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Ted Danson is 'doing some things differently' after a recent health scare
Don’t worry, Ted Danson is doing okay. But he did have a health scare that forced him to make some changes in his life.
Science diplomacy lessons from a North Korean volcano
Mount Paektu, a mythic, active volcano on the border between North Korea and China, is almost the epitome of a scientific challenge that crosses political lines. In 946 CE, it erupted in one of the five biggest volcanic events of the past 10,000 years, kicking up huge quantities of ash and sending destructive mud flows down river channels for hundreds of kilometres. Should this happen again, the entire region, including easternmost Russia, South Korea and even Japan could be hit. “It’s definitely got the potential to be big,” said James Hammond, a professor of geophysics at Birkbeck, University of London. An eruption on the scale of 946 would have “huge regional impact.” For the past 15 years, Hammond has helped lead a groundbreaking collaboration with North Korean scientists to study the volcano, navigating scientific sanctions, tough export controls on scientific equipment and a long, pandemic-enforced exodus from the country. Although he seems more at home on far-flung research expeditions – before speaking to Science|Business, Hammond was camping out on a Greenland ice sheet – he has also advised the European Commission on its changing science diplomacy strategy. His long experience with North Korea has made Hammond sceptical of blanket bans on science collaboration, no matter the country.This is a live question in Europe, where in the wake of Russia’s 2022 invasion of Ukraine, institutional ties with Russian universities were almost entirely severed, although some scientists fear this could undermine our understanding of climate change’s impact on the Arctic. Here, Hammond tells the story of the Mount Paektu mission and the policy lessons he takes from it. Ominous rumblingsThe genesis of Hammond’s collaboration came in 2002, when Mount Paektu began to rumble ominously. Earthquake activity picked up and the volcano began to emit unusual gases. North Korean scientists took notice. “People felt we need to know more about this volcano,” said Hammond. In 2011, North Korean vulcanologists put out a request for international expertise to help them learn more. At the time, Hammond and his collaborator, Clive Oppenheimer, were working on a vulcanology project in another sanctioned country, Eritrea, and so decided to answer the call. Within a month, they had flown into Pyongyang. “It was pretty incredible,” recalls Hammond (left). “We were made to feel like honoured guests, and invited to official celebrations.” The scientific opportunity was huge. Paektu is unusually positioned, a thousand kilometres from where tectonic plates rub against each other in the Pacific. “It was an incredibly interesting volcano, but not much research had been done, at least not in the international community,” he said. “There was so much we felt we could do. And we had these partners that were super keen to engage.”The mission received an unusual visitor in the form of volcano-obsessed filmmaker Werner Herzog, who accompanied Hammond and Oppenheimer while directing his 2016 film Into the Inferno about volcanos across the world. Four days into the trip, the German director delivered a long speech about reunification to his North Korean hosts, recalls Hammond. “He got to the heart of the Koreans and how they felt, and how they thought, in a way that I'm not sure I ever will,” he said. UN sanctionsHowever, Hammond realised he’d been “naïve” about how difficult it would be to collaborate with North Korea, which was sanctioned far more heavily than Eritrea. “We didn’t fully appreciate the all-encompassing nature of restrictions,” he said. In 2016, as tensions escalated over Pyongyang’s nuclear tests, a United Nations resolution banned all joint scientific work with North Korea. However, the UN sanctions did allow countries to request carve outs, and the UK successfully requested an exemption for Hammond’s work. Related articlesEU pushes for joint science diplomacy, but care needed to avoid gridlock, experts sayRussia severs its last ties with German scienceAnchor Greenlanders in Arctic climate research, experts tell EU ahead of policy updateExport controls have also delayed Hammond’s work. In one case, it took 18 months to get approval from the UK government to take seismometers, which measure earthquakes, to North Korea. “It was frustrating,” he said. “But they didn’t just say no.” However, one instrument, called an induction coil, used to measure how the earth conducts electricity, was blocked entirely because it can in theory be used to detect submarines. Karaoke bondingSince the collaboration started in 2011, Hammond has visited the country around 15 times, although the pandemic closed off North Korea for more than five years. A trip last November was Hammond’s first since the outbreak. Despite this lengthy interlude, Hammond has deep bonds in the country. The North Korean scientists Hammond works with are somewhat isolated, as they struggle to access the latest research papers and travel to international conferences. That said, they are “excellent geophysicists” and are “very well trained in the field,” he said. Over karaoke and chats about their families, “we’ve made friendships, for sure,” he said. The authorities have to sign-off things like the placement of seismometers, for example, but Hammond said these requests have been approved. “Everything that we've asked for within a scientific context has been delivered.”Scientific backchannels? These kind of personal links between scientists across political lines are one purported benefit of science diplomacy. During the Cold War, some historians argue, scientific contact between the US and Soviet Union laid a groundwork of trust for other cooperation, such as on arms control. Hammond agrees that backchannel contacts to North Korean geophysicists are hardly likely to defuse a military crisis on the Korean peninsula, but the simple fact of the scientific collaboration makes contacts between diplomats that little bit easier. “It creates opportunities to understand each other a little bit better,” he said. “When maybe you have those more difficult discussions as diplomats, it's coming from a slightly better place.” Cutting tiesDrawing lessons from the Mount Paektu mission for today’s links with Russian science isn’t simple. The analogy is far from exact, Hammond said, “because one is essentially a Cold War, versus a pretty hot war in the case of Russia.” But Hammond’s broader argument is that the challenges we face, such as climate change, pandemics, biodiversity loss, pollution and so on, have globalised in an unprecedented way, making blanket shutdowns in collaboration with any country unwise.He’s somewhat critical of the UN scientific sanctions imposed on North Korea in 2016, even though they did allow for exceptions. “I think a blanket halt to some of these things, when we face big global challenges [. . .] that’s quite a risky thing to do,” he said.Institutional endorsement?European academics are still by and large free to work individually with Russian counterparts. However, official, institutional partnerships have largely ended. Shortly following the full-scale invasion of Ukraine in 2022, Russian university rectors wrote a public letter endorsing the war, meaning European universities fear official collaboration could also be seen as a kind of endorsement. Hammond acknowledges there is a risk of legitimising regimes, and state-controlled universities, through scientific cooperation. “That’s the trade off you have to make,” he said. Strategic projectsWith Russia, instead of giving a green light to restart all Arctic science, a middle ground might be firing up a few carefully selected “strategic” projects, said Hammond. After all, European countries are still collaborating with Russia on the International Thermonuclear Experimental Reactor, an experimental nuclear fusion plant in the south of France. However, even if Europe did try to revive Arctic science with Russia, there’s no guarantee Russian scientists would play ball. A series of high-profile arrests of physicists in Russia accused of sharing their findings with the outside world has made collaboration fraught. Even before the invasion of 2022, “the Russian regime made it increasingly difficult, and this sort of discouraged people,” Dag Rune Olsen, rector of the Arctic University of Norway, told Science|Business last year.
Is the FDA Really Suppressing Science? Plus. . .
It’s Thursday, May 7. This is The Front Page, your daily window into the world of The Free Press—and our take on the world at large. Today: Aaron MacLean says Trump is poised to snatch defeat from the jaws of victory in the Iran war. Joe Klein on the life of CNN founder Ted Turner. Jillian Lederman on why cruise ships are here to stay. And much more. But first: Is the FDA suppressing science? On Tuesday, The New York Times published a story with an alarming takeaway. “FDA Blocked Publication of Research Finding Covid and Shingles Vaccines Were Safe,” read the headline. It is the latest in a string of stories that all have the same message: The Food and Drug Administration (FDA), and other agencies, are engaged in a cover-up—and silencing scientists trying to get the word out about the Covid vaccine. What all these stories suggest—some more subtly than others—is that the outsiders now running the public health establishment, officials such as Marty Makary at the FDA and Jay Bhattacharya at the National Institutes of Health, are on a revenge tour. That they are doing harm to the country to get back at the scientists and bureaucrats who ostracized them for deviating from the public-health consensus during the pandemic. It’s a seductive narrative. But is it true? That’s the question we address in our latest editorial. —The Editors Read [ Marty Makary's FDA Has All the Right Enemies ](https://www.thefp.com/p/marty-makary-vaccine-study-fda) [ Trump Blinks First ](https://www.thefp.com/p/iran-peace-deal-pakistan-trump-strait-of-hormuz) Aaron MacLean In return for no detectable concessions, President Trump this week gave up on forcing open the Strait of Hormuz. Now, the Trump administration looks desperate for a deal to end the war with Iran. It’s easy to understand the desire to end the war, but are they blowing the chance at victory? Aaron MacLean makes sense of the administration’s latest moves—and Iran’s response—in his column today. Read full story Aaron MacLean and Niall Ferguson: Live in New York City Join Aaron MacLean and Niall Ferguson on May 19 for a live recording of School of War at the iconic New York Historical. In a conversation as timely as it is wide-ranging, Aaron and Niall will explore the strategic stakes of the moment, including the Middle East, China, and the future of American leadership on the global stage. Get Tickets Now [ Ted Turner, the Optimist Who Built CNN ](https://www.thefp.com/p/ted-turner-cnn-tribute) Joe Klein The man who gave us CNN and the 24-hour news cycle, Ted Turner, died Wednesday at the age of 87. Today, political writer Joe Klein—who almost ghostwrote Turner’s autobiography—remembers his friend, the American media mogul who stood out for his idealism and lack of a filter—something that got Turner in trouble more than once. “His was not a traditional intelligence, but one of horizon: Ted saw things before other people did,” Joe writes. Read full story [ Nothing Can Sink the Cruise Ship ](https://www.thefp.com/p/cruise-ship-hantavirus) Jillian Lederman A viral outbreak on a cruise ship that left three passengers dead has left some people wondering: Are cruise ships on the way out? Not so fast, says Jillian Lederman, who has been on many a cruise herself. Read her piece on why 38 million people a year take a cruise—and aren’t about to stop. Read full story [ The Great Writers Who Were Terrible People ](https://www.thefp.com/p/the-great-writers-who-were-terrible) Shilo Brooks Throughout history, some of the greatest literary geniuses have also been immoral bigots. In the latest episode of Old School, Shilo Brooks is joined by Eli Lake for a conversation about those geniuses, from Voltaire to Norman Mailer and Roald Dahl—and why we should read their work despite their odious prejudices. Listen on MORE FROM THE FREE PRESS [ Inside the Digital Intifada ](https://www.thefp.com/p/digital-intifada-social-media-hamas-terror) Warren Kinsella Read full story [ This Week in American History: Trump’s Over-Arching Problem ](https://www.thefp.com/p/this-week-in-american-history-trumps-over-arching-problem) Jonathan Horn Read full story [ Humanity Is Still Evolving—and Fast ](https://www.thefp.com/p/humanity-is-still-evolvingand-fast) Razib Khan Read full story THE NEWS Thirteen D.C. Metropolitan Police officers have been placed on administrative leave and could face termination after an internal investigation found evidence that crime statistics were manipulated to make the city look safer. The Republican-led House Oversight Committee previously alleged that former D.C. police chief Pamela Smith pressured officers to skew data. Tennessee Republicans unveiled a redrawn U.S. House map yesterday that would split up Memphis’s black-majority Democratic district, the latest move in a nationwide push to redraw congressional boundaries ahead of the midterms. The effort follows a Supreme Court ruling last week on Louisiana’s districts, which Tennessee House Speaker Cameron Sexton said gave states the green light to redraw maps along partisan lines. Israel struck Beirut for the first time since a ceasefire with Hezbollah took effect last month, saying it targeted a commander of the militant group’s elite Radwan force in the city’s southern suburbs. The strikes risk destabilizing that truce at a delicate moment, as Iran and the U.S. report progress toward a deal to resolve their own standoff. The U.S. Air Force is aiming for a Fourth of July delivery of a Boeing 747 gifted by Qatar, hoping to add it to the Air Force One fleet in time for the U.S.’s 250th anniversary, Reuters reported. (For more on the controversy surrounding the aircraft, read Jed Rubenfeld’s piece “It’s a Terrible Idea, but Trump Probably Can Accept a Free Jet from Qatar.”) Commerce Secretary Howard Lutnick testified privately before Congress that he has no memory of why he and his family dined on Jeffrey Epstein’s private island in 2012, according to Reuters. The admission contradicts Lutnick’s earlier claim that he had cut ties with the convicted sex offender well before that visit. Weeks before a former JPMorgan investment banker filed a lawsuit packed with explosive allegations, the bank reportedly offered him $1 million to settle his sexual assault and harassment claims, according to The Wall Street Journal. The suit, filed by Chirayu Rana, alleges he was sexually assaulted by a female colleague, subjected to racial discrimination, and forced into a degrading dynamic at work. JPMorgan says the claims lack merit, and the female colleague’s lawyers call the accusations fabricated. A new report from the Hartford Institute for Religion Research shows that, for the first time in roughly 20 years, church attendance is trending upward, with more people volunteering and clergy expressing renewed optimism. The study’s authors described the findings, based on a survey of more than 7,400 congregations, as showing signs of widespread recovery from low attendance numbers.
‘The Seminarians: Sovereignty Through Education’ premieres May 7 in Tahlequah
Just 12 years after forced removal, Principal Chief John Ross and the Cherokee National Council made a powerful declaration about the Nation’s future with the opening of the Cherokee Male
Takeaways from Indiana, Ohio and Michigan: Trump's flex pays off and Democrats win special election
Elections in Indiana, Ohio and Michigan on Tuesday reinforced a picture that's becoming increasingly clear — while President Donald Trump still dominates the Republican Party, Democrats seem to have the momentum ahead of November's midterm elections.
CEA Retail + Hospitality Winner: Biggers blends produce, entertainment
Biggers Market’s roots run deep, tracing back to the 1940s when founder and partner Sven Wallin’s grandfather, alongside his brothers, opened Biggers Brothers, a family-run produce business in Charlotte. Decades later, the family’s reputation for farm-fresh fruits and vegetables lives on. In 2010, Wallin opened Biggers Market, building on a reputation that endured for the past 16 years. “I learned a lot about my grandfather, who passed away when my mother was young, through my uncle. The one thing that is ingrained in me is my grandfather’s willingness to go the extra mile for a better product, not settling for what’s easy, but finding what is better,” said Wallin. “He taught me the importance of name and reputation. If your name was on it, it had better be right. Word-of-mouth was always very important to gain a good reputation.” So was hard work. Entrepreneurialism has always been central to Biggers Market’s identity, Wallin said. In high school, Wallin worked at a produce stand in Charlotte, an experience that shaped how he thought about food. “I realized all produce was not created equal, and we could focus on freshness, seasonality and flavor. Grocery stores were convenient, but the produce often didn’t have the same taste or quality,” he said. As a college graduate without a paying job, Wallin took a leap and opened a 20-by-30-foot roadside stand with just three employees. “It was so small we had to put tables with umbrellas out in the yard to accommodate everything. We didn’t have pallet jacks or forklifts to unload the trucks. We would form a line and toss watermelons to get them to where they needed to go,” he recalled. In year two, Wallin opened a market on Carolina Beach Road, still in operation today but larger, and later on Market Street, setting up tents for extra space. In 2019, the sale of the land forced a hunt for a new property, and Wallin landed on his current location at 6250 Market St. “We had ambitions beyond produce,” he said. “We wanted this market to be a place that felt different from a typical grocery store.” In 2024, Wallin added his kitchen to the Biggers brand. “I’ve blurred the lines of a market and a grocery store,” Wallin said. “It’s a place where you can shop, eat, have a drink and listen to live music with friends and family. It’s a mix of retail and social experiences cultivated over time.” What hasn’t changed, however, is Wallin’s Southern hospitality, a strong sense of pride, purpose and responsibility and a commitment to seasonality. Spring brings the garden center to life with herbs, veggie plants and jumbo ferns. Summer leans heavily into produce. Fall brings the pumpkin patch, and winter hosts a Christmas market. “It means a lot to have what we’ve built recognized, especially in Wilmington. There’s a lot that goes into the business from our team. And that’s something we’re genuinely grateful for,” Wallin said. With plans underway for a new larger Carolina Beach Road location, Wallin continues to look ahead. “It’s an opportunity to build another market from the ground up and continue growing what we’ve been doing,” he said. “We’ve been through development before, so we understand what it takes.”
Ramaswamy advances in Ohio, and other takeaways from Tuesday’s primaries
Primaries in Indiana and Ohio reinforced President Donald Trump’s power in the GOP and set the stakes for several top-tier midterm races.
Rising housing costs in Bexar County tied to growing public health crisis
As housing costs climb across Bexar County, data from Metro Health reveals families are increasingly forced to choose between housing and healthcare — a tradeoff now being linked to worsening physical and mental health outcomes.
Lawncare businesses forced to embrace fuel surcharges as Iran war keeps gas prices climbing
Trump Backed Forced Treatment for Homeless People. Utah Shows the Challenges.
State lawmakers declined to back a Trump-inspired plan to move 1,300 homeless people to a campus on the edge of Salt Lake City, but supporters are trying to keep the plan’s spirit alive.
David Benavidez calls out Canelo Alvarez after destroying Gilberto 'Zurdo' Ramirez to capture the WBA and WBO cruiserweight titles
David Benavidez batters Gilberto Zurdo Ramirez en route to becoming the new WBA and WBO cruiserweight champion; Ramirez was down in the fourth and then again in the sixth when he took a knee and was forced to succumb to The Mexican Monster
Civil rights pioneers of the sky: Pan Am's first Black flight attendants reunite
The Civil Rights Act of 1964 forced airlines to end discriminatory hiring practices.
Sports media race-baiters are already taking Nikola Jokic criticism too far
Nikola Jokic deserves some criticism after Denver's playoff loss, but the gloating and forced LeBron comparisons reveal more about sports media.
The high-ranking officials Trump has fired, forced to resign or moved elsewhere in his second term
Administrative turnover is nothing new for this notoriously fickle president
Florida Yacht Charter Business Fights $1.5 Million Tax Bill
A Florida yachting venture that participated in high-stakes offshore fishing tournaments before unforeseen setbacks forced a pivot to luxury charters told the US Tax Court the IRS wrongly defined its business as a hobby and assessed more than $1.5 million in tax liabilities.
Oscar is lost then found after director forced to check it on flight out of JFK
He co-directed "Mr. Nobody Against Putin"
Oscar is lost then found after director forced to check it on flight out of JFK
He co-directed "Mr. Nobody Against Putin"
Emerald Youth Foundation pivots to building its sports complex in Five Points
The Christian nonprofit planned to build on Chilhowee Park land, will was forced to change plans. It bought private property instead.
Hurzeler on Gomez, 'refreshing not relaxing' and 'unpredictable' league
Brighton boss Fabian Hurzeler has been speaking to the media before Saturday's Premier League game against Newcastle United at St James' Park (kick-off 15:00 BST). Despite being forced off with an injury last time out, Mats Wieffer will be available. James Milner and Solly March will not feature at St James' Park.
PEST PARTY: Dozen Central Florida eateries shut down after health inspections
Last week, 12 more eateries across Central Florida were forced to close after a visit from a health inspector, according to state records.
House Passes Stalled Homeland Security Funding Bill, Ending Shutdown
Republicans were forced to use a special maneuver to steer around opposition in their own party and speed the measure to the floor, relying on Democrats to push it through.
Illinois business owners navigate murky waters of tariff refunds
A Chicago-area company forced the Trump administration to undo much of its tariff policy. Now that toy company and others want their money back.
Justin Berfield regrets 'Malcolm in the Middle' revival forced costar Erik Per Sullivan back into the spotlight: 'Leave Erik alone!'
‘Malcolm in the Middle’ star Justin Berfield feels bad that the show's revival turned the spotlight on his former costar Erik Per Sullivan after he left Hollywood.
Denver business owners worried they'll be forced to close following plans for Asia Center demolition
The Asia Center's owner has submitted plans to the city to demolish the strip of stores for a mixed-use development project, including affordable housing and retail.
Column: After Swalwell scandal, a 'safe choice' for Democrats emerges
Xavier Becerra's appeal as a steady, non-flashy candidate for governor may be his biggest advantage after former Rep. Eric Swalwell was forced to drop out amid scandal.
Forced Windows updates can now be paused forever
You can now continually put a pause Windows 11 updates, 35 days at a time.
Apple wanted to blow us away for the 20th anniversary of the iPhone, now it’s not so sure
The iPhone 20 Pro sounded so good. Now Apple might be forced to abandon the plan entirely.
Windows 11 will let you skip updates, pause longer, and avoid forced restarts
New controls let you skip updates during setup, extend pauses, and avoid forced reboots.
Windows Update gets new controls to reduce forced restarts
Microsoft is rolling out Windows Update improvements that give users more control over how updates are installed while reducing disruption from frequent or poorly timed restarts.
Senate rejects measures meant to lower the cost of gas, groceries
Senate Democrats, in a fierce political battle over immigration enforcement funding, forced Republicans to vote on measures meant to lower costs.
Life sciences lab real estate is clawing back from disaster. Here’s what that means for investors
Life science laboratories saw a massive drop in demand last year after the NIH was forced to cancel billions of dollars in research grants.
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For Techmeme, the price hike has forced a major change.
Sebastian Maniscalco gets Sirius on Harry Styles' 'SNL' imitation, Bieber's ball pit
Sebastian Maniscalco has much to talk about on his new SiriusXM channel, like golf fashion, forced dog walks and ball pit frolics with Justin Bieber.
Shaky political science: using "simulated" elections over real-world elections
[Dear DSOS readers – this article is the latest in our “Shaky Political Science” series. In our 38 page report, “Shaky political ‘science’ misses mark on ranked choice voting,” released in early December, we examined over 40 studies focused on ranked choice voting. We found that many of these studies suffered from puzzling research methodologies, poorly constructed surveys, unrealistic simulated elections, cherry picked data, and faulty analyses that often were contradicted by results from real-world elections (a link to our full paper is here). Here are links to the first three articles in our series: the first one summarizing the overall results of our report, the second one analyzing a study co-authored by University of Minnesota academic Larry Jacobs, which was one of the most error-prone of all the research we reviewed in our report, and a third article showing an admirable example of two political scientists holding two other political scientists accountable for their flawed, sloppy research]. In this fourth article in our “Shaky Political Science” series, we shine a spotlight on seven studies that were web-hosted and funded by New America’s Political Reform Program and its Electoral Reform Research Group (the ERRG is an ad hoc committee headed by New America’s Political Reform Program and joined by the American Enterprise Institute, the Unite America Institute and Stanford University’s Center on Democracy, Development, and the Rule of Law). This research consortium has been led by Lee Drutman, senior fellow with New America’s Political Reform Program. These seven studies are simply not credible from any objective standard about how political “science” is supposed to illuminate our understanding of either ranked choice voting or politics in general. The feature that six of these seven studies have in common is that they all used surveys – artificial, simulated elections -- to attempt to say something cogent or interesting about ranked choice voting (RCV) elections. None of them used real world data from actual RCV elections – either the 1000+ elections in the US or the many thousands of elections from places like Australia, Ireland and elsewhere where RCV has been used for 100 years. While a few of these studies conclude with some mixed positives about RCV, our analysis here is content neutral. The idea that, with a political reform like RCV, you can ask respondents in a mock, artificial election to vote with that method, with only the barest of explanation about how RCV works or its likely impacts (i.e. no spoiler candidates, majority winners, voters liberated to pick their favorite candidates, coalition-building), and then ask them their thoughts/reactions about voting in that system, with fake candidates and no real campaigning, no real exposure to an actual election or actual candidates, rests on some very puzzling assumptions. The findings of these seven studies actually are contradicted by the findings from many other studies based on real-world RCV elections. These New America studies also failed to list the real-world RCV studies in their own citations, instead including those studies that reinforced their conclusions. The seven studies featured in this article were chosen because they form a cohesive cohort which precisely illustrates one of the main points of our research paper, namely that using surveys, i.e. artificial elections, or mathematical/theoretical models, instead of real-world data, is in fact “shaky political science.” Below are summaries of our analysis of five of the seven New America studies. You can read our complete analysis of all seven studies at our paper, “Shaky political ‘science’ misses mark on ranked choice voting.” Choosing to “Vote As Usual” by Andre Blais, Carolina Plescia, and Semra Sevi. New America. (Blais et al., 2021). This study, web-hosted and funded by New America’s Political Reform Program and its Electoral Reform Research Group, used two surveys in which respondents completed ballots for simulated elections using plurality, approval, RCV and point (Score) voting. In both cases the authors provided the respondents with only minimal explanation of each method. For example, the entire explanation for RCV was “For this vote, rank the candidates from your first to your last choice (you do not need to rank them all). This is called the ranked vote.” That’s it. The study did not provide any context or explanation to survey respondents about why she/he might want to rank multiple candidates. Participants were not even told that ballots would be tabulated using an “instant” runoff, not to mention any description of RCVs ability to eliminate the spoiler effect or liberate voters to rank their favorite candidates without fear of helping the “greater evil” candidate to win. That’s like taking an iPhone back in time to 1970 and asking someone if they like it better than their rotary phone without explaining how it works. Their first survey targeted states that held 2020 Super Tuesday Democratic primaries and used the real candidates’ names in the survey; the second survey used fictitious candidates. In other words, they surveyed respondents who had only ever participated in plurality elections, had no history or background with using RCV or any of the other methods, had no clue about its likely impacts, and did not communicate how the alternative methods would be counted, and then asked them: “How satisfied are you with using each system?” Predictably, the winner was plurality elections, the system used for president, Congress, gubernatorial and state legislative elections – in other words, the method they have been using, year after year, all their voting lives. With so little explanation of RCV and its impacts, this study is simply not credible in discovering anything useful about real-world RCV elections. It merely shows that a basic voter education campaign is needed when adopting a new election system. Additionally, the result contradicts many other post-election surveys following real RCV elections, asking opinions from voters who had just participated in a RCV election, that showed a great deal of satisfaction with RCV (see details on that in Studies 22-25 in our paper, as well as the four studies cited in the review for Study 28). Share Other studies on “satisfaction” and “understanding” make similar mistakes, in terms of basing their surveys on inadequate explanation to respondents and lack of education about context. How could any survey ever hope to measure accurately, in essence simulate a real-world election, without actual campaigning candidates, the media writing about those candidates, organizations endorsing candidates and voters being inundated with crucial information? More than anything, what these “studies” based on surveys show is that if you ask voters about something they don’t know very much about, and fail to adequately educate them, their responses will unsurprisingly reflect their confusion. Equally puzzling is that New America’s Electoral Reform Research Group, headed by political scientist Lee Drutman, found this to be a credible enough study that they not only published it but highlighted it in Drutman’s own discussion of research related to ranked choice voting. This pattern was repeated in study after study featured by New America’s Electoral Reform Research Group. For example in Ranked-Choice Voting and Political Expression: Voter Guides Narrow the Gap between Informed and Uninformed Citizens by Cheryl Boudreau, Jonathan Colner, and Scott MacKenzie, the researchers based their analysis on a survey which found that respondents who were asked to vote in a simulated RCV election, with minimal explanation of RCV or how it works, displayed less evidence of being informed about how to use RCV effectively, with the least informed voters ranking fewer candidates. As pointed out under the study above, in a real election voters are informed by a wide variety of methods, including public education by the election administration, by interested political groups, the media, and the candidates themselves who benefit from voters being aware of how to vote in the new system. In Support for Ranked-Choice Voting across Race and Partisanship by Joseph Anthony, David C. Kimball, Jack Santucci and Jamil Scott, the researchers used respondents from different parties and races voting in simulated plurality and RCV elections, who indicated their satisfaction with each voting method. Instead of using real world election results, the authors fell back on the easy, armchair and less reliable academic research methodology of making up mock elections. As with the other studies, little explanation was given of how RCV works or what its implications might be (electing majority winners or eliminating spoilers, for example). Unsurprisingly, this study found that respondents were not very satisfied with RCV. However, when the authors added an explanation that RCV has a tendency to elect more women and people of color, they found that this greater explanation increased the preference for RCV. The more voters were familiar with it, and the more they understood potential positive impacts – surprise! -- the more they were open to switching away from the status quo. Of note, the results from this study are thoroughly contradicted by a number of other studies whose data was obtained from real RCV elections with real voters. Those studies show a great deal of satisfaction with RCV. More “fake election” research An interesting wrinkle on this “research by fake elections” approach, which only served to illustrate how unreliable such “research” can become, was taken in Ranked-Choice Voting, Runoff, and Democracy: Insights from Maine and Other U.S. States by Joseph Cerrone and Cynthia McClintock_,_ also web-hosted and funded by New America’s ERRG. It gets high marks for creativity, but an eye-roll for thinking this could possibly add anything meaningful to our understanding of real world RCV elections. This study tried to determine whether RCV, plurality or two-round runoff elections provided greater voter satisfaction and acceptance of election results. To determine that, the authors conducted a survey asking if voters were satisfied with a fictional newspaper report of an election, with three different versions given to respondents – plurality, runoff and RCV, with variations of Republican/Democrat winners and variations of “come-from-behind” winners,” i.e. candidates not initially in first place but who win the “runoff.” Again, a minimal explanation of RCV or how it works was given, and the survey showed that respondents had the greatest unfamiliarity with RCV than the other methods. The unsurprising result? Respondents were much more satisfied with “come-from-behind” victories in a traditional two-round runoff election than in RCV, even though RCV is also a runoff system but with a single round of counting. Interestingly, the dissatisfaction with RCV disappeared for those who were more familiar with RCV. In fact, among those respondents who were “very familiar” with RCV, they were equally satisfied with RCV, runoff and plurality. Surprise, surprise. Again, what this study revealed, more than anything, is not only the inadequacy of the explanation for RCV given by the authors of this study, but the failure of the research format itself, thinking that such an artificial mock election could somehow simulate what actually happens in the real world in a real RCV election. Those four studies reviewed above are fitting examples of inadequate and shaky political “science.” Other studies reviewed in our paper from the New America/Electoral Reform Research Group cohort which also used mock elections included: Ranked-Choice Voting is an Acquired Taste by Joseph Anthony and David C. Kimball. New America. (Anthony et al., 2021). Ranked-Choice Voting is No Refuge for Extreme Candidates by Melissa Baker. New America. (Baker, 2021). Also included in this New America cohort is Does Ranked-Choice Voting Reduce Racial Polarization? by Yuki Atsusaka and Theodore Landsman, which actually did use real-world election results data but applied an odd and unconventional methodology to the data which relied on shaky assumptions and non-real-world scenarios that were too divorced from reality. To determine levels of “racially polarized voting,” the researchers imagined “ethnic parties,” by which they mean political parties for each ethnic group, which was especially odd since the election data they were using came from nonpartisan RCV races. But then they made an even odder assumption, namely that since race and ethnic characteristics of studied voters were not available, the authors tried to infer that information based on who voters selected and the racial make-up of voters in each district. This amounted to little more than vague and ambiguous guesswork dressed up with a bunch of mathematical equations used to give it a veneer of scientific appearance. Indeed, it seemed to assume racial polarization in order to prove racial polarization. Based on this questionable methodology, the authors concluded that RCV doesn’t reduce racial polarization. But the premise of this study missed an obvious reality: since RCV incentivizes more candidates to run and can result in more diverse fields of candidates, one would expect more racially-polarized voting in voters’ top rankings, not less, because more voters would have someone on that ballot who represents their racial or ethnic identity and more freedom to vote for their real first choice. By encouraging more diverse candidates and eliminating the spoiler effect, RCV facilitates voting for a favorite candidate of your own race and then selecting a second choice with the best likelihood of winning. The real measure is what voters do with their additional rankings – do they consider other candidates and vote “for the best of the rest”? This study didn’t tell us anything useful about that. But readily available data shows this is common in real RCV elections, and candidates act on this knowledge by engaging with voters outside their racial group. So the authors of this study failed to consider or account for what actually happens in real-world elections, and their conclusions are tainted by this failure. New America has contributed a great deal over the past 2.5 decades to our understanding of many policy areas, including politics and political reform (full disclosure: Steven Hill, one of the authors of this article and of the “Shaky Political Science” research paper and series, is a former senior fellow and former director of New America’s political reform program, 2005-2010). So it was especially disappointing that New America funded and published such a large batch of dubious studies about ranked choice voting. The stated praiseworthy goal of its Electoral Reform Research Group was to inspire new academic research about ranked choice voting that would shed light and help the public better understand the impacts of RCV. Instead, the ERRG research did just the opposite. It produced dubious research that created more confusion and misinformation. In so doing, New America’s political reform program contributed to “shaky political science.” Steven Hill and Paul Haughey Share Upgrade to $5 subscription Thanks for reading DemocracySOS, a reader-supported digital portal for the pro-democracy movement. Subscribe for only $5 per month to receive full benefits and to support our work. Subscribe
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Advancing epidemic and pandemic preparedness through research readiness: SEAR Unity Studies Network Sites chart the way forward in 2026
On 25 March 2026, WHO Regional Office for the South‑East Asia Region (SEARO) convened the first meeting of the SEAR Chapter of the Unity Studies Network Meeting in 2026 to take stock of progress and plan next steps for strengthening epidemic and pandemic preparedness across the Region. The meeting focused on reviewing the ongoing adaptation of selected, standard Unity Study methodologies, sharing field implementation experiences from 2025, and identifying key priorities to guide collaborative work in 2026.Held virtually, the meeting brought together representatives from six Unity Studies network sites across five countries (Bangladesh, India, Nepal, Sri Lanka, and Thailand) as well as participants from all three levels of WHO.The meeting took place against the backdrop of ongoing regional efforts in South‑East Asia to strengthen early investigations and studies for epidemic and pandemic preparedness, with a focus on pandemic influenza and other emerging respiratory pathogens with epidemic and pandemic potential. In this context, and as part of preparedness for the rapid generation of evidence, the WHO Health Emergencies Programme in SEAR (WHE/SEAR) encourages Unity Studies sites to adapt prioritized, standardized Unity Study protocols to their national contexts. This approach supports the generation of timely and reliable evidence to inform public health decision‑making during epidemics and pandemics.These efforts are supported through a combination of experience sharing, participation in the global Unity Studies network webinars, capacity‑building of the national public health workforce, and regional collaboration that promotes inter‑country, inter‑agency, and inter‑ministerial action. In parallel, sites are encouraged to explore diversified funding sources to help sustain research preparedness over the long term.Discussions highlighted the importance of WHO’s catalytic financial support through the Pandemic Influenza Preparedness (PIP) Partnership Contributions (PIP‑PC). When combined with national and institutional resources, this support enables countries and sites to maintain continuity of activities at a core level and remain prepared to respond rapidly and effectively to future epidemics and pandemics.Regional and Global Updates: Opening the session, Dr Pushpa Ranjan Wijesinghe, Programme Area Manager, Pandemic and Epidemic Management (PEM) Unit, WHO Health Emergencies Programme, highlighted the progress made in operationalizing the Unity Studies Network across the Region and acknowledged the collaborative efforts of WHO at all three levels, together with country unity studies sites. He emphasized the availability of limited but catalytic funding through the Pandemic Influenza Preparedness (PIP) Partnership Contribution (PIP‑PC) workplan at SEARO to sustain network activities in 2026, while encouraging sites to leverage additional funding sources to expand implementation.Representing SEARO, Dr Ashok Basnet, consultant, Pandemic Influenza Preparedness reported that, at the regional level, the Unity Studies Network currently includes six sites across five countries: Bangladesh, India, Nepal, Sri Lanka, and Thailand. He noted that in 2025, catalytic funding supported protocol adaptation, training, and pilot implementation. In addition, a regional Unity Studies symposium held during the Global Public Health Summit in Sri Lanka strengthened and advocated collaboration between the Unity Studies site, national decision‑making forum, relevant technical units of the ministry of health, WHO and other partners.The symposium also highlighted the role of early investigations and studies as a key component of a multi‑source surveillance system needed at country level to generate a broad range of evidence. It underscored the critical role of country Unity Studies sites and similar research entities in generating evidence to support public health decision‑making during epidemics and pandemics.Participants of the WHO GISRS Unity Studies Sites Network- SEAR Chapter Meeting 2026 (Photo credit- PEM/WHE/SEARO). SEARO also updated participants on ongoing efforts to develop a regional Unity Studies webpage and to promote participation in global knowledge‑sharing platforms, including webinars and the WHO Community of Practice. Priorities for 2026 include supporting the implementation of Unity protocols, strengthening collaboration and experience sharing across sites, documenting and publishing findings, integrating Unity Studies activities as a component of multi-source national surveillance systems, and building workforce capacity.Dr Nickle Boddington of the Global Influenza Programme (GIP) at WHO Headquarters, which coordinates the Unity Studies Network globally, provided updates on global Unity Studies activities, noting that the network has expanded to 16 sites worldwide. New and updated protocols, including rapid clinical severity assessment tools and standardized data platforms, are being developed to support implementation. The global Community of Practice has also been launched to facilitate technical exchange, and continued support will be provided to sites for protocol adaptation, ethical approvals, and readiness for early investigation during outbreaks. Updates from Unity Studies sites in SEAR in 2025Unity Studies sites shared progress and experiences in implementing protocols across diverse country contexts. Sites initiated activities in 2025 using catalytic funding from SEARO, complemented by the mobilization of internal national resources. The Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh, reported the adoption and piloting of investigation protocols on non‑seasonal influenza and emerging respiratory diseases during recent avian influenza outbreaks, demonstrating a multi‑source funding approach involving government, WHO and One Health partners.The Hamdard Institute of Medical Sciences and Research (HIMSR), New Delhi, India, highlighted the piloting of household transmission investigation studies, the expansion of the national Unity Studies network, and the contribution of study findings to global evidence through published outputs. The All-India Institute of Medical Sciences (AIIMS), New Delhi, India, shared experiences from large‑scale seroprevalence studies conducted during the COVID‑19 pandemic, recent efforts to strengthen national Unity network sites through training activities, and plans to initiate multi‑centre studies on respiratory viruses.Similarly, Prince of Songkla University, Thailand, highlighted its experience in developing integrated surveillance and diagnostic protocols for multiple respiratory pathogens, enhancing readiness for targeted investigations of emerging threats. The University of Sri Jayewardenepura, Sri Lanka, reported ongoing engagement with the Ministry of Health and exploration of additional funding sources to initiate studies. Meanwhile, the National Public Health Laboratory, Nepal, provided updates on continued coordination with national stakeholders to initiate implementation, despite delays related to the country context.Across sites, shared experiences underscored the importance of protocol adaptation, multisectoral collaboration, and sustainable funding to operationalize Unity Studies and generate evidence for public health action.Discussions and Way ForwardThe meeting reinforced key priorities for 2026, including strengthening unity studies protocol implementation, enhancing collaboration, knowledge sharing, integrating research as a component of national multi-source surveillance systems, and ensuring that generated evidence informs public health decision‑making. Participants also emphasized the importance of documentation, visibility, and leveraging multiple funding sources, and agreed on the following action points.Unity Studies Sites and WHO Country Offices:Advance adoption and implementation of at least one Unity protocol, continuing activities initiated in 2025 with catalytic funding, supplemented with other sources of funding where feasible.Document site-specific experiences, outcomes, and lessons learned; participate in regional and global knowledge-sharing platforms including WHO webinars and the Community of Practice.Work closely with ministries of health to establish unified national platforms for translating generated evidence into national public health decision-making. WHO Country Offices may facilitate technical support and complementary, synergistic funding opportunities where feasible. WHO Regional OfficeCoordinate with WHO Country Offices to support implementation of core unity studies activities by network sites through catalytic funding and provide technical guidance and virtual engagement opportunities throughout 2026.Facilitate the participation of all Unity Studies sites in the regional meeting on Unity Studies implementation in October 2026, to be held back‑to‑back with the Annual SEAR Regional PIP‑PC Meeting; develop and host a SEAR Unity Studies website; and mobilize support from academic institutions within the SEAR Unity Studies Network to support the development of regional manuscripts that showcase Unity Studies activities to scientific audiences and promote knowledge‑sharing.Explore complementary funding opportunities and partnerships to sustain and expand network activities across the Region.WHO HeadquartersProvide global technical guidance, updated protocols, and toolkits to support the implementation of Unity Studies in SEAR.Facilitate engagement of SEAR sites in global webinars, the Community of Practice, and opportunities to showcase their work.Support joint publications, inclusion of SEAR experiences in global outputs, and identification of additional funding and collaborative opportunities to strengthen Unity Studies activities.
California State Association of Counties warn key services are at risk
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Curing U.S. Health Care, Part I
In 2008, much to their own surprise, leading Democrats unified around a program of major health care reform. Policy wonks had spent years developing the concepts behind what eventually became Obamacare; big Democratic victories in the 2006 midterms and the prospect of controlling both Congress and the presidency made it possible to imagine turning those ideas into reality. During the Democratic primary, Hillary Clinton and Barack Obama advocated similar plans, based on those ideas, for expanding insurance coverage. And it happened! The Affordable Care Act was enacted in 2010. When it was fully implemented in 2014, millions of Americans got health insurance: Impressive as the raw numbers are, they don’t tell the whole story. Before the ACA, even upper-middle-class Americans often found it impossible to get health insurance if they had pre-existing medical conditions. Many Americans were trapped in jobs they wanted to leave but couldn’t for fear of losing their employment-based coverage. Meanwhile, dire predictions from the usual suspects about runaway costs proved wrong. In fact, overall U.S. medical spending has grown much more slowly since the ACA was enacted than before. But the U.S., alone among advanced nations, still falls far short of providing universal health care. As you can see from the chart above, 8 percent of the population was still uninsured in 2024, a number that is set to rise over the next two years as a result of Republican policies. True, many of the uninsured in 2024 were undocumented immigrants, who we don’t try to cover. But there are still a lot of uninsured. Moreover, a significant number of Americans who have health insurance are in fact underinsured. As a result, they are at risk of incurring devastating healthcare costs and are sometimes forced to forgo needed care. This number is set to rise sharply in the next two years as a result of Republican policies adopted under Donald Trump. And not only is the U.S. unique among advanced countries in its under-provision of health care coverage, it also incurs by far the world’s highest healthcare costs per capita. So now may well be a good time to get behind a new push for major health reform — an effort, if you like, to finish the job begun under Obama. Today’s primer is devoted to the economics of health reform. During his failed effort to repeal the Affordable Care Act, Donald Trump famously complained, “Nobody knew healthcare could be so complicated.” Actually, we did know — and it’s not that complicated. Health economists understand the principles very well. And because health policy varies greatly among advanced nations, we know a lot about what works and what doesn’t. This will be the first in a series about health reform. Beyond the paywall I’ll address the following: 1. Why markets can’t be trusted to deliver healthcare 2. Routes to universal healthcare 3. What works? In a follow-up post I’ll discuss the pros and cons of different approaches, and possible paths forward for the United States.
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* * *
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Your Thymus and Your Healthspan
Our thymus gland plays a central role in the development or our immune system, specifically for supporting T cell development (how these cells got their name, maturation and differentiation in the thymus) and discriminating between self and foreign, non-self antigen proteins with production of dendritic cells. As we age, our thymus gland shrinks—the process known as involution—with progressive change from spongy to fatty tissue, with loss of functionality. But this process, with respect to timeline and extent, markedly varies from one person to the next. And to make things even more complicated, our thymus gland anatomy and precise location in the chest also is highly variable. So the famous Frank Netter diagrams from the 1960s (such as at left below) don’t capture the remarkable heterogeneity that a random set of 12 chest CT scans (below at right). What I consider as 2 landmark papers in Nature this week (here and here) used AI to quantify health of the thymus in 2 large cohorts, and then correlate the metric to a broad array of health outcomes. In this edition of Ground Truths, I’m going to cover three questions: (1) How was thymus health determined by AI?; (2) How is thymus health linked to key clinical outcomes? and (3) Are there ways we can promote a healthy (aka rejuvenate) thymus gland in our later years? Subscribe 1. How was thymus health determined by AI? This was accomplished by extensive work developing and validating an AI pipeline for 2 stages, the first for localization and segmentation of the thymus bed, and the second to quantify a digital marker, termed the thymic health score. There’s a lot to this algorithmic development, so I won’t go into all the details, but just provide a rudimentary outline of what was done. The 1st stage used supervised learning with 2 radiologists reviewing 2,461 chest CT scans. That work trained a 3D U-Net model to automatically identify the thymic bed’s 3D cropped region using center of mass coordinates, which reached 99.8% accuracy. The 2nd stage used a foundation model that was pre-trained with SwAV (which stands for Swapping Assignment between multiple Views), a self-supervised model, that generated a high-dimensional thymus representation of 4,096 features. That compares to the radiology reductionist and subjective scoring of 0 to 3 where 0 means the thymus is fully degenerated and fatty, and 3 is considered dense, intact glandular soft tissue. Notably, the self-supervised learning (SSL) performance was superior to supervised (AUC ~0.75 vs 0.55, respectively) reflecting the shallowness of the 0-3 classifier vs SSL’s holistic, self-taught AI. The thymic health score ranged from 0 to 100, with the highest number indexed to fully preserved thymic health. The algorithmic work extended to explainability with both Shapely value distribution, meaning the model was holistic not relying on any “magic” pixel, and occlusion sensitivity, demonstrating the model’s performance was not affected by ribs, sternum, lung tissue, but rather focused on the thymic bed directly. Below are a few saliency maps from the occlusion sensitivity that indicate the thymic bed focus, not affected by neighboring structures, using the jet color scale. Now the AI was ready for processing ~25,000 CT scans, each over 30 MB files, from the 2 large participant cohorts to provide a thymic health score, it did so in less than 14 hours, which is less than 2 seconds per scan! Share 2. How is thymus health linked to key clinical outcomes? The two cohorts were the National Lung Screening Trial, NLST (N=25,031) and the Framingham Heart Study, FHS (N=2,581) each with baseline demographics and long term follow up of >12 years for health outcomes. From the NSLT, you can see below that increased age and body-mass index were correlated to reduced thymic health. And, overall, men had reduced thymic health scores compared with women. There are a lot of graphs in the paper for outcomes, for both the NLST and FHS cohorts. To simplify the major outcomes, below is a composite Figure with striking reduction of all-cause mortality and for the different causes of death. The results were consistent between the 2 cohorts. For example, the cardiovascular mortality hazard ratio average was 0.57 in NLST and 0.38 in FHS (weighted to be 0.53 for the aggregate). The reduction of mortality also extended to digestive diseases and pulmonary disease (data not shown below). Lung cancer incidence was reduced by 36% for high vs low thymic health (Figure below, with a panel -incidence and b panel-mortality, adjusted for age, sex, BMI, smoking status). Notably, there was a smoker’s paradox: lower incidence and improved survival for lung cancer in smokers who had a high thymus health score. Smoking was associated with lower thymic scores whereas alcohol was not. Higher thymic health was linked to higher HDL cholesterol, lower triglycerides, lower fasting blood glucose, and lower systolic and diastolic blood pressure. Inflammation biomarkers, such as C-reactive protein and interleukin-6, were elevated in the people with lower thymic health scores. In their second paper, the same team looked at the relationship between thymic score and outcomes for 3,476 patients receiving cancer immunotherapy. The non-small cell lung cancer progression-free survival was reduced in patients with low thymic health score. A parallel relationship for survival was seen for other types of cancer including melanoma, breast, and kidney with a 44% lower risk among high thymic scores (Figure). A similar pattern was seen with different immune checkpoint inhibitors. The thymus health score outperformed programmed death ligand-1 (PD-L1)and tumor mutation burden (TMB) assay of the tumor and was an independent prognostic marker of progression-free survival. In this dataset, a direct connect with thymus score and adaptive immune function was noted with a correlation before cancer treatment for both T-cell diversity and thymus T-cell production (a metric known as T cell receptor excision circles). Thymus Removal Study There is a highly relevant citation about thymus function before moving onto ways to rejuvenate it. In 2023, a very important study of thymus removal during cardiothoracic surgery was published, with 1146 patients undergoing thymus removal vs 1146 matched controls (mean age 55 years). The adverse outcomes for thymus removal were striking, with a 2.9 higher risk of all-cause mortality and doubling of cancer incidence, 1.5 fold increase in cancer mortality, and 1.5-fold increase in autoimmune diseases. The immune function showed marked compromise after thymus removal, as reflected by CD4+ and CD8+ T cells (Figure below) Share Ground Truths 3. Are there ways we can promote a healthy (aka rejuvenate) thymus gland in our later years? In recent months we’ve learned a lot about the process of thymus involution and the pathways by which this may be modulated. Thymus involution is primarily due to loss to thymus epithelial cells (TECs) and there are 2 subtypes with different functions: the cortical, responsible for positive selection of T cells, and the medullary, for negative selection. When adipose tissue infiltrates the thymus, thymic adipocytes are pro-inflammatory, knocking out T-cell output. Likewise, systemic inflammation, or “inflammaging,” from smoking, obesity, and chronic stress promote thymic adipocytes. Now, from preclinical studies, we know about key pathways that account for these processes. Historically, back in 2014, FOXN1 was recognized as a single master transcription factor essential for TEC function, with studies in mice with forced FOXN1 upregulation leading to thymus regeneration. That laid the foundation for potential regrowth of quiescent thymus cells. It took awhile to find pathways to accomplish this goal and to even refute its role as the master regulator. The Liver-Thymus Axis Feng Zhang and his team recently showed that injection of an mRNA vaccine to the liver encoding DLL1, IL-7 and FLT3-L in combination, factors known to support thymopoiesis (Figure), successfully enhanced immune function in aged mice. However, the effect was transient. The FGF21 Story Two reports in 2025 addressed the thymus gland’s production of FGF21, a growth factor (fibroblast growth factor 21) and its control of thymus involution. This growth factor is also produced by the liver, but it doesn’t have impact on the thymus in aged rodent models. In contrast, The liver’s hepatocyte growth factor (HGF) has been shown to reverse senescent TEC structural changes. Growth hormone stimulates production of insulin growth factor-1 (IGF-1) in the liver and the thymus. Two small studies in human participants (TRIIM, for Thymus Regeneration, Immunorestoration, and Insulin Mitigation) of 6 and 50 people, respectively, treated with combined human growth hormone, metformin and DHEA, suggested the potential of slowing epigenetic aging and improving thymus mass and function. But the combination of drugs, small sample, and lack of controls make conclusions murky. Increased thymus FGF21 led to increased CD8 T cells in old mice and extended healthspan and improved physical performance. Building on the previous FOXN1 data, ablation of β-klotho, the obligatory co-receptor for FOXN1, accelerated thymic aging. The benefit to FGF21 was confirmed in a companion paper using an FGF21 knock-in mouse model showing thymus enlargement and increased TECs throughout the lifespan. (schematic Figure below). The accompanying editorial for these 2 papers speculated: “The proposed link between age-associated thymus involution and organismal aging is intriguing, and suggests we might seek to achieve systemic rejuvenation by counteracting thymic involution.” Other Factors Lessons from the Axolotl (Mexican Salamander) In an elegant set of experiments of the axolotl (Figure), known for its complete thymus regeneration after total surgical removal, mediators were identified. Surprisingly FOXN1 was dispensable. But midkine, a growth factor, appeared to be the driver, the initiator of thymus cell growth, survival, and repair. Other components that contributed were Postn+ (periostin-expressing mesenchymal niches) and Ccl19, a chemokine protein from the bloodstream. RANK and RANKL RANK (receptor activator of nuclear factor κB its ligand (RANKL) have been considered key regulators of medullary TECs. In a study of both aged mice and human thymus cell cultures, their key role was confirmed, with multiple benefits of resorting TEC function, recruitment of progenitor cells, and T cell development. Subscribe Summing Up This body of work strongly supports the health of the thymus gland as a critical regulator of human healthspan, not just a correlate or link. The new landmark studies are reinforced by the regenerative biology experimental models that have shown, via an array of mediators, that healthspan of aged mice is at least in part dependent on thymus gland function and its critical role for maintaining adaptive immunity. It sure seems that we’d be better off having an immune reservoir of naive T cells instead of a profile in older adults of exhausted, low quality, memory T cells, with a senescent phenotype. It is striking that we ignored the importance of the thymus gland for many decades. A wake-up call was the results of the thymectomy matched control study reviewed here, with the opposite of high thymic health score improved health outcomes. The convergence of AI and healthspan here is notable. The exceptional and laborious work for developing and validating (no less explaining) the AI to quantify thymus health set the foundation for probing the connect the major health outcomes in two cohorts with extensive follow-up. We’ve never had a way to meaningfully quantify the thymus gland before, so this represents important leverage of supervised, self-supervised, and transformer models. The study wouldn’t have been possible without AI. And it begs the question as to whether there are ways we can maintain our thymus at a high health score. But it’s not so simple to rejuvenate our thymus. There are multiple risks including the induction of autoimmunity, increasing the risk of cancer, and inducing a pro-inflammatory state. For example, factors that increase TEC proliferation could compromise the medulllary negative selection process and leak out auto-reactive (self-attacking) T cells. Thymic cells could be induced to proliferate, but we know, for example, that growth hormone and IGF-1 are associated with an increase risk of cancer. If thymus rejuvenation doesn’t clear out the accumulated senescent cells in older adults, then inflammation within the gland could block the production of TECs. Keeping these risks in mind, we now have identified many ways to keep our thymus healthy as we age that undoubtedly will be tested in clinical trials going forward. Ultimately, the benefit-to-risk tradeoffs will be defined. In the meantime, we have desperately needed an immunome. As I’ve stressed in multiple prior Ground Truths, we have no test in the clinic to assess a patient’s immune status! It was very encouraging for me to get an email from Hugo Aerts, the senior author of the landmark papers in the days after they were published: “I also wanted to say that your Substack on “Why We Need an Immunome” was inspiring for this work. We found it a very compelling perspective and greatly enjoyed reading it.” Just having an assessment of a person’s immune status via a chest CT scan, with millions of these performed per year, might help in guiding the right immunotherapy for cancer (e.g. more intensive, combinations for those with low thymic health scores) and help define people who are increased risk for age-related diseases of cancer, cardiovascular, and neurodegenerative. The main theme of Super Agers is that we now have many layers of data (genetics, proteins, biomarkers, organ clocks that can be integrated via multimodal AI) for us to define a person’s specific risk decades before one of these age-related diseases leads to symptoms, enabling prevention. From the new studies this week, we can add thymus health score as yet another way to understand a person’s risk, a window into their adaptive immune system and healthspan. And perhaps someday we will be able to safely rejuvenate the thymus, or maintain its health through one’s life, and use the thymus health score to monitor. NB: I wrote this post (No A.I.) A Quick Poll Loading... ********************************************************************* Thanks to Ground Truths subscribers (now > 200,000) from every US state and 212 countries. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. Please join! If you found this interesting PLEASE share it! Share Ground Truths Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don’t hesitate to post comments and give me feedback. Let me know topics that you would like to see covered. Leave a comment Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years. It enabled us to accept and support 47 summer interns in 2025! We aim to accept even more of the several thousand who will apply for summer 2026.
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