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Tofersen, SOD1 , and the Treatability of Amyotrophic Lateral Sclerosis

For years, amyotrophic lateral sclerosis (ALS) has universally been defined as a progressive, fatal disease with limited treatment options. Numerous therapeutic treatment trials failed to significantly slow disease progression or prolong survival. Until recently, there have been only 2 drugs approved in the US for treatment of ALS: riluzole and edaravone, which slow disease progression and prolong survival modestly. The reason for the lack of therapeutic success has been largely attributed to minimal understanding of the cause(s) of ALS and that treatment is generally initiated late in the pathological progression of disease, once neurodegeneration has become profound.

Benzodiazepine Use in Pregnancy—Understanding Risks for Informed Decision-Making

Benzodiazepines are used in an estimated 2% of pregnancies in the US. Benzodiazepines cross the placenta and have been associated with a number of adverse pregnancy outcomes. Therefore, many clinicians advise avoiding benzodiazepines during pregnancy. However, benzodiazepines can play an important role in treatment of some conditions, including seizure disorders, neurological conditions and tremors, alcohol withdrawal, anxiety, and panic disorder. Furthermore, for patients with long-term benzodiazepine use, abrupt cessation can lead to withdrawal and seizure. Thus, in some circumstances, complete avoidance of benzodiazepines may be contraindicated. Understanding the risks of benzodiazepine use during pregnancy may help pregnant people and their clinicians weigh treatment benefits and risks, and make informed decisions about benzodiazepine use and management.

Mobile Health Smoking Cessation Treatment for People With Tuberculosis

Almost 150 years ago, Lyubov, Fyodor Dostoevsky’s 11-year-old daughter, recorded a terse but poignant note: “January 28, 1881—Papa died.” It was not the content but the location of the inscription that was most remarkable—she chose to write it on her father’s cigarette case. Dostoevsky died at age 59 years of a pulmonary hemorrhage. He had pulmonary tuberculosis, and he was also a chain smoker. Long before the medical world expressed any understanding of the devastating health synergy of tuberculosis and tobacco smoking, this grieving child may have left a prescient clue.

Sociodemographic Characteristics in Clinical Algorithms

Although widely acknowledged as a social construct, race has historically been used as a factor in assessing and treating patients. Race-based clinical algorithms are presently being eschewed due to systematic biases, often underestimating the severity of disease or symptoms among Black patients. Instead, race is increasingly being substituted for alternate measures, such as social determinants of health, that are thought to more directly reflect social disadvantage and to influence health outcomes. For instance, the American Heart Association’s Predicting Risk of Cardiovascular Disease Events (PREVENT) equations, which were released in 2023 and are beginning to replace the Pooled Cohort Equations in cardiovascular disease guidelines, removed race and added, optionally, Social Deprivation Index–calculated at the zip code level. Despite these shifts, little is known about how the public views the changing role of patient race in medical decision-making.

Mitigating Suicide Risk for Minors Involving Artificial Intelligence (AI) Chatbots

In this Viewpoint, a California artificial intelligence law is described, including its positive contributions to making these companion chatbots safer for minor and adult users and the limits of the law, and recommends further steps California and other states can adopt to improve protections for mental health and chatbot safety, especially for minors.

Scientists who use AI tools are publishing more papers than ever before

Science is entering a massive publishing boom, in large part due to artificial intelligence. New research published in the journal Science has revealed that scientists who use large language models (LLMs) like ChatGPT are producing significantly more papers across many fields. The technology is also helping to level the playing field for researchers whose first language isn't English.

Modifying chirality with electricity: Voltage-driven method enables reversible, tunable states

A way to electrically modify the chirality of organic–inorganic hybrid materials, in which chiral molecules adsorb onto inorganic surfaces, has been demonstrated by researchers at Science Tokyo. By using an electric double-layer transistor with a chiral electrolyte, specific chirality was imposed on an otherwise achiral molybdenum disulfide surface. This reversible method enables tunable chiral electronic states and opens new possibilities for advanced spintronic devices and the emerging field of "chiral iontronics."

SN 2022ngb is a faint and slow-evolving Type IIb supernova, observations reveal

An international team of astronomers has conducted optical and near-infrared observations of a supernova designated SN 2022ngb. As a result, it was found that SN 2022ngb is a faint and slow-evolving Type IIb supernova with a low-mass envelope. The new findings were presented Dec. 10 on the arXiv preprint server.

[Health Policy] Advancing real-world evidence in Brazil: regulatory gaps and global lessons

Regulatory agencies are increasingly incorporating real-world data (RWD) and real-world evidence (RWE) into decision-making frameworks to complement randomized clinical trials. While some regions, such as the U.S. and EU, have developed structured approaches for RWE use, Brazil's regulatory environment remains comparatively limited. This study examines the status of RWE regulatory integration in Brazil through an analysis of normative documents, institutional publications, and selected case studies, using a comparative policy perspective.

Early motherhood carries wage penalty, while delaying pays off

A woman's early career pregnancy decision may shape her financial future for decades, according to new research co-led by Eden King, the Lynette S. Autrey Professor of Psychology at Rice University, and Nicola Lawrence-Thomas, a lecturer in work psychology at the University of Sheffield. The study, one of the first to examine long-term earnings across different early reproductive paths, found that women who became mothers early in life earned significantly less over time than those who had an abortion or never became pregnant.

First beta-delayed neutron emission observed in rare fluorine-25 isotope

A research team at the Facility for Rare Isotope Beams (FRIB) is the first ever to observe a beta-delayed neutron emission from fluorine-25, a rare, unstable nuclide. Using the FRIB Decay Station Initiator (FDSi), the team found contradictions in prior experimental findings. The results led to a new line of inquiry into how particles in exotic, unstable isotopes remain bound under extreme conditions. Led by Robert Grzywacz, professor of physics at the University of Tennessee, Knoxville (UTK), the team included Jack Peltier, undergraduate student at UTK, Zhengyu Xu, postdoctoral researcher at UTK, Sean Liddick, professor of chemistry at FRIB and interim chairperson of MSU's Department of Chemistry, and Rebeka Lubna, scientist at FRIB.

Saturday Citations: Self-repairing quantum computer; AI carbon footprint; active listening forges bonds

In the best possible news for people who like pizza, researchers report that high-fat cheese may protect brain health and reduce dementia risk. Ancient hunter-gatherer DNA could explain why some people live 100 years or more. And one philosopher believes that we may never be able to tell whether an AI has become conscious.

Lessons from the Caldor Fire's Christmas Valley 'miracle'

In what came to be called the "Christmas Valley miracle," the Lake Tahoe Basin communities of Christmas Valley and Meyers were spared in late August 2021 when the massive Caldor Fire entered the basin, burning more than 222,000 acres and forcing roughly 30,000 people to evacuate during one of the hottest, driest summers on record. Outside of the Lake Tahoe Basin, the fire destroyed over 1,000 structures, many of them homes.

Improving Affordability of Pharmaceutical Treatments for Diabetes: A Call for Action

Unaffordability of pharmaceutical treatments remains as a critical barrier to diabetes care in the U.S. Through a synthesis of recent evidence on affordability of diabetes drugs, with particular attention to emergent reforms, this call for action focuses on structural solutions to improve the affordability of pharmaceutical treatments for diabetes in the U.S. that providers should be aware of and consider supporting. Incentivizing competition in biosimilars and generics markets, increasing transparency, reforming pricing models that influence drug coverage, and expanding federal negotiation of drug prices, among other actions, can help make prescription drugs more affordable for patients, reduce budgetary impacts on payors, and increase access, ultimately helping to improve the health of all Americans living with diabetes. 10.2337/dci25-0002Video 1.Video 1. American Diabetes Association 85th Scientific Sessions Diabetes Care Symposium: How Do We Fix a Broken Health Care System?64b6f191-67cd-495b-b485-6ab383e2d0e6

How to Fix a Broken Health Care System: Pathways to Maximize Health and Well-being for All

The U.S. health care system is broken, with particularly low performance for health outcomes, access to care, equity, and administrative efficiency in comparison with other high-income countries, despite high cost. By virtue of the many elements required for optimal care, the poor diabetes care quality and outcome metrics of the U.S. are canaries in the coal mine for the health care system. The fundamental problem with the U.S. health care system is that it does not prioritize the long-term health and well-being of all individuals and communities. Three intertwined elements are foundational for an understanding of why the U.S. health care system is built the way it is and what changes are necessary to improve it: 1 ) ethics and culture; 2 ) political economy, the underlying political and economic structures that shape our nation and thus our health system; and 3 ) the definition and measurement of value in health care. This article recommends that health care policies around health insurance and payment be designed to support, incentivize, and sustain effective population health models that address medical, social, psychological, and behavioral needs of all individuals and communities. Good governance is essential to assure that payer and provider market incentives are explicitly aligned to prioritize the health and well-being of individuals and communities and cost-effectiveness of care, beyond short-term financial gain for health care systems and investors. Equitable access allows for health care resource distribution according to need, enabling all individuals to have a fair and just opportunity for health. 10.2337/dci25-0001Video 1.Video 1. American Diabetes Association 85th Scientific Sessions Diabetes Care Symposium: How Do We Fix a Broken Health Care System?64b6f191-67cd-495b-b485-6ab383e2d0e6