on their own faster and reducing the risk of serious complications.
BUSINESS UPDATE: Port Perseveres Despite Tariffs’ Negative Impact
‘We are hanging tough ... in an environment that is incredibly difficult to do business in right now,” the port’s director says By Stefan Yablonski Tariffs imposed by the Trump administration have hurt the Port of Oswego by slashing Canadian aluminum cargo volumes and reducing revenue. “We’re doing good. We are hanging tough. It is a tough time for our line of business in general, you know with these tariffs and the amount of Canadian aluminum that we see through our docks,” said the new executive director, Tom Drumm. “Compared to 2025, we are doing exceedingly well in traffic coming in; not necessarily the volumes we were seeing, but yeah we are hanging tough in an environment that is incredibly difficult to do business in right now.” “I don’t know where people get these numbers to be honest. We have never publicly stated how much our revenue is down or up or left to right. We don’t have a strong sense of those revenue numbers until the shipping season really closes up. We won’t have an accurate picture of the revenue standpoint until after the shipping season, typically in late November,” he added. “What I can tell you is several of our Canadian vessels that carry the aluminum cells — the volume of aluminum on those vessels we have seen decreasing. That is attributed to a few factors. One is where Novelis is in in their restart process. Novelis is rocking and rolling right now. They are starting to pull a lot of aluminum from the port of Oswego, the aluminum that they roll down into coils. “Another factor plainly is the tariffs. Canadian aluminum is tariffed at 50%. So, on those vessels we are seeing lower numbers than we would like. We’d like to see vessels carrying roughly 10,000 metric tons of aluminum. Over the course of this year, we have seen more in the range of 4,000 to 6,000. “Every piece of that aluminum that we receive here by vessel at the port is from Canada and is subsequently hit with the 50% tariff. It directly affects us because we’ve received less volume than we would traditionally see pre-tariff times.” When the port receives less aluminum from those vessels it means less hours for the ILA (International Longshoremen Association) as far as folks that work on the dock, he said. When cargo declines, it affects everyone, fewer hours for longshoremen, fewer loads for truck drivers, fewer rail shipments and less business for local suppliers. “Outside of the aluminum that comes in by vessel, the port topped out at having roughly 4,600 aluminum ingots stored on site at the port. That project had never been done before. The port of Oswego had never had that many of those size ingots in our yard,” he said. “It has been a busy summer for the ILA. Would we like to see more work for them? Sure. They are working all those barges when they come in, but as opposed to working 15 hours they might be working seven or eight hours. It hasn’t been a distinct decline in ILA hours. There has been plenty of work to keep our guys busy throughout the summer.” More salt “We just brought salt back to the port in several, several years. Around Harborfest time at one point we had a salt barge here with about 24,000 metric tons of rock salt and we had an aluminum barge here the same week. We had close to 40 men working,” he said. “Yeah, the other products definitely keep us busy. The salt project was a massive project, one that we are proud of. I’ve got 24,000 metric tons of salt on site that has to go somewhere — that’s going to be another project.” It is important for the port to continue to look at different products, different commodities to try to diversify some of its revenue, he said, adding, “We have done a pretty good job of that in my first five months here … particularly with the rock salt we have on site right now. It is important to continue to try to stand out and work through some projects outside our usual business. I enjoy it. It is a challenge every single day we put our head down and we try our best.”
Teladoc Health unveils new AI capabilities within Solo platform for hospitals
Teladoc Health announced Wednesday the launch of two new artificial intelligence capabilities within its enterprise smart care platform Solo. | The two new tools aim to help health systems surface timely patient insights into their care environments while reducing technology fragmentation, executives say.
More than 200 employees laid off at St. James Parish fertilizer plant
The company said it is reducing staffing at the plants in Convent and St. James, because of the availability and cost of sulfur, one of the key components of phosphate fertilizer production. Ammonia production at the Faustina plant in St. James will not be affected.
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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Belly fat and visceral fat are linked to serious health issues. A doctor shares how lean protein, fruits and vegetables, and healthy fats can help reduce stomach fat.
Chinese team achieves fourfold leap in fuel-cell power
The proton-transfer breakthrough could improve hydrogen vehicles and space systems, while reducing the use of costly platinum.
UNC Health Rex Holly Springs Adds New Patient Beds to Meet Demand for Care
Expansion Increases Capacity, Reducing Patient Wait Times
Mental and Behavioral Health Profiles – Memorial Regional Hospital’s Outpatient Behavioral Health Center
Encouraged by growing awareness of mental health and continued progress in reducing stigma, Laura Pawlicki, LCSW, believes compassionate care begins with building trust. As a social worker at Memorial Regional Hospital’s Outpatient Behavioral Health Center, she is committed to helping individuals and families navigate life’s challenges and improve their well-being and quality of life. “Mental […]
Phnom Penh recognised with WHO Healthy Cities Award for safer, healthier urban mobility
Phnom Penh City Hall has been awarded the World Health Organization (WHO) Healthy Cities Recognition Awards 2026 in the Safe, Active and Health-enabling Transport category, recognising its commitment to improving road safety and creating healthier urban mobility for residents. The award was presented during the 11th Global Conference of the Alliance for Healthy Cities held in Sydney, Australia, from 1-3 September 2026. Phnom Penh was recognised for the project “Safe, Active and Health-enabling Transport: Advancing Health and Reducing Inequities in Urban Mobility”, supported through the Partnership for Healthy Cities. The initiative has focused on creating safer and more accessible environments for vulnerable road users, particularly around schools. The project combines road safety data, infrastructure improvements, 30 km/h speed management, enforcement, education and community engagement to address risks around high-risk schools. Improvements have included the installation of traffic signs and road markings, smart speed limit signs, safety camera systems and strengthened monitoring in school zones. At the two intervention schools, infrastructure conditions improved from 1.0-star rating to 4.2 and 3.5 stars using the Star Rating for Schools tool. The project also contributed to lower vehicle speeds, provided road safety training for 500 students and achieved a reported 58% reduction in self-reported crashes. iRAP was proud to serve as the technical advisor to the project, supporting evidence-based approaches to infrastructure safety and helping to guide interventions that protect people walking, cycling and travelling to and from school. The WHO recognition is particularly significant given the strong level of regional participation. More than 150 cities from across the Asia-Pacific region applied for the awards, with only eight cities ultimately selected for recognition. The award demonstrates how targeted investment in safer roads and sustainable transport can contribute to healthier, more equitable cities while supporting broader goals for urban development and quality of life. iRAP congratulates the Phnom Penh City Hall and all project partners on this important achievement and looks forward to continuing to support initiatives that deliver safer roads and safer journeys for everyone. Read original article hereRead more on the project here
How Often You Exercise May Matter More Than How Hard You Work Out for Mental Health
When it comes to reducing the risk of depression and anxiety, how often students exercise may matter more than how hard they push themselves. A large Norwegian study found that students who exercised infrequently were more likely to develop clinically defined depression, anxiety, or another common mental disorder over the following year. How often they
Reducing the $2T federal deficit could lower inflation, interest rates for Americans: CRFB
Curbing the federal government's roughly $2 trillion budget deficit could lower inflation and current interest rates for households, a CRFB report finds.
Video GMA Health Alert: Sleep quality may help prevent disease
A new study suggests that sleep quality may be just as important as the amount of sleep we get when it comes to reducing the risk of a wide range of diseases.
Darling completes sale of sausage casings business to SARIA
Sale positions company for continued growth and value creation potential while optimizing portfolio and reducing debt.
Burning through Türkiye's GDP: The high cost of fossil fuel PM2.5 pollution on public health – Centre for Research on Energy and Clean Air
Türkiye’s reliance on fossil fuels is generating massive air pollution health costs both within the country and throughout the region. This report finds that fossil fuels account for more than half (52%) of Türkiye’s population exposure to PM2.5 air pollution. The cumulative health impacts are estimated to cost the Turkish economy approximately USD 55 billion each year, equivalent to 4.1% of national GDP in 2024. The pollution is also responsible for roughly 26,500 deaths per year in the country, including deaths from cardiovascular and respiratory diseases, lung cancer, stroke, and diabetes.The impacts begin at the very start of life, with fossil-fuel-derived PM2.5 pollution contributing to an estimated 8,000 preterm births, 8,200 low-birthweight infants, 5,100 new cases of childhood asthma, and 6,500 emergency-room visits for asthma each year in Türkiye.Beyond the estimated deaths each year in Türkiye, air pollution from the country’s fossil fuel emissions also contributes to deaths and economic losses in neighbouring countries. In 2024, these emissions were estimated to cause: 32,000 deaths and USD 2.1 billion in economic burden in Egypt; 1,700 deaths and USD 0.2 billion in economic burden in Syria; 800 deaths and USD 0.8 billion in economic burden in Iraq; 500 deaths and USD 4.5 billion in economic burden in Israel; and 400 deaths and USD 1.5 billion in economic burden in Greece.Türkiye currently has no national ambient air-quality standard for PM2.5, despite the substantial health burden associated with exposure to the pollutant. Figure — The percentage of annual PM2.5 emissions in Türkiye’s fossil fuel emissions, using the EMEP emission inventory and EMEP MSC-W chemical transport model Key findings Türkiye’s fossil fuel emissions (from domestic sources as well as international aviation and shipping) account for 52% of population exposure to PM₂.₅ nationwide. PM2.5 pollution attributable to Türkiye’s fossil fuel use is responsible for approximately 26,500 deaths in the country every year, including deaths from cardiovascular and respiratory diseases, lung cancer, stroke, and diabetes. Children are among the most affected, with fossil fuel-derived PM2.5 pollution contributing to an estimated 8,000 preterm births, 8,200 low-birth-weight infants, 5,100 new cases of childhood asthma and 6,500 emergency room visits for asthma each year. The cumulative health impacts of fossil fuel-derived PM2.5 pollution are estimated to cost the Turkish economy approximately USD 55 billion each year, equivalent to 4.1% of national GDP in 2024. Transboundary pollution attributable to Türkiye’s land-based fossil fuel emissions also leads to thousands of deaths in five neighbouring countries, with estimated economic burden per year (as of 2024) reaching USD 2.1 billion in Egypt (3,200 deaths), USD 0.2 billion in Syria (1,700 deaths), USD 0.8 billion in Iraq (800 deaths), USD 4.5 billion in Israel (500 deaths), and USD 1.5 billion in Greece (400 deaths). Türkiye currently has no national ambient air quality standard for PM2.5, despite the substantial health burden associated with exposure to the pollutant. Reducing fossil fuel use and emissions across Türkiye’s energy, transport and industrial systems would deliver substantial air quality and public health benefits by reducing exposure to PM2.5 and preventing associated illness and deaths. Figure — Annual deaths attributable to Türkiye’s land-based fossil fuel emissions in the five most affected countries, based on 2024 emissions
Lakers Make Final Roster Cut Before Beginning of Season
The Los Angeles Lakers waived forward Dalton Knecht on Monday, reducing the size of their roster to 15 just before their Monday deadline. The post Lakers Make Final Roster Cut Before Beginning of Season appeared first on LA Sports Report.
Monroe County promotes infant safe sleep, parenting support programs
Monroe County families can access free newborn home visits and safe sleep education aimed at reducing preventable infant deaths.
To the editor: The taint of corporate involvement in politics and government
hen we hear Republican candidates earnestly talking about reducing regulations, cutting government programs and lowering taxes to help ordinary Americans, we need to recognize the distinction between tactics and strategy. These proposals are tactics. The broader strategy behind them is to drastically reduce the role of government in our lives. We have watched this strategy
Oklahoma City awarded $11.5M in federal grants to improve children's mental health care
Two federal grants totaling $11.5 million will help Oklahoma City expand mental health care for children in schools and communities, addressing growing needs and reducing emergency room visits.
The politics of city rats: What urban rodents tell us about housing and sanitation
Why have cities had so little success in reducing rat numbers? It’s usually because they’re failing to address the larger social services issues that allow rats to thrive.
From Boosting Mental Health to Reducing Dementia Risk, Here's Why Reading Is Extremely Good for You, According to Science
Mounting evidence suggests that regularly cozying up with a book can increase brain and mental health, improve literacy and math skills, and even slow cognitive decline. What's more, fiction seems to have the added benefit of introducing readers to others' perspectives