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Abdul El-Sayed says Kamala Harris' visit for his Michigan U.S. Senate race is about Democratic unity
El-Sayed said Harris, who will attend a roundtable on Black maternal health with him and separately join an event hosted by the Detroit chapter of the NAACP, is a critical advocate in helping him close ranks as he tries to defeat Republican Mike Rogers.
Abdul El-Sayed says Kamala Harris' visit for his Michigan U.S. Senate race is about Democratic unity
El-Sayed said Harris, who will attend a roundtable on Black maternal health with him and separately join an event hosted by the Detroit chapter of the NAACP, is a critical advocate in helping him close ranks as he tries to defeat Republican Mike Rogers.
What we know — and don’t
Paramount has cleared the final hurdle in its year-long race to take over Warner Bros. Discovery. Now comes the really hard part.
New Census Data Contradicts Claims of Declining Children’s Health Coverage
The OBBB will ease severe provider shortages that have plagued the program and denied care to those who require a public safety net.
Jung’s Adjustments Paying Off After Return to Rangers Lineup
Josh Jung’s refined pregame preparation fuels a dominant return from the Injured List, restoring a vital power source to the middle of the Texas Rangers lineup.
State Of Decay 3 Studio Announces It's Now Free From Xbox And Employee-Owned
The studio behind open-world zombie series State of Decay confirmed it has completed its separation from Microsoft
AG Rob Bonta reaches settlement with Paramount/Skydance’s David Ellison over entertainment mega-merger with Warner Bros.
After clearing a state antitrust lawsuit with minor concessions, David Ellison pledges to keep the combined media empire in LA. By Sarah Lin Major California AG Rob Bonta settled an antitrust lawsuit against Paramount and Warner Bros., securing commitments from David Ellison to keep operations in Los Angeles.
Hellblade developer Ninja Theory to be shut down in new wave of Xbox cuts, as two separate agreements collapse
Ninja Theory - developer of the Hellblade series - is shutting down as part of today's Xbox cuts. Its proposed buyers pulled out, resulting in the closure.
$10M Ill. fire station puts firefighter health, safety at center of design
Buffalo Grove's new Fire Station 25 features cancer-reduction measures, sleep-focused bunk rooms, expanded apparatus bays and a larger fitness area
Caesars Entertainment supplements proxy over counsel conflict disclosure amid merger
Caesars Entertainment voluntarily supplements its definitive proxy to disclose Latham & Watkins’ separate representations of Fertitta affiliates while denying any required additional disclosure.Key Highlights:Original SEC Filing: Caesars Entertainment, Inc. [ CZR ] - 8-K - Sep. 22, 2026This is an A…
What’s Next for Paramount
Hollywood watchers believe the studio prevailed over states seeking to block its deal for Warner Bros. Discovery. It’s now free to reshape the media industry.
ParaSolution Recognized as a High Performer on the G2 Grid® for Business Continuity Management Software
Premier Continuum’s business continuity management software, ParaSolution, has been recognized as a High Performer on the G2 Grid® for Business Continuity Management Software. Learn more.
Is 50 the new 60?
Subscribe TL;DR: Younger generations are showing signs of worse health compared to earlier-born cohorts at the same age This backward “drift” is showing up both in mortality risk and chronic disease Worsening trends in obesity and diabetes are the most consistent signals Taking the long view, we’ve made astonishing gains in health and life expectancy in the last century. Global average life expectancy has more than doubled from 32 years in 1900 to 73 years in 2024. (But don’t forget, there were still old people when life expectancy was 32). As people lived longer, they also generally lived healthier along the way. It turns out that avoiding things that can kill you early, like malnutrition and lots of childhood infections, also keeps you healthier later in life. In a classic 2004 paper, Finch and Crimmins proposed that cohorts of children who benefited from fewer early life infections had less lifetime exposure to inflammation and cardiovascular disease later in life, accelerating mortality improvements at older ages. Poor nutrition in the womb has also been linked to a higher risk of later chronic disease. The upshot is that improvements in childhood health can pay dividends many decades later. The combination of better living conditions (nutrition, sanitation) and medical advances (antibiotics, vaccines, blood pressure meds, etc) meant that people’s healthy lifespan generally expanded, even as they lived longer. Aging researchers call this best-case scenario “compression of morbidity”—meaning we delay the onset of disease and disability even faster than the years of life we are adding. During my 20+ year research career, we could generally bank on the idea that younger generations would not only live longer but also keep getting healthier along the way. “60 is the new 50” as they say… Enter “Generational Health Drift” Sadly, this expectation of steady progress may be changing. You’ve probably heard that US life expectancy gains have slowed to a crawl in the past couple of decades. Mortality improvements are also slowing (though less dramatically) in many other high-income countries (you can read more about that in a review paper I wrote here). Mortality is a very blunt health measure, but it is often a good barometer for the broader population health trends happening underneath. And we are now seeing that younger generations may be in worse health at similar ages compared to earlier born cohorts. My collaborator Prof. George Ploubidis at University College London coined this worsening health in more recently born cohorts “generational health drift.” “Generational health drift” is bad news on multiple fronts. Most obviously, we don’t want our health progress to go backward. But the timing is also bad, since our populations are aging. In demographic terms, “population aging” means that the proportion of the population at older ages (i.e >65 years) is increasing. Fun demography fact: Current population aging is not due to the recent declines in the birth rates making the news, but declines in fertility decades ago, after the “baby boom.” As baby boomers reach older ages, the smaller cohorts behind them mean the percentage of older adults will increase. For example, the share of the population age 65 and older in the US increased from 12.4% in 2004 to 18.0% in 2024. This story of population aging was written long ago. Many worry that population aging will put pressure on health care and pension systems. But if people reach older ages in better health than in years past, those fiscal pressures would be less dire than projected. Healthy older people can also continue to contribute to society in many valuable ways, including paid work, caregiving, community service….even high political office 🤷. On the flip side, if younger generations reach retirement age in worse health and with more disabling conditions, this could magnify the societal challenge of population aging. Evidence for worsening generational health A recent paper that I LOVED in the Proceedings of the National Academy of Sciences by Dr. Leah Abrams and colleagues examined which birth cohorts (aka generations) were behind worsening US mortality. Behold the Lexis diagram (cue swooning demographers). Calendar time is on the x-axis, age on the y-axis. Birth cohorts can be followed over time as they age on the diagonal lines moving up and to the right. This figure plots the year-on-year % change in all-cause mortality at a given age. Green shading indicates mortality improvements over time, white is stagnation, and gray shading indicates worsening mortality. Following the diagonal line for those born in 1950, you can see a noticeable shift from green to gray that follows this cohort for most of their lives. This gray shading shows generally worsening mortality for the 1950 to 1959 birth cohorts compared to their predecessors across all ages. Concerningly for my GenX and elder millennial peeps, there was also a deterioration in mortality for birth cohorts born in the 1970s and 1980s, visible as dark gray areas at ages 30 to 45 during the 2010s. While some of these mortality changes reflect specific shocks such as the opioid epidemic, most deaths still occur from major causes of death such as cardiovascular disease and cancer. For cancer, the gray in the top left corner of the figure below reflects the legacies of smoking for older cohorts, followed by a period of green with improvements in cancer mortality as smoking rates declined. But the white/gray shading in the bottom right corner highlights a stagnation and reversal of the cancer trends, with cohorts born around 1970 to 1985 experiencing worsening cancer mortality. This deterioration was most noticeable for colon cancer mortality, possibly linked to obesity or dietary factors. Not just dying more, but less healthy along the way. A recent paper by Dr. Laura Gimeno of University College London (of which I am a co-author), found evidence that more recently born cohorts in Great Britain have stagnating or worsening health. A stylized picture of what“generational health drift” might look like: The review paper found: Rates of childhood overweight and obesity were highest among Gen Z. Rates of diabetes in the 40s almost doubled from 3.1% among the Baby Boomers to 5.9% in Generation X. Gen Z reported higher rates of poor mental health in adolescence compared to earlier-born groups. These UK results are consistent with studies showing worsening health across generations in the US as well. A 2021 US study found that more recently born cohorts had worse biological markers (like blood pressure and blood sugar) than earlier generations at the same age. A separate 2022 study of Americans aged 50 and over found that more recently born generations had a higher number of chronic diseases, with younger age of disease onset. A 2024 Lancet paper found that in the US, women born in 1945 had 33% obesity prevalence at age 50, rising to 48.2% for women born in 1970 turning 50. So what’s going on, and can we turn it around? We don’t have a definitive answer for what’s causing the deteriorating health of younger cohorts, but circumstantial evidence points to worsening trends in obesity and diabetes in both the US and UK. Remember that cohort trends reflect lagged effects of early environments, and younger generations have faced both earlier onset and more severe obesity across their lifetimes. Despite these very concerning trends, the future is not set in stone. We’ve reversed poor generational health trends before: drops in smoking are a major reason cancer and heart disease deaths fell so dramatically in recent decades. GLP-1 drugs may finally turn the tide against rising rates of obesity and diabetes, though it is still early days. But things could also get worse…for example from a return to higher levels of childhood infectious diseases that can have a lasting impact on health. See for example: [ ](https://jenndowd.substack.com/p/dont-you-forget-about-measles-the) [ Don’t You Forget About Me(asles): The Virus That Erases Immune Memory ](https://jenndowd.substack.com/p/dont-you-forget-about-measles-the) Jenn Dowd, PhD · March 24, 2025 [ Read full story ](https://jenndowd.substack.com/p/dont-you-forget-about-measles-the) Even as an optimist, emerging data on the “generational health drift” has my full attention. For most of my research career, we took it for granted that each generation would be healthier than the last. But if present trends continue, **50 could be the new 60….**and Gen Z celebrities will soon look older than Paul Rudd :). Stay well, Jenn Share the Health! If you found this post useful, please share it with a friend. Share
Paramount Center for the Arts announces October lineup
The Paramount Center for the Arts in St. Cloud has released its October schedule, featuring concerts, plays and art classes.
The lifelong habit that could slow ageing
Study probes usefulness of health parameter called ‘vitality capacity’ to understand ageing
Alibaba plans AI model with 5 trillion to 10 trillion parameters, unveils new chip
Alibaba Group plans to train a new artificial intelligence model with between 5 trillion and 10 trillion parameters, Chief Executive Eddie Wu said on Tuesday, as the Chinese technology giant outlined a sweeping strategy encompassing AI models, chips and data centres.
PUBLIC COMMENT — Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes
This proposed rule represents one of the most economically significant and socially beneficial deregulatory actions in HHS’s history.
Avera Health, USD, SDSU earn joint healthcare grant worth over $11m
It comes with a clear goal – break apart the walls separating research institutions to improve health outcomes for the people of the state.
David Ellison: Me, Move? I Love L.A.
After telling top lieutenants he was serious about relocating Paramount from its century-old home if the states' lawsuit proceed, the mogul has now changed tune.
How the Paramount-Warner settlement could change movies
Moviegoers and subscribers may see more films, and workers could benefit from new spending after Paramount-Warner Bros. merger.
How the Paramount-Warner settlement could change movies
Moviegoers and subscribers may see more films, and workers could benefit from new spending after Paramount-Warner Bros. merger.
What to know about Paramount's settlement and its impact on movies
Movie studio Paramount has agreed to settle an antitrust lawsuit filed by 12 states, the last big obstacle blocking the company’s $81 billion acquisition of Warner Bros. Discovery in a
Read Paramount CEO David Ellison's memo after settling WBD lawsuit
Paramount Skydance's CEO confirmed to employees that the company had settled the lawsuits that were holding up its deal to buy Warner Bros. Discovery.
Nicole Kidman urges fans to ‘demand’ a season 4 for ‘Lioness’: ‘We need loud voices’
Nicole Kidman weighs in on the shocking ‘Lioness’ season 3 finale and what might come next for the Paramount+ series.
Deal Terms Revealed: Paramount, 12 States Unveil Warner Bros. Settlement Plan
The settlement clears the way for Paramount and Warners to merge, creating an entertainment colossus.
Paramount reaches deal with states to settle their case challenging Warner buyout, AP source says
A person familiar with the matter told The Associated Press that Skydance-owned Paramount has reached a settlement with a group of state attorneys general that had sued to challenge the company’s...
State attorneys general agree to settle Paramount merger lawsuit
The state attorneys general suing to block Paramount’s acquisition of Warner Bros. Discovery, CNN’s parent company, have reached a settlement, clearing the way for the companies to complete the merger.
Aging Untold: Why gut health matters more as you age
On this episode of Aging Untold, we sort fact from fad when it comes to gut health, exploring why digestive wellness matters more as you age. Plus, we look at why some happily married couples stay together but choose to live in separate homes and how they make it work.
Aging Untold: Why gut health matters more as you age
On this episode of Aging Untold, we sort fact from fad when it comes to gut health, exploring why digestive wellness matters more as you age. Plus, we look at why some happily married couples stay together but choose to live in separate homes and how they make it work.
Aging Untold: Why gut health matters more as you age
On this episode of Aging Untold, we sort fact from fad when it comes to gut health, exploring why digestive wellness matters more as you age. Plus, we look at why some happily married couples stay together but choose to live in separate homes and how they make it work.
Aging Untold: Why gut health matters more as you age
On this episode of Aging Untold, we sort fact from fad when it comes to gut health, exploring why digestive wellness matters more as you age. Plus, we look at why some happily married couples stay together but choose to live in separate homes and how they make it work.
The Strange Politics of Giving Paraprofessionals More Money
NYC’s most under-paid educators got organized – and are now caught in a complicated political crossfire.
Paramount, attorneys general settle lawsuit, clearing a path for Warner Bros. merger
With the agreement, California Atty. General Rob Bonta and his coalition plan to withdraw historic lawsuit that aimed to derail the $111-billion deal.
Scientists teleport quantum states across 100 parallel optical channels
Quantum communication networks consist of several connected nodes that exchange information encoded in quantum states. These networks could potentially enable more secure communications between quantum ...
Paramount to Resolve Antitrust Lawsuit, Clearing the Way for Warner Bros. Acquisition
The deal would remove the last significant hurdle the media mogul David Ellison faced to create a news and entertainment empire, home to movie studios, HBO, CBS and CNN.
The Business School Paradox
Business schools should be more than trade schools. But you can't teach a profession without knowing how it is practiced.
Environmental science takes an average of seven years to influence international policy, study finds
A new study led by the University of Alicante (UA) and the Mediterranean Center for Environmental Studies (CEAM) analyzes the barriers separating scientific knowledge from environmental policy and its ...
The Netherlands is bracing for potentially devastating US sanctions against the ICC
The Netherlands is making preparations for the United States to sanction the International Criminal Court, in the last escalation of the Trump Administration’s attacks on the global tribunal.
Environmental Science Takes an Average of Seven Years to Influence International Policy, Study Finds
A study led by the University of Alicante (UA) and the Mediterranean Centre for Environmental Studies (CEAM) analyses the barriers separating scientific knowledge from environmental policy and its effective implementation.
Chubb names two digital heads to fill Ringsted's former remit
The insurer has split its global digital business into separate technology and partnership tracks, each with its own dedicated head
MORNING BUSINESS REPORT: Paramount settlement, parents rely on family for money, CT foliage rank
Paramount looks to settle antitrust lawsuits, more parents are relying on family to make ends meet, and where CT ranks for foliage. Here's the Morning Business Report for Sept. 21.
Celebrate Dolly Parton Day on 9/25 with parties, books and tattoos!
In honor of the iconic star and her song “9 to 5,” Sept. 25 has been dubbed “Dolly Parton Day.” Check out these Parton-inspired events to celebrate!
Parasites, often seen as villains, may help shape gut and metabolic health
Blastocystis has long been viewed mainly as a marker of parasitic infection. Emerging research suggests that its presence is not necessarily linked to disease, but may instead reflect greater microbial diversity and metabolic health in certain contexts.
US coffee chain Starbucks plans global tech centre in India
By Praveen Paramasivam CHENNAI, Sept 21 (Reuters) - US coffee chain Starbucks has signed a pact to set up a global capability centre (GCC) in the southern Indian city of
Paramount, California AG discuss concessions including $1.5 billion investment, WSJ reports
Sept 20 (Reuters) - Paramount and California's attorney general have discussed a range of concessions in advanced settlement negotiations, including a $1.5 billion investment in production in the
Stanford scientists discover the human brain may actually be two separate organs
Scientists have found that the human brain develops from two distinct cellular systems, suggesting that evolution fused together two ancient nervous systems with very different jobs. The discovery also allowed researchers to grow human hindbrain neurons in the lab, opening new possibilities for studying ALS, spinal muscular atrophy, and other brainstem diseases.
Merriam-Webster welcomes ‘looksmaxxing,’ ‘vibe coding’ and ‘cuffing season’ to new word list
Merriam-Webster added 1,400 new words including vibe coding, looksmaxxing, parasocial, rickroll and meme coin in a sweeping internet-age update.
Opposition grows to Paramount-Warner Bros. merger settlement as the Hollywood deal enters a critical week
Paramount-Warner Bros. merger deal faces a critical week ahead
Will There Be a “Lioness” Season 4? What We Know About the Paramount+ Series’ Future
The ‘Lioness’ season 3 finale aired on Sept. 20 and ended with a major twist
Why Is BP (LSE:BP.) Reshaping Its Business And Investment Approach Now?
BP (LSE:BP.) CEO outlined a new investment approach focused on more selective capital allocation across projects. Management is reorganising BP into separate upstream and downstream divisions to increase operational accountability and clarity. The group adjusted fuel deliveries and production in response to the recent Iran conflict, highlighting its operational flexibility. This new upstream and downstream structure, combined with tighter project selection, only captures part of what is...
In ‘Lioness’ finale: Arlington hospital, Fort Worth restaurant and more
The Paramount+ series has wrapped up its third season.
Analysis: Eagles unlucky to not gain win
This was a good test for boss Pierre Sage, with the Eagles playing on Thursday in the Europa League and having three days less preparation time than Leeds. Crystal Palace created the first chance of the match, only for Quinten Timber to fire over from 25 yards, before Adam Wharton and Tyrick Mitchell had their only other chances of note in the first half, with both strikes deflected and easily dealt with. Palace had conceded a late goal to lose 3-2 to Ipswich Town last weekend and it would have been harsh on them if something similar had happened here.
Nicolas Cage, 62, Reveals Striking White Hair and Beard Transformation With Wife Riko Shibata, 31
Martin O'Neill's post-match reaction on CelticPlayer
It was a disappointing afternoon in the East End of Glasgow for Celtic as Rangers ran out1-0 winners in the Glasgow derby.Ryan Naderi’s first-half goal was enough to separate the sides and give Dere...
Joey Cantillo thriving after Guardians use opener in his outings
Joey Cantillo began to struggle with his command, leading to a parade of walks. He's now finding out how the simplest solution might be best.
Mark Ruffalo urges California AG Rob Bonta not to 'cave' in Paramount-Warner Bros. merger fight
Mark Ruffalo urged California Attorney General Rob Bonta not to cave on settlement talks over the $110 billion Paramount-Warner Bros. Discovery merger.
Apple’s A20 Pro Demonstrated To Be An On-Device AI Beast, Can Run A 27B Parameter Model At Double The Speed Of The iPhone 17 Pro’s A19 Pro
Apple’s next-gen A20 Pro chip demonstrates groundbreaking on-device AI capabilities, running a massive 27B parameter model at double the speed of the iPhone 17 Pro's A19 Pro
Kyle Whittingham Makes Eye-Opening Tommy Carr Statement
Kyle Whittingham praised Michigan freshman QB Tommy Carr’s preparation and potential after his impressive debut against UTEP.
Trump Faced Loss After Loss. He Then Turned to a Familiar Target: The Press.
The president’s ban of three media outlets from the White House fits a pattern of using the apparatus of government to crack down on his perceived enemies.
Wanted: An Associate Attorney (5+ Years) and a Paralegal (10+ Years). Want to Put Us Out of Business? Come Help Us Try.
We need a lawyer who can find the defendant and a paralegal who can find the one page that matters. Marler Clark has been suing the companies that poison
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. 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Science Vs on the 49ers Substation: Anatomy of a Hatchet Job
In August, Pablo Torre Finds Out and Science Vs released an episode about my theory that electromagnetic fields from the electrical substation beside the 49ers facility may be contributing to the team’s run of soft-tissue injuries. As the originator of the theory, I was also a subject of the episode. I sat was interviewed by Wendy Zukerman and Rose Rimler of Sciene Vs. I sent them research, connected them with scientists, and spent hours digging through the City of Santa Clara’s and Silicon Valley Power’s records to help clarify critical details. Both Wendy and Rose came off as affable and professional, showing curiosity during the interviews, with Wendy going out of her way to question the “conspiracy theory” framing itself. Then they titled the episode We Solve the 49ers Viral Conspiracy Theory. I was familiar enough with their catalog that I never expected them to agree with my theory, but I did expect them to give it a fair hearing and to deliver their findings honestly. On both counts they came up short. They were not directly dishonest in anything they said, but rather in what they left out, in how what remained was cut, and in the picture painted by those two things in combination. They asked me to recorded the interview on my phone for better audio quality, and I held on to my copy for reference later. That turned out to be a fortuitous decision. Here is the raw audio of my first interview, unedited*. Only my side was recorded, so their questions aren’t on it, but you can generally infer them from the answers, and every claim I make below about what I said can be checked against my statements in this clip. (Note: Wendy had connection trouble at the beginning of the interview and was cutting in and out, which accounts for the false starts.) 0:00 -1:19:13 Audio playback is not supported on your browser. Please upgrade. Science Vs is a fun show. It is pitched at roughly a high-school understanding of science, for an audience that is skeptical, Snopes-oriented, and worried about misinformation. Take a claim circulating online, interview a supporter of the claim, interview consensus scientists, and then tell people which side of the line it lands on. I have listened to their episodes on raw milk, seed oils, 5G and other contested issues in the wellness space. I have problems with all of them, but each at least made an honest attempt to represent the actual range of scientific opinion by talking to credentialed scientists with differing perspectives. Dissenting researchers were heard from, answered, and often given a chance to respond. This episode did not do that. This article is not a relitigation of the science. I have written extensively about that already. This post is for the record. It is simply an accounting of what was wrong with their episode. Contents Is there a power plant next to the 49ers practice facility? — the clearest single example of getting something objectively wrong For the record — a high-level overview of all of the problems with their investigation Draw your own conclusions — why they had to make this episode at all What they left out about childhood leukemia — the exposure threshold, and playing games with statistics to minimize sick children What they left out about the mechanism — the body of literature they refused to cover, and evidence for the mechanism used against it The scientists Science Vs interviewed and did not air — four credential scientists who support myhe theory, recorded and cut, or not even called How they misrepresented me and my case — an answer severed from its question, and three telling edits How you would actually study the injuries — it doesn’t actually matter which team is the most injured, overall The theory: magnetic fields, oxidative stress, and collagen Since the episode never states my theory, here it is below. Those who are familiar with my work can skip this section. Electrical equipment produces magnetic fields, and those fields induce faint electrical currents in anything that passes through them, including people. My argument goes further than induced current. Mitochondria — the structures that generate a cell’s energy — run on continuous flows of electrons and protons, and those flows carry faint electromagnetic fields of their own. Maxwell’s principle of superposition shows that when two fields share the same space, they add together. An external field does not need to be strong to alter an internal field, it only needs to be present. The electron transport chain inside the mitochondria leaks a small fraction of its electrons by design, and those become reactive oxygen species — free radicals, which healthy cells use as signals. External magnetic fields cause the rate of leakage to change, increasing free radicals. When free radicals accumulate faster than the cell’s antioxidant systems can clear them, the result is oxidative stress. Oxidative stress is a recognized driver of chronic illness, including cardiovascular disease, neurodegeneration, diabetes and cancer, and it is in every medical school curriculum. One of its ordinary effects in connective tissue is that it switches on matrix metalloproteinases — MMPs, the enzymes that break collagen apart — while suppressing new collagen synthesis. Tendons are made of collagen. An athlete loading his soft tissue heavily six days a week is already creating oxidative stress in the tendons, so the addition of magnetic field exposure compounds the damage and inhibits repair, making him more susceptible to injury when enormous force lands on a tendon in a fraction of a second. That is the theory. We know that EMF causes oxidative stress, and we know that oxidative stress degrades collagen. The only thing missing is a study showing that direct connection. I have never claimed certainty that the substation is contributing to the elevated injury rate. I do believe it is likely, and I believe it warrants caution, and that a revenue machine like a major NFL team can easily afford to remove the exposure out of precaution. Is there a power plant next to the 49ers practice facility? Here is the clearest single instance of the problem with this episode. It requires no knowledge of electromagnetic fields at all. This story first came to me through Jon Feliciano, a former 49er, in an interview on Willard & Dibs on 95.7 The Game. Asked about why the 49ers are always injured, he said players used to joke that it was the power plant behind the practice fields. Wendy Zukerman corrects him on air. “It’s important to say that it’s not a power plant near the 49ers site.” Torre then asks her to explain the difference between a substation and a power plant. Her answer: a power plant generates electricity and transmits it to a substation, which converts the voltage into something your house can use and sends it on to your home or your business. There are two problems with that. The first is that there is a power plant on that site. The Gianera Generating Station is a natural-gas-fired peaker plant owned by Silicon Valley Power, and it has been there since 1986. I have published aerial photographs of the location from 1987 in which the gas plant is the only thing standing, before the practice facility was even there. I even mentioned the gas plant in my first interview. (Feliciano has since gone on record about this issue, and it is clear he had the substation in mind rather than the gas plant.) The second is that her definition describes a distribution substation, and the facility beside the 49ers is not that. It is the Northern Receiving Station, which takes in bulk power from outside the city’s grid and delivers it to distribution substations. Silicon Valley Power’s own map distinguishes receiving stations from substations, and Rose Rimler even reads the label out loud in the episode when she walks through that map on air. A few minutes before the map segment, Zukerman tells Torre: “like I said, we fact check everything.” Well, maybe not everything. I made a mistake On the morning of July 6th, at 10:20, I sent Rose and Wendy two studies. During the interview I had been asked which human studies show oxidative stress from electromagnetic fields, and I had not been able to name one on the spot. Rose emailed asking for the studies, I quickly searched for a couple, and I wrote that I thought these were the most relevant from that search. Unfortunately, I was busy and did not read either one closely at first. I picked them because they were topically relevant — one on substation workers, one on power plant workers. Neither were great studies, and their problems go past the ones raised in the episode. That was careless on my part. There is context that did not make the episode, though. Before that email I had been on a Zoom call with Rose talking about EMF and oxidative stress, and I pointed her to Dr. Henry Lai at the University of Washington, who has spent years aggregating the literature on this question. His tallies show that roughly 90% of studies since the late 1990s find oxidative effects from electromagnetic field exposure — hundreds of studies, systematically counted. Rose told me she was already aware of his work. So when she asked for studies, I understood her to have the aggregate view already and that she would report anything within that context. Not reading those two carefully was still a mistake, but the larger mistake was assuming the episode would be based on a thorough review of the actual body of literature, rather than on whatever I happened to send that morning. The second email At 1:49 that same afternoon — three hours and twenty-nine minutes after the first — I sent them a second email that I had been preparing for a while. It was a structured document in six numbered sections, written in response to a request they had made two weeks earlier, laying out my entire argument with citations attached to every link in the chain. The episode aired on August 13th, five weeks later, and not a single item from the second email is in it. Here is how it opens: The full email is included at the bottom of this post in Appendix B. Nearly 1,500 words in total. It contains two named mechanisms with the physics behind them. Occupational studies in humans. The literature on oxidative stress and collagen. A section addressing the strongest counter-evidence against my own theory, which I raised myself. And a closing section stating plainly what the theory cannot yet show. My entire argument, in writing, with detailed citations for every claim, provided to them five weeks before broadcast, and none of it made it into the episode. That is the single largest omission, but it is not an isolated one. The whole episode is riddled with similar problems, and the conclusion they came to is not merely a difference of opinion about the scientific evidence. Through omission and through strategic editing, Science Vs misinformed its audience — about what the evidence shows, about what I argued, and about who they spoke to. That is a notable outcome for a show whose stated purpose is correcting misinformation. For the record I am not going to tell you that Science Vs set out to discredit me, or that they had come to their conclusion before they reported the story, or that they used misleading editing to make me look like a man retreating from his own theory. I cannot know what was in anyone’s head, and I am not going to pretend otherwise, either. What I can tell you is what is on the record. They asked me for evidence and aired the weakest thing I sent. They interviewed three scientists who supported my theory and aired none of them. They discussed childhood leukemia without ever saying the exposure level at which it appears. And they took an answer I gave weeks before Ken Karipidis, the one EMF scientist who was put on air, was interviewed, and placed it directly after his critique, where it comes off as a major concession. A friend of mine who has worked as a journalist for thirty years read that last one and called it sleazy. I agree with her. Those are just the four issues that are impossible to defend as pure editorial decision, but they are not the only issues. The most glaring issues stem from what they left out: The exposure level at which the childhood leukemia association actually appears — three to four milligauss, a number the episode never states despite it being much lower than what I measured. The mechanism itself: The episode gets as far as “oxidative stress could weaken collagen,” which leaves it sounding like speculation, rather than a known pathway. The second email, and all the studies in it. Dr. Paul Héroux at McGill, whose work my proposed mechanism rests on, whose contact details I supplied, and who was never called. Dr. Beatrice Golomb at UC San Diego, who runs a research group on oxidative stress and mitochondrial function and has specific expdertice in collagen, interviewed and not aired. Dr. David Carpenter at Albany, the most prominent academic voice on the harm from magnetic field exposure, interviewed and not aired. Dr. Joel Moskowitz at Berkeley, interviewed and not even credited. The specific, testable condition I put in writing that would make me abandon the theory. My own unprompted statement of the theory’s evidentiary gap. My caveats about my own measurements. My ranking of EMF as one factor among several rather than the only one. The new equipment installed at those facilities between 2010 and 2014, and the sharp rise in system load from 2013 onward. But that is not all. What they kept, they selectively edited to serve a narrative that was not served by the raw transcripts of the interviews. A description of thousands of commercial routers in a workplace, reduced to the Wi-Fi in your house. My own acknowledgment, multiple times, that "I'm not a scientist" clipped in an episode that spends considerable energy pointing out that I am not a scientist. And a qualification I volunteered about my own measurements, cut from my answer and delivered later by their EMF expert as a correction. Together their edit produce a portrait of a wellness guy with Wi-Fi phobia and two bad studies, backing away from his theory the moment a “real” scientist looked at it. A practice facility where nothing changed because no new substation was built. Injuries written off as random because the 49ers were not quite the single most injured team in the league over the period in question. That portrait is false even though almost no individual statement made in the episode is. Draw your own conclusions At the top of the episode, Pablo Torre says his show had been flooded with requests to investigate the substation — that it was the thing they were asked to look into over and over again. Neither show went hunting for this story. It arrived from their own audience, in volume, and it could not be waved off. A thread I posted on X reached twenty-two million people. A guy with a gaussmeter and a brand-new Substack obligated a Pultizer prize winning program to spend an hour on a question about player health, that is considered fringe enough that most media operations won’t touch it. Pablo Torre Finds Out could not ignore it. So Science Vs came in and ran a “debunking” operation instead of an investigation. Everything below is what had to be left on the cutting room floor to deliver the “debunking”. They could not ignore it. So they tried debunked it instead. The demand was strong enough to force an episode, and since the episodes release the 49ers have sustained more injuries, including season ending ones, and interest has only grown. Demand from fans and playets is strong enough to force a better investigation from someone else. An omission is not a lie until you find out what was omitted. What follows is the detailed record so you can see the full picture. Draw your own conclusions. I have drawn mine. I am going to keep publishing. A note about Pablo Torre Finds Out After the episode aired I posted publicly, calling out Pablo Torre Finds Out for concerns I had about the integrity of their investigation, and about an interview directly with Pablo Torre which had been offered but never happened. I have since spoken with a producer at PTFO. The offer had rested on a misunderstanding about where things stood between us, and it fell away as the Science Vs part of the production widened past the science. He apologized for the miscommunication and I accepted. The producer also confirmed to me that they did essentially hand off the entire investigation to Science Vs for narrative purposes — so Pablo would be genuinely curious or potentially surprised by their findings — while still taking responsibility for what went out under their name. I appreciated the candor and the accountability, and I am comfortable with where we left things. So this post is not about PTFO. My disagreement is with Science Vs. What they left out about childhood leukemia Childhood leukemia appears at three milligauss. They gave no number at all. 1. They built an EMF ruler, then discussed childhood cancer without it. The sequence on air went like this: First I measured almost 9 mG, then I measured up to 50 milligauss. Torre reacts with concern — “that sounds high.” Cut to Karipidis: the public limit is 2,000 milligauss. Torre reacts again — “What happens at 2,000?” Karipidis explains that nothing happens at 2,000, that safety factors are built in. Then: at more than 50,000 milligauss you get flickers of light in the retina, and higher still, nerve stimulation. The listener now has a ruler (their ruler) to measure these numbers with. Fifty is nothing by their ruler. Then the episode turns to childhood leukemia and states, accurately, that there is a real association — but tellingly, they never give the exposure level at which that association appears. Childhood leukemia appears at three milligauss. They conveniently left that out. The pooled analyses that produced the World Health Organization’s carcinogen classification found roughly a doubling of childhood leukemia risk above three to four milligauss. That is the number that belongs in that segment, and it is more than ten times below the reading that had just been dismissed as trivial. I gave them that number myself, on tape, in the interview. Describing my own threshold, I said my comfort level for long-term chronic exposure is three to four milligauss, but preferably one. 2. Six children in thirteen million. The episode reports that these fields might explain one to four percent of childhood leukemias, then reframes it as a German estimate of perhaps six cases among thirteen million children. Torre, to his credit, is uncomfortable. What never gets explained is why that number is small. Almost no children lives above three milligauss in Europe. Fewer than two children in a hundred, in the Italian data. So even if the risk to those children doubles, the number of additional cases across an entire country stays small — not because the hazard is small, but because hardly anyone is exposed to it. Count the whole population and the few who are exposed disappear. And the reason hardly anyone is exposed is that siting rules keep housing away from transmission lines. In Europe, at least. The Dutch government has a standing precautionary policy against building new homes in any zone where the annual average magnetic field exceeds 4 milligauss — the same number the episode never mentioned. Denmark and Norway treat 4 milligauss as the level that triggers a look at mitigation. That is five hundred times below the ICNIRP figure quoted on air. The United States has no federal equivalent. That is evidence of infrastructure siting policy working. It is not evidence that there is no hazard. It is evidence that we already act as though there is one. If you listen to the raw audio you will hear that my proposed solution is EMF exposure is to build better infrastructure. What they left out about the mechanism 3. They accused me of cherry-picking, and then cherry-picked themselves. On air, Zukerman tells Torre that people who worry about electromagnetic fields dismiss the studies showing null results and collect the ones showing harm, and that this is why you have to be careful not to cherry-pick. They had two papers I had rattled off in a hurry, and a second email containing a carefully chosen set. They ran the two weakest, graded them on air, and presented the result as the state of the evidence for not only my theory, but the whole question of oxidative stress from magnetic fields. That is cherry-picking from my emails. The bigger picture is what they did with the literature as a whole. Zukerman acknowledges it exists, dismisses it, and disposes of it in a single stroke. You can go online right now, she tells Torre, and find scores of studies showing these fields increase oxidative stress. The issue, she says, is that they are not studies in people. Many of them are in people. The occupational studies in my second email are in people. That email had been in her inbox for five weeks. She waved off the literature on a factual claim that the documents in her possession contradict. (I have written separately about the evidentiary standard at work here). The effect was that they essentially baited me: ask the subject to supply the evidence, take the weakest thing he sends, and let that stand as a proxy for the whole argument. Wendy has been doing this show for ten years and clearly knows how to extract what she needs for her desired narrative. 4. They presented the collagen-improvement research as a gotcha, but I had already addressed it. The episode treats the existence of studies showing that EMF can improve collagen as a surprise that undercuts me, but I had pre-emptively addressed that five weeks earlier in the email they ignored. Those studies use measured, high-intensity pulsed dosing. The mechanism by which they work is oxidative signalling. The cell reads a controlled rise in reactive oxygen species as a warning, upregulates its antioxidant defenses, mounts a repair response, and the therapy stops before the system is overwhelmed. The key point is that it induces an oxidative response, which means those studies are actually evidence for my proposed mechanism, not against it. A field that produces a therapeutic effect cannot be biologically inert (which is the implication when they say “Nothing happens at 2,000 milligauss). Chronic ambient exposure is the same pathway with no off switch, and it is most consequential during the evening and while sleeping, when the body is in repair mode and the exposure does not stop. Section 5 of my email is titled What about the study showing improved collagen synthesis. I raised the counter-evidence myself, explained why I did not think it refuted the theory, and wrote that I was disappointed the question had not come up in the interview. That is worth holding against the cherry-picking charge in the item above: the studies they presented as inconvenient for me were studies I had gone out of my way to put in front of them. 5. Section 1 of my email stated a critical argument that was never put to the expert directly responsible for it. My email says the exposure limits exist to prevent acute effects and do not address chronic exposure at all, and that my dispute is with the entire framework. Zukerman gestures at this once. After Karipidis gives the 2,000 milligauss figure, she tells Torre that I would object because those levels do not capture “more subtle effects.” That is not my argument, and “subtle” is doing a lot of work here. My argument is that the limits are built to prevent acute effects — nerves firing, muscles twitching, etc — and were not designed to address chronic exposure at all. In fact, ICNIRP’s own documents state as much themselves. Mine is a structural objection to what the standard measures, reduced as a concern about subtlety, it becomes a matter of degree, rather than a categorical difference. They interviewed Ken Karipidis, vice chair of ICNIRP — the body that writes those limits. He was asked what the limit is, but he was never asked how it applies to chronic exposure. The scientists Science Vs interviewed and did not air 6. They interviewed four officials of the standards body. The episode credits roughly a dozen researchers. Four of them are associated with ICNIRP. Ken Karipidis is the vice chair. Rodney Croft chaired ICNIRP from 2020 to 2024 and led the development of its current guidelines. Dan Baaken is ICNIRP’s scientific secretary. Frank de Vocht sits on the Main Commission. One of them speaks in the episode. Their institution’s position is more than adequately represented — the 2,000 milligauss figure, the safety factors, the assurance that nothing happens below the line. 7. The four who were left out. Dr. Beatrice Golomb is Professor of Medicine at UC San Diego — a physics undergraduate degree, a PhD in biology, an MD. She directs a research group whose stated focus is the relationship between oxidative stress, mitochondrial function and health. That is the mechanism the episode spent its first half dismissing. Her published work includes the fluoroquinolone case series behind the FDA’s black box warning on an antibiotic class that ruptures tendons, where the accepted mechanism is oxidative stress and mitochondrial toxicity — the back half of my chain, already on a drug label. She is in the credits. She is not in the episode. She has told me she finds my theory biologically plausible, and that she has a recording of her interview. Dr. David Carpenter directed the Institute for Health and the Environment at the University at Albany for decades and is the most prominent academic voice arguing these fields cause harm. Childhood leukemia is the reason these fields carry a WHO classification at all, and Carpenter is the person you call if you want that case made by someone who has spent a career on it. He is in the credits. He is not in the episode. He has told me that when he was interviewed they could not have been less interested in what he had to say. Dr. Joel Moskowitz directs the Center for Family and Community Health at UC Berkeley’s School of Public Health. He told me directly that they interviewed him and that he thought it went well. He does not appear in the episode, and unlike Golomb and Carpenter, he does not even appear in the credits. Dr. Paul Héroux at McGill is the researcher whose work provides the foundation for the oxidative stress mechanism my theory rests on. I gave Rose his email address and phone number. He was never interviewed. They never even called him. 8. “He’s not a scientist.” The episode leans hard on the fact that I am not a credentialed scientist. Zukerman says it. Torre repeats it. “At all.” Having built a segment on that, they then left out the physicist-biologist-physician, the professor of public health, the director of a university environmental health institute, and the McGill researcher whose work the primary mechanism comes from. They spent the episode telling their audience I am not a scientist, and then kept four actual scientists who support the theory off because their argument does not survive otherwise. How they misrepresented me and my case 9. They played my words as a response to an interview I had never heard. Near the end of the hour, Zukerman says she went to me and told me the evidence was lacking. Then she plays me saying I am not wedded to it being an EMF, that I have staked my reputation on it needing more study, and that I am not certain of anything. That segment was placed immediately after Karipidis had finished taking the cherry-picked papers apart. It plays as a man folding under expert scrutiny. Commenters have used it against me since, but it is incorrect. Here is the sequence as it happened. I was interviewed. Karipidis was interviewed weeks later. I was never told what he said, or even who he was. I was never asked to respond to it. I did not know his name until the episode aired. That is not a simple editing decision. That is a quote from one interview, moved to follow a critique from a different interview it was not a response to, so that it would land as a concession. A friend of mine who has spent thirty years as a journalist read that sequence and called it sleazy. She is right. The full passage is reproduced in Appendix A, and it is worth reading. What airs is the preamble. Four paragraphs later I say “to directly answer your question” — and that answer, about what would change my mind if the team relocated, is not in the episode. Neither is the sentence two paragraphs on, where I say the EMF might turn out to be ten percent of the problem. I will say the underlying point again, though, because I meant it and I still do. I am not wedded to my theory that magnetic fields from the substation are contributing to the 49ers injuries. I could be wrong. What I am wedded to is the process of scientific inquiry, and the fact that we should be cautious around these exposures and we need more independently funded studies. 10. Three telling edits. They cut “I’m not a scientist” mid-sentence. What I said: “...and I am not certain of anything. I’m not a scientist. To me, I find the mechanisms compelling. I will go back to the fact that I got into this not because of the 49ers, but because of clients I was working with who suffer from EDS...” What aired: “...and that I am not certain of anything. I’m not.” The clip ends on the first two words of the sentence in which I say I am not a scientist, in an episode that spends considerable energy establishing that I am not a scientist. The full sequence is in Appendix A. They cut my own description of my work. Asked what I do, I said I run a wellness business, that I am focused on writing software to help people navigate environmental stressors, that environmental health is my focus, and that I also do independent journalism and research. What aired is the wellness business and the environmental health, with the software and the journalism removed from my own answer. The software engineering does come up later — narrated by them, as a hacker who grew up to write firmware — but my current work, in my own words, arrives as “wellness guy.” Thousands of commercial routers became home Wi-Fi. What I described: working at a wireless networking company surrounded by thousands of Wi-Fi routers, and a stress-induced health collapse afterward that working in that environment contributed to. What aired: Wi-Fi, the kind you have at home — reinforced by a clip of Christian McCaffrey talking about turning his router off at night. Three cuts, and every one of them makes me seem less credible. That is not a coincidence. 11. I gave them my own caveats and the test that would disprove me. In the first email I wrote that a well-designed chronic, ambient-level exposure study in tendon showing no collagen degradation, run over many months, would undercut my confidence in the theory. That is a specific, testable condition, stated in advance and in writing. There was a second interview, weeks later, which was not used in the episode, but in that I asked again for the falsification criterion to be included. What the episode presents instead is a man saying “we need more study,” which reads as a hedge, an open-ended request for the benefit of the doubt. It is the opposite of a hedge. Section 6 of my second email says, unprompted, that as far as I am aware there is not a single study showing EMF-driven oxidative stress degrading collagen in a human in vivo or in human tendon in a lab. I wrote that because it is true and because it is the first thing anyone should check. Under their standard it becomes the hinge of the entire first half, framed as something they had to surface without my cooperation. I had handed it to them five weeks earlier. And in the interview I said that my 25 to 50 milligauss readings were taken at knee level, and that these fields attenuate quickly, so by the time it reaches your head it is not that high anymore. That did not air either. The qualification arrives later, from Karipidis, as a correction. How you would actually study the injuries 12. They measured the wrong thing. The episode spends its final act on whether the 49ers are the most injured team in the NFL, finds no clean ranking, and lands on “injuries are random”. That is the wrong test. You would define the exposure — measured field levels at the facility — and the outcome narrowly: soft-tissue injuries, not a single MSK injury count that a broken finger and a ruptured Achilles both land in. Then you would compare the 49ers to themselves before and after the exposure changed, and compare that change against every other team over the same window. That controls for league-wide shifts in rules, turf and training load. It is a difference-in-differences design, and it is standard. I sent them that argument on July 28th, in writing, along with the fact that in eleven of the past twelve seasons the 49ers had finished top ten in Adjusted Games Lost. And by the episode’s own reporting, the 49ers are second in games lost to injury over the past decade, with FTN’s Aaron Schatz confirming that once you adjust for starters they come out second worst in the league — after having been one of the healthiest teams for years before that. A finding like that is where an investigation starts, not where it stops. 13. I did a lot of substation research for the episode that was never aired. I had reported that the substation next to the facility was expanded in 2014. That was wrong, and Rose Rimler and I sorted it out together. They gave me credit on air, which I appreciated, but framed it as a concession on my part to something they had found. In fact I had been investigating it myself, was uncertain before they asked, but was waiting for clarification from Silicon Valley Power. The uncertainty centered around a substation named “Esparanca” that was proposed right behind the facilities as part of the stadium construction, but now appears to never have been built. I spent days in Silicon Valley Power’s records, and did eventually reach Silicon Valley Power for confirmation and indentified the mistake myself. I also gave them highly detailed documents on what we do know about those facilities: new equipment installed between 2010 and 2014, and load growth across the system with an inflection around 2013–2014, with the Northern Receiving Station carrying the highest capacity in the system and sitting closest to the data center corridor. None of that is in the episode. I have a separate piece about it coming out soon. *I cut 2 seconds from the raw audio to remove personal information that had no connection to anything in the episode. Appendix A: the passage the clip was taken from This is the sequence from my first interview, in full. The episode uses one fragment of it. It’s tricky because my understanding is that there’s something like a 15-year half-life on collagen remodeling issues. They’re going to get a new crop of players. What I really need, though, is for the injuries to be broken down so we can see the soft tissue injuries. Right now, they’re categorized as MSK injuries, but let’s say we can actually identify them more specifically. Is that right? He was able to do that? Oh, cool. I wasn’t able to find that information. Interesting — I didn’t know that data existed. I tried so hard to get it, and I didn’t know it was available. Maybe you could connect me with that person. That would be amazing. I’m not wedded to it being an EMF, honestly. I’m not. I would say that, to a certain extent, I’ve staked my reputation on the fact that it needs more study. It’s important to look into it, and I am not certain of anything. I’m not a scientist. To me, I find the mechanisms compelling. I will go back to the fact that I got into this not because of the 49ers, but because of clients I was working with who suffer from EDS, Ehlers-Danlos Syndrome, a tendon hypermobility issue. This condition is documented to be partially caused by oxidative stress. I’ve worked with them to mitigate their EMF exposure and have seen people improve. I think it’s a bigger story. In a way, the 49ers represent an occupational cluster with specific exposure risks. If someone would conduct a study on this, I believe we could learn a lot. Perhaps we would discover that it’s like, okay, maybe it’s 10% of the problem. I don’t know the exact number, but I think either way, conducting the study would provide valuable insights. To directly answer your question, it’s challenging for me because it’s part of a bigger story. If the 49ers move and stop having injuries, I might conclude that it was related to the substation. However, if they move and still experience injuries, I would want to analyze the nature of those injuries. Are they primarily soft tissue injuries? I don’t think it’s necessarily a case closed, but the story might lose traction at that point regardless. Three things are worth noting. The aired fragment stops immediately before the sentence in which I say I am not a scientist — the cut described in item 10. It also stops four paragraphs before the words “to directly answer your question.” What the episode plays is the throat-clearing. The actual answer, about what would change my mind, never airs. And two paragraphs in, I say the EMF might turn out to be ten percent of the problem. That is the ranking the episode says I never gave. Appendix B: the full email, July 6th, 1:39 PM Hi Rose, You asked me to send you some studies a couple of weeks ago. I apologize for the delay. I have been incredibly busy. I also wanted to give you a chance to dig in yourself, and get your own perspective before I influenced you too much with mine. That said, I do want to make sure that the actual argument is abundantly clear, so here it is! One note before I begin, there are really two separate questions here: Does the substation cause the soft-tissue injuries? That was my specific claim, and what the podcast is about. Is the theory biologically sound? Can 50/60 Hz fields at these levels do anything biological below the safety limits? Question two is why people have been calling me a conspiracy theorist. The regulatory and advisory bodies (ICNIRP, etc) maintain that anything below their exposure limits is biologically inert, and that position is broadly accepted within the mainstream, but the actual science paints a different picture. To defend my theory I’ve had to defend a much larger claim: that the advisory bodies have the biology wrong. I can’t honestly answer question 1 without first addressing that. Here’s is a simplified outline of my theory, with links to studies: 1. Advisory body thresholds for biological effects The ELF magnetic-field limits (ICNIRP’s ~2,000 mG public / 10,000 mG occupational) exist to prevent acute effects from exposure. If a magnetic field is strong enough, it makes nerves fire and muscles contract. Muscles twitch. You can see faint flashes of light in your vision. People can even feel tingling or even a shock. That happens due to Faraday’s law, which states that a time-varying magnetic field induces an electric field inside the body via the creation of Eddy currents.The standards assume that those currents do nothing below the twitch threshold. They do not consider chronic effects at all. My argument is that they are biologically active and do have chronic effects. 2. There are multipe ELF-EMF mechanisms for inducing oxidative stress. This is basic biophysics. Below are the two primary mechanisms. Simplest first. Dr. Paul Héroux of McGill has the most intuitive explanation, which rests on Maxwell’s principle of superposition: because Maxwell’s equations are linear, two sets of electromagnetic waves sharing the same space simply add together. In the interview I pictured a pebble dropped into a pond, sending out clean ripples. Then a boat motors past at distance, sending larger waves, and where they meet the ripples, the two add together and the original pattern gets distorted. In our cells, the mitochondria run on continuous currents of electrons and protons that carry their own faint electromagnetic fields. An external field from a substation, by the principle of superposition, adds to those internal currents and shifts the pattern. The electron transport chain in the mitochondria leaks a fraction of its electrons by design as reactive oxygen species (ROS), which act as signalling molecules in a healthy cell. Distorting that field increases that electron leakage, creating oxidative stress. A tiny electromagnetic interference results in a large downstream effect. https://www.sciencedirect.com/science/article/pii/S2405844025006474 The more complex pathway is Dimitris Panagopoulos’s Ion Forced-Oscillation / Voltage-Gated Ion Channel (IFO-VGIC) mechanism. Weak, polarized, low-frequency fields force the ions (calcium, potassium, sodium) next to an ion channel’s voltage sensor to oscillate; because that force scales with the inverse cube of the distance involved, fields far below the stimulation threshold can still force the channel open, disrupting the cell’s ion balance and driving ROS overproduction (Nitric oxide and superoxide interact and produce peroxynitrite, a highly unstable cytotoxin that breaks down into free radicals). https://www.researchgate.net/publication/366088934 https://www.spandidos-publications.com/ijo/59/5/92 https://www.mdpi.com/1422-0067/22/18/10041 https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1585441/full https://pmc.ncbi.nlm.nih.gov/articles/PMC3772193/ 3. Evidence of oxidative stress, in vivo, in humans from ELF-EMF There are many studies, and the strongest are occupational, which applies to the 49ers situation. 115 power-plant workers vs. 145 office controls. Serum malondialdehyde (MDA, the standard lipid-peroxidation marker), superoxide dismutase, and catalase were all significantly higher in the exposed group, and the markers rose with increasing field exposure. https://journals.sagepub.com/doi/abs/10.3233/WOR-203244 A follow-up where they reversed the oxidative stress in power plant workers. A double-blind randomized controlled trial: 91 power-plant workers given vitamin E, vitamin C, both, or placebo for 90 days. The antioxidant groups showed reduced lipid peroxidation and raised antioxidant capacity versus controls. https://pubmed.ncbi.nlm.nih.gov/32191586/ A spot-welder study: 46 welders occupationally exposed at 50 Hz, showed significantly altered red-blood-cell antioxidant enzyme activity and concluded ELF-MF “might act as an oxidative stressor… even at the recommended levels of exposure.” https://pubmed.ncbi.nlm.nih.gov/18504600/ A substation-specific study found oxidative stress and DNA damage https://pubmed.ncbi.nlm.nih.gov/24460415/ 4. Oxidative stress degrades collagen This half isn’t controversial at all. Oxidative stress activates the matrix metalloproteinases (MMPs) that break collagen down and suppresses its synthesis. Here are three example studies: Siwik et al. 2001: Oxidative stress raises MMPs and lowers collagen synthesis in cardiac fibroblasts. https://pubmed.ncbi.nlm.nih.gov/11121376/ Fisher et al. 2009: Collagen fragmentation drives oxidative stress and elevates MMP-1 in aged human skin. https://pmc.ncbi.nlm.nih.gov/articles/PMC2631323/ Varani et al. 2006: Decreased collagen production in oxidatively aged skin. https://pubmed.ncbi.nlm.nih.gov/16723701/ 5. What about the study showing improved collagen synthesis I’m glad you asked this question, and I’m bummed we didn’t get to it in the interview because it is a great question, and very important to understand. Superficially it may appear to be a refutation of my theory, but I would argue that it actually supports the underlying argument. That study used a short, high-intensity pulsed dose: therapeutic-PEMF, the same type of field used clinically to stimulate bone and tissue healing. The reason this works is because it triggers the very same biological pathways that can lead to oxidative stress. The exposure still stimulates ROS production, but done at a controlled dosage, for a limited duration it has a different effect. The cell reads the ROS as a warning signal and it upregulates its antioxidant defenses, and mounts a repair/proliferation response. The therapy is then stopped before the cell gets overwhelmed. That is essentially a hormetic response: a small dose of a stressor producing a beneficial adaptation. Two things follow: At the very least, this means the field is biologically active, which by itself undercuts the regulatory claim that these fields are inert below their thresholds. There is a wealth of literature on PEMF (pulsed EMF) bone regeneration and calcium channel signalling (which is the second mechanims in section one). Here is one. https://www.nature.com/articles/srep13856 At best, it leads us straight to my actual concern, which is that under chronic, chaotic and unregulated exposure, the cell’s antioxidant capacity gets overwhelmed, resulting in oxidative stress. There are plentiful examples of things that are beneficial at controlled doses, but harmful at uncontrolled doses. Excecise is one obvious, uncontroversial example. Botox is perhaps a more interesting example. 6. What about a study that shows EMF causing collagen degradation in humans? As far as I am aware there is not a single study showing EMF-driven oxidative stress degrading collagen in a human, in vivo, or in human tendon in a lab. There are studies involving isolated fibroblasts though, which secrete collagen. The most relevant one showed that human fetal scleral fibroblasts exposed to 50 Hz ELF-EMF showed a significant decrease in collagen synthesis and that MMP-2 expression was upregulated, which is the exact mechanism I described in section 2. https://pmc.ncbi.nlm.nih.gov/articles/PMC3626379/ That’s it! Thanks again for the interview. Best, Peter Anthony Cowan Environmental Health · Wellness Tech · Researcher & Journalist Publisher & Editor, Living Energy Bio: petercowan.comSocial: X · Instagram · TikTokApp: sunlightis.lifePhone: [redacted]
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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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Session 3 of the 100-Day Sprint BackgroundOral diseases remain among the most prevalent noncommunicable diseases (NCDs) across Asia, affecting people throughout the life course and placing a significant burden on individuals, families and health systems. Countries across the World Health Organization (WHO) Western Pacific Region and South-East Asia Region have committed to strengthening oral health through regional action plans and by advancing universal health coverage (UHC). The 16th Asian Chief Dental Officers Meeting (ACDOM) serves as a regional platform for Chief Dental Officers in Asia to exchange experiences, strengthen collaboration and accelerate implementation of oral health commitments. For the first time, the meeting is being jointly organized by the WHO Regional Offices for South-East Asia and for the Western Pacific and the ACDOM Secretariat. This year's meeting introduces a 100-Day Sprint, bringing together oral health and UHC leads and technical experts to support countries in strengthening integration of oral health within national UHC benefit packages. Through the Sprint, participating countries will develop, refine, cost and operationalize country-specific essential oral health-care benefit packages using WHO tools, including the Service Package Delivery and Implementation (SPDI) Platform. The in-person 16th Asian Chief Dental Officers Meeting represents Session 3 and the midpoint of the 100-Day Sprint, providing an opportunity for countries to review progress, exchange experiences, identify challenges and refine their approaches before continuing with the remaining Sprint sessions. 100-Day SprintSession Date Format Title Session 1 (Day 0) 19 Aug Virtual Setting the Scene and Introducing Key Principles and Frameworks Session 2 16 SepVirtual Introduction to the SPDI Platform and Initial Mapping Exercise Session 3 27-29 Sep In-person, 16th Asian Chief Dental Officer Meeting, Malaysia Review and Refinement of Oral Health Service Packages Session 4 14 Oct Virtual Finalizing National Essential Oral Health Services Packages and Costing Exercise Session 5 (Day 100) 26 Nov Virtual Country Presentations and Closing of the 100-Day Sprint ObjectivesLeverage the 100-Day Sprint to define priority implementation actions for oral health in countries; Strengthen national capacity to design, cost and operationalize country-specific essential oral health care packages using SPDI platform; andExplore cross-country collaboration to expand access to essential oral health supplies and products, including harmonized specifications and pricing, and improve supply chains for essential dental preparations and medicines.Expected outcomesA draft country-specific essential oral health care benefit package developed using the SPDI platform and aligned with WHO’s Essential Oral Health Care packageA strengthened regional network in Asia of oral health and UHC leaders, fostering collaboration among South-East Asia and Western Pacific countries, WHO offices and WHO Collaborating Centres to support sustained implementation beyond the meetingParticipantsChief Dental Officers and national oral health programme leads;National focal points responsible for universal health coverage, health financing and health systems;Representatives from WHO country offices, regional offices and headquarters;WHO Collaborating Centres; andAcademic institutions and technical partners.
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