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Supreme Court rejects Trump's order to end hormone treatments for transgender prisoners
The decision is a rare win for trans rights at the Supreme Court.
Scientists discover that male and female skin play by different rules
Scientists have uncovered a surprising difference in how male and female skin repairs and renews itself. By tracking individual skin stem cells in living mice for five months, researchers discovered that female cells work together in a highly coordinated way, while male cells operate more independently. This synchronization, driven by sex hormones, helps explain why wounds heal faster in female mice, especially during the first few days.
Scientists discover how deep sleep builds muscle, burns fat, and boosts the brain
Scientists have discovered a surprising two-way relationship between sleep and growth hormone, revealing how the brain carefully balances physical recovery with wakefulness. The findings could help explain why poor sleep harms metabolism and brain health, potentially opening the door to new treatments for sleep and neurological disorders.
“Baby Brain” During Pregnancy: What Science Says About Forgetfulness
Discover new research into pregnancy-related forgetfulness, how hormones may affect memory and practical ways expectant parents can cope.
Stand Up for Science Traces the Surprising Story Behind Ozempic and Related Drugs in the Latest 'Traces
Venom from a desert lizard, a hormone that vanishes in minutes & 40 years of persistence: the “overnight” weight loss drug revolution wasn’t overnight at all
Spending More Time With Your Cat May Have Positive Mood Benefits That Correlate With Cat And Their Owner's Hormones
Owning a dog has been shown to consistently offer a range of benefits, but less can be said about cats. This new study may help explain why.
This Overlooked Part Of Your Stress Hormones May Affect Metabolic Health
How the body stores fat goes way beyond calories and macros.
Hormone Therapy Fears
Hormone therapy remains a safe and effective treatment for many menopausal women when used appropriately, experts say.
Health conference to cover GLP-1 drugs, hormone therapy, youth sports
The Area Health Education Center (AHEC) will host its 42nd Annual Update in Medicine Conference.
Livelong Women’s Health Summit Builds Momentum for 2027 Expansion
The Livelong Women's Health Summit brought together consumers, clinicians, researchers, and health experts for conversations spanning menopause, strength and performance, brain health, nutrition, hormones, and the science of aging. The Health & Fitness Association (HFA) served as a sponsor for the event.
Can HRT help prevent dementia? New research suggests it might
As debate continues over whether hormone replacement therapy can protect against dementia, new studies suggest timing and formulation are key.
Contributor: There's federal progress on women's health. No joke
States have been the laboratory for policy changes on menopause care and hormone access, and the feds are now following leaders such as California.
Virginia Tech leads multimillion-dollar project for women's health
The National Institutes of Health (NIH) has funded a Virginia Tech–led research project to better understand and predict women’s health outcomes by investigating how hormones shape the structure and function of vaginal tissue across the lifespan. The award for up to $9.26 million is part of a growing initiative by the NIH Office of Research on Women’s Health.
Virginia Tech leads multimillion-dollar project for women's health
A team of researchers from across the country will investigate the connection between hormones and vaginal tissue health in a project funded by the National Institutes of Health.
Toledo summit will focus on women’s health issues including menopause and hormones
The Northwest Ohio Women’s Health Summit is described as a day of evidence-based answers for women who are ready to feel better, get well and take charge of their health.
‘Powerful and beautiful’: Here’s why we all need body fat
From releasing hormones to regulating our temperature, fat has myriad roles in the body. Here’s how much you need and why chasing extreme fat-loss goals is unhealthy.
‘Powerful and beautiful’: Here’s why we all need body fat
From releasing hormones to regulating our temperature, fat has myriad roles in the body. Here’s how much you need and why chasing extreme fat-loss goals is unhealthy.
Scientists Just Learned a Bear’s Sex From a Strand of Its Hair
Researchers matched hormone traces in grizzly hair to known bears and correctly told males from females 80% of the time, rising to 94% in adults.
This Vitamin May Help Women 50+ Balance Blood Sugar & Hormones
It also helps with bone health and immunity.
I WITNESS: A column that has nothing to do with politics and everything to do with hormones
After 20 years of hormone replacement therapy (HRT), my doctor cut me off at the age of 55. I am now nearly 70 and ready to report back from the front lines of menopause.
Hot flashes and hormone therapy: the science of perimenopause
After decades of controversy over prescribing hormone therapy for perimenopause, many providers are reconsidering their approach.
Scientists find a hidden cause of high blood pressure that routine tests can miss
A wearable device has revealed nighttime hormone surges that may expose a frequently missed cause of high blood pressure. The discovery could help explain why primary aldosteronism often escapes standard blood tests and point toward a more accurate way to diagnose it.
Europe's endocrine community calls for policy action as growing demand puts hormone health workforce under pressure
The Prague Declaration and accompanying white paper, "Endocrine Workforce 2026: Recommendations for a Healthier Endocrine Future," set out 29 recommendations informed by ESE's State of Endocrinology surveys, ...
Would you try a pink pineapple vaginal probiotic gummy?
The new hormone-free gummies pair a clinically studied probiotic strain with vitamin D and sea buckthorn to support vaginal health, gut health and overall women's wellness.
Bone Health Without the Hype
I am at the Australasian Menopause Society meeting and we had a fantastic lecture on Bone Health on Day 2, called, “Everything you need to know about bones - except the boring bits!” Spoiler alert, there were no boring bits. The lecture was given by Dr. Amanda Beech, who is a senior staff specialist in Obstetric Medicine and Endocrinology at the Royal Hospital for Women, where she is director of the Bone Density Unit. I want to summarize my top 10 take-aways for you. Share Osteoporosis is a disease of low bone mass, disruption of bone microarchitecture, and fragility of the skeleton. It is a silent disease…until someone develops a fracture. The diagnosis of osteoporosis is based on either fragility/minimal trauma fractures or a T-score of less than -2.5 on a DXA (Dual-Energy X-ray Absorptiometry) or bone scan. It is important to recognize that about 50% of minimal trauma fractures occur when women have low bone mass (often referred to as osteopenia), but not osteoporosis. This tells us that bone strength is more complicated than a number on a DXA report. I am going to add a little here that wasn’t in the talk (one can only include so much in 25 minutes), as many women might read the above paragraph and think, “Shouldn’t we be treating everyone with low bone mass if this is when 50% of the fractures occur?” Many fractures happen for women with low bone mass because there are so many women with low bone mass –it is a statement about the population on a whole, not about the fracture risk of low bone mass. For you as an individual, bone density is only one component of fracture risk and many women with lower bone mass will not have a significantly elevated fracture risk. This is why individualized risk assessment matters. Subscribe We build bone in our teens and twenties, and by the time we are about thirty we have reached peak bone mass. This is why, when we discuss risk factors for osteoporosis, it is important to consider factors that might have affected us in our teens and twenties when we were actively building bone, such as nutritional restriction/energy imbalance. It is important to ask women about a history of eating disorders, and for those with such a history, getting a bone scan in perimenopause or at age 50 is likely warranted. (This image below isn’t from the talk, but is similar to one that was). Bone mass is relatively stable until about two years before the final menstrual period, and perimenopause marks a time of rapid bone loss for women. Using urinary markers of bone loss we know that the time of significantly accelerated bone loss starts about 1 year before the final period and ends about 2 years after the final period. The Study of Women’s Health Across the Nation (SWAN) shows that over the menopause transition women lose an average of 10.6% of the bone at their lumbar spine and 9.1% at the femoral neck While this wasn’t covered in the lecture, I want to add that the rapid bone loss during perimenopause is clearly related to more than estradiol, because during this time estradiol levels can be erratic and not uniformly low. Bone loss during perimenopause is likely a multi-hormone event. For example, rising FSH (follicle stimulating hormone) tracks with bone loss better than estradiol, and there is evidence that FSH may act directly on bone. While decreased estrogen matters, there is clearly more going on. FSH and bone is an active area of research. Subscribe Screening for osteoporosis was recommended fairly broadly before age 65, and was taken from the “Practitioner’s Toolkit for Managing Menopause,” from Monash University. Here is a screenshot from the toolkit that was used as a slide: I am going to add a little bit more about body weight here for clarification. Low body mass (typically 152.1 lb): 0 points (risk neutral) 60–69 kg (132.3–152.1 lb): 3 points (adds some risk)
Wilmington health tech founder launches new venture
Several years after launching his health tech startup Artemis Immersive, founder Adam Isley is setting his sights on new horizons. Co-founded in 2023 by husband-and-wife Adam Isley and Kaylan Barbrey, along with Matthew Raffa and Bill Blakesley, Artemis Immersive began as a spatial medtech company that created digital renderings of medical scans for viewing in augmented reality (AR). Isley said the firm, which won an NC Tech award in the Biotech + HealthTech Innovation category last year, has raised $1.2 million in total in seed funding since launching. Isley has since created a new venture, Research and Me, building on the Artemis platform. Like Artemis Immersive’s core software, VoxScan, Research and Me combines health data with artificial intelligence in a 3D interactive environment to help patients better understand health outcomes and provide integrative wellness support. While the Artemis product is no longer Isley’s primary focus, he said the company’s technology and ambitions have evolved into different ventures, like Research and Me. "It's a different venture building on the Artemis platform, and there'll probably be more,” Isley said. He added, "I was very disappointed in the quality of the information available to general patients about their healthcare... I wanted to give patients more and a better plate of choices." Research and Me is still in its beta phase, Isley said, with usability testing ongoing in partnership with the firm’s partner, Medicap Pharmacy and Wellness Center, owned by Barbrey. "As someone who's kind of dedicated their life to working in healthcare, I've tried to bring this spirit and passion to it,” he said, “and a lot of the resources that we'll be providing are free — like a base level of free care for any patients, or medical education if they've got specific conditions." Isley describes Research and Me as a “patient-first” platform designed to securely store and pseudonymize health data and use AI and medical literature to generate insights. The insights are presented in an interactive 3D environment for patients and providers to explore conditions, treatments and wellness plans together. "It's almost like a democratization of understanding medical information," Isley said. "We take a whole bunch of clinical data, we take a whole bunch of peer‑reviewed, published studies on PubMed, and we try to turn them into chunks of information that normal humans can understand." Like VoxScan, the Research and Me platform lets users interact with 3D anatomical models for visualization. The platform provides a space for tracking, notes and insights. The platform also supports video conferencing, Isley said, allowing providers or coaches to examine models and data together. "We wanted to create a safe environment where you can start to learn and experiment with new features about your health, using agents to do that,” Isley said. While Research and Me is in beta-phase testing with Medicap Pharmacy, Isley said he envisions the platform serving a wellness-oriented community, working with sports performance clinics and hormone optimization. Isley, who is working towards a wellness-coach board certification, also plans to offer functional wellness consults through the platform. Long‑term, Isley says he wants the platform to embody an “integrative health practitioner” approach, “connecting experts of different fields and specializations in a way that they can make a greater impact in people's lives.” “For people in the state of North Carolina, it's already a win,” Isley said of the Medicap rollout, noting that partner clinics get “immediate resources for learning about their health and wellness conditions… out of the box.” Isley plans to launch Research and Me’s provider portal in 2028 and begin pursuing integrations with larger systems, he said.
Hormone therapy for menopause might have heart health benefits
Hormone therapy may do more than ease hot flashes and night sweats. A new study suggests it may also be linked to a lower risk of heart problems.
‘GLOW’ forum brings women together to talk mental health
The Junior League of Mobile held a forum Thursday night focused on women’s mental health, hormones, sleep and burnout.
Hormone Therapy For Menopause Might Have Heart Health Benefits
By Dennis Thompson HealthDay ReporterTHURSDAY, Sept. 10, 2026 (HealthDay News) — Hormone therapy started during menopause might reduce a woman’s risk of heart attack and stroke, a new study says. For common menopause symptoms such as hot flashes and night sweats, which affect as many as 80% of ...
Spiraea genome reveals how Rosaceae evolved a key defense hormone
A chromosome-level genome of Chinese spiraea reveals how the rose family conserved and remodeled a major route for producing salicylic acid, a hormone central to plant immunity and environmental stress responses.
BhSUN coordinates calcium signaling, microtubule organization, and hormone metabolism to drive directional fruit growth in wax gourd
Fruit shape determines market value in wax gourd (Benincasa hispida), but the genetic programs that make some fruits long and cylindrical while others turn out short and round have remained largely mysterious.
In 2001, scientists began adding 5 to 6 nanograms per litre of synthetic estrogen to an Ontario lake; after 2 seasons its minnow population collapsed
A tiny concentration of a synthetic hormone was enough to trigger a dramatic ecological change in a remote Ontario lake. In 2001, scientists began adding the synthetic estrogen 17α-ethynylestradiol (EE2) to Lake 260 in northwestern Ontario, maintaining concentrations of about 5 to 6 nanograms per litre.
Asthma Is Worse for Women. Doctors Are Finally Starting to Figure Out Why.
Scientists are learning how female hormones may impact asthma risk and severity from menstruation to pregnancy to menopause.
Growth hormone peptides promise to stall aging—but does the science stack up?
Sermorelin, tesamorelin and other growth hormone peptides are being touted as antiaging elixirs, but what evidence is behind those claims?
FDA approves tirzepatide for reducing cardiovascular risk in adults with type 2 diabetes
The popular drug, sold by Eli Lilly and Company under the brand name Mounjaro, has been at the center of many cardiology trials over the years. It is now the first dual GIP and GLP-1 hormone receptor agonist approved by the FDA for this indication.
Menopausal Hormone Therapy Could Cut Costs While Adding Healthy Years
An analysis finds that menopausal hormone therapy could save thousands of dollars per patient while improving quality of life and reducing cardiovascular disease and deaths.
New Mexico to continue funding gender-affirming care for minors after federal cuts
Trump administration finalized rule to end Medicaid support for care including hormones and speech therapy
4 Doctor-Approved Exercises To Manage Cortisol Levels
In TODAY.com’s Expert Tip of the Day, Dr. Natalie Azar, rheumatologist and NBC News medical contributor, shares common myths about the stress hormone and how to keep it in check.
4 Doctor-Approved Exercises To Manage Cortisol Levels
In TODAY.com’s Expert Tip of the Day, Dr. Natalie Azar, rheumatologist and NBC News medical contributor, shares common myths about the stress hormone and how to keep it in check.
This weight-loss hormone may protect the liver even without weight loss
A hormone already known for curbing appetite and supporting weight loss may have a surprising second job: protecting the liver from inflammation and scarring. Researchers at McMaster University found that GDF15 activates a previously unknown brain-to-liver pathway that triggers the release of glucocorticoids, helping calm immune activity in the liver.
Orexins: the brain’s Ozempic moment?
Drugs that mimic hormones involved with wakefulness, attention and motivation could transform narcolepsy treatment, and offer hope for depression and ADHD
It is finally time to talk about the impact of fluctuating hormones
For decades, women have felt the need to hide the impact of changes in their hormones, while scientists have excluded women from research to avoid hormonal fluctuations complicating their research. Thankfully, this is starting to change
Coffee drinkers have less fat, more muscle, and surprising hormone differences
Coffee drinkers may be getting more than an energy boost. A Finnish study found that people who drank more coffee tended to have less total and abdominal fat, more muscle, and healthier metabolic markers despite having similar BMIs. Higher coffee intake was also linked to lower levels of certain amino acids associated with insulin resistance and type 2 diabetes risk.
Nexira spotlights science-backed solutions for women’s health
Women’s health is expanding through hormone-focused, lifecycle nutrition. At Vitafoods Asia, Nexira launches BloomEase, a science-backed solution combining botanicals and marine magnesium to support premenstrual syndrome and improve women’s comfort and well-being
Why women with ADHD feel overwhelmingly 'controlled' by their hormones
People with ADHD are unusually sensitive to hormone shifts. Psychiatrists have started to pay attention, creating strategies to address the intense emotions and cognitive challenges caused by these changes
Is hormone therapy the cheat code to perimenopause?
Perimenopause can be overwhelming. Mood swings, insomnia and hot flashes can make you feel like a completely different person. Hormone therapy is one way a lot of women are treating the symptoms. Life Kit’s Marielle Segarra talks with Dr. Mara Gordon of NPR’s Real Talk with a Doc column about the risks and benefits.Follow us on Instagram: @nprlifekitSign up for our newsletter here.Have an episode idea or feedback you want to share? Email us at lifekit@npr.orgSupport the show and listen to it sponsor-free by signing up for Life Kit+ at plus.npr.org/lifekit
How menopause can impact mental health
Dr. Lulu Zhao, a mood disorder specialist at Cleveland Clinic, says during perimenopause, a woman’s hormone patterns can become erratic, which can impact their mental health.
The Science Behind Why a Banana at Night Might Help You Sleep
Eating a banana may help you relax and improve your sleep hormones thanks to nutrients like tryptophan, vitamin B6, magnesium, and potassium.
A stress hormone may help the brain repair itself
A surprising stress-related signal may help the brain repair itself after injury. Researchers found that myelin-producing precursor cells rapidly release the stress hormone CRH near damaged brain tissue, helping control how those cells mature and rebuild protective nerve insulation. The same system also influences brain development and the thickness of myelin later in life. The findings could offer new clues about how early-life stress contributes to psychiatric disorders.
US bars federal funding of gender-affirming care for low-income minors
WASHINGTON, Aug 11 (Reuters) - The Trump administration finalized a rule on Tuesday barring two major federal health programs from funding puberty blockers, hormone therapy and surgeries to treat gend...
Frequent cannabis users wake up with their “stress hormone” already elevated
Frequent cannabis users may wake up with unusually high levels of the stress hormone cortisol, suggesting their daily stress rhythms could be disrupted. Researchers say the finding raises questions about whether using cannabis for stress relief might, over time, interfere with the very system that helps the body handle stress.
Everyone's talking about hormone therapy for menopause. Should I be on it?
For years doctors advised women against hormone therapy for women in the menopausal transition. Now everyone's talking about how great it is. Is it really a wonder drug that women should all be on?
Butterfly lilies wing their way to Science
Many animals and plants show left-right differences in how their bodies or organs are arranged, but we still know little about how such asymmetries evolve or how genes control them in natural populations. Mirror-image flowers, in which female and male sex organs are deflected to opposite sides in left- and right-handed forms, provide a notable example of such asymmetry. Here, we studied South African butterfly lilies, where individual plants produce only left- or right-handed flowers. Their mirror-image flowers promote outcrossing by depositing pollen from each floral form onto a specific region of a pollinator’s body that matches the stigma position of the opposite form. This suggests that selection for efficient pollen transfer between forms maintains this natural polymorphism. Our work uncovers a hemizygous supergene that coordinates the left-right orientation of female and male sex organs in mirror-image flowers by linking two independently acting genes for style and stamen handedness in a single, nonrecombining genomic segment. This architecture ensures the coinheritance of a matched pair of organ orientations that is essential for efficient cross-pollination between floral forms. At the developmental level, we show that floral handedness emerges from the interaction between an intrinsic tissue chirality and a gravitropic response that orients the style and median stamen relative to gravity. Together, these findings reveal how a supergene, hormone and microRNA signaling, tissue chirality, and an external physical cue combine to produce and maintain a stable left-right polymorphism in natural plant populations.
Living longer could hinge on one surprising dietary change, study review suggests
A review of 350+ studies finds protein restriction triggers the hormone FGF21, delivering longevity benefits similar to calorie restriction.
54% of men believe a dangerous testosterone myth — the troubling places they’re getting their info
Testosterone is so hot right now. And many men believe boosting this hormone can make them hotter. That’s just one of the strange beliefs highlighted in a new Men’s Health survey of...
Expert: Testosterone, masculinity and the politics of “low T”
The Trump administration's decision to screen U.S. military personnel for testosterone deficiency has renewed debate about the hormone's role in health and performance. The move also reflects wider
Flawed studies linking hormone therapy to breast cancer made doctors reluctant to prescribe it for menopause relief – especially for breast cancer survivors
Menopausal hormone therapy no longer has the highest-level warning label about the risk of breast cancer, opening a gray area on who would benefit most from treatment.
The key to better brain health and ‘super-ageing’ could lie in your bones
Our bones produce a hormone called osteocalcin, activated by exercise, that crosses into the brain to fight memory loss and anxiety.
Ida Tin Coined Femtech. Now She’s Funding Continuous Hormone Monitoring
Femtech pioneer Ida Tin is leading a €40M government challenge to build continuous hormone monitoring—and end the diagnostic delays that cost women years.
Does the science of peptides live up to the hype?
Synthetic peptides are getting some serious hype, from fitness influencers on your FYP to people seeking new options for chronic conditions. And while the human body already makes peptides, like insulin and the hormone oxytocin, most of the viral synthetic peptides are not approved by the Food and Drug Administration. Scientists say that raises some big concerns about safety and efficacy. So ahead of this week’s FDA meeting to discuss seven commonly used peptides, we get into the science with health reporter Sarah Boden.Interested in more science behind health trends? Email us your question at shortwave@npr.org.Support public media with NPR+ and enjoy perks for over 25 podcasts like this one. It includes perks like bonus episodes, early access, archive access, curated playlists and sponsor-free listening. Learn more at plus.npr.org.
Who can access testosterone hormone medication in the U.S.?
Wildfire smoke health hazards, a new idea for treating Duchenne, and more health news from Morning Rounds
Pete Hegseth’s Plan for ‘High T’ Troops Is a Junk Science Fever Dream
The defense secretary’s idea of administering testosterone therapy to service members of the US Armed Forces reveals little understanding of the complexity of hormones.
Trump officials want to make testosterone drugs easier to prescribe. Is that a good idea?
Officials under President Donald Trump want to make it easier for men to get a prescription for testosterone, the latest shift in a decades-long debate over the benefits and risks of replacing the hormone that affects sex drive, mood and other health factors.
"High-T Department": Hegseth approves testosterone screening in military
Hegseth says he is authorising hormone screening to ensure US troops "operate at your absolute best".
Pete Hegseth’s Questionable Testosterone Plan
The secretary of defense wants to monitor the hormone levels of every service member over 30.
How weight, diet and lifestyles are affecting women’s hormonal health - Baylor College of Medicine Blog Network
Dr. Mona Romezi explains how weight, diet and lifestyle affects women's hormonal health and how to balance those hormones.
ADHD and periods: Are my hormones making my symptoms worse?
A first-of-its-kind study by UK researchers is looking at the link between menstrual cycles and ADHD.
A vitamin A discovery is changing what scientists know about vision
A surprising discovery is reshaping scientists' understanding of how humans develop sharp central vision before birth. Instead of blue cone cells migrating away from the retina's center, the study found they transform into red and green cones under the influence of vitamin A-related signals and thyroid hormones. The findings could improve lab-grown retinal tissue and lay the groundwork for future cell therapies to restore vision lost to age-related eye diseases.
Doc strikes out on her own with hormone therapy practice Lumineux Health near Willow Lawn
An OB/GYN and former partner at Virginia Physicians for Women, Amanda Vaughan said she started Lumineux after seeing a need from women experiencing perimenopause and menopause.
CaroMont Health Opens CaroMont Hematology & Oncology in Belmont
CaroMont Health has opened CaroMont Hematology & Oncology in Belmont, expanding access to cancer and blood disorder care across the region. Located in the CaroMont Health Medical Pavilion on the campus of CaroMont Regional Medical Center in Belmont, the practice offers physician visits, infusion therapy and laboratory services in one convenient location, along with comprehensive hematology and medical oncology care including chemotherapy, immunotherapy, targeted therapy, hormone therapy and survivorship support. The opening is part of CaroMont Health's $200 million investment in cancer care, the second largest investment in the health system's history, which will double its oncology capacity across the region.
Is testosterone therapy a fix for aging? The Trump administration proposes easing prescription rules
Boosting low levels of the hormone is seen as a possible fix for men’s chronic health problems.
Stanford grads secure $11.6 million for women's hormone bracelet
Clair Health says today's wearables overlook women's health. Read the pitch deck behind its $11.6 million seed round.
Scientists discover the deep sleep circuit that builds muscle, burns fat, and boosts the brain
Researchers have identified the brain circuitry that links deep sleep with the release of growth hormone, revealing how the two regulate each other. The newly discovered feedback loop helps explain why poor sleep can interfere with growth, muscle repair, fat metabolism, and brain function. Understanding this system could pave the way for new therapies for sleep disorders and diseases tied to metabolism and the brain, including Alzheimer's and Parkinson's.
Karpa Health Launches Turnkey Nationwide Telehealth Platform as GLP-1, Peptide, and Hormone Demand Accelerates
The all-in-one platform helps entrepreneurs, clinics, med spas, gyms, and wellness brands launch cash-pay telehealth programs nationwide. TAMPA, FL / ACCESS Newswire / July 3, 2026 / Karpa Health today announced the general availability of its turnkey ...
People are taking allergy and heartburn pills for PMS. Could it work?
Can the mix really help with premenstrual woes? Theoretically, the link between histamine and hormones could explain why the trendy DIY treatment seems to help some women.
What your sleep schedule says about your health
From the time you naturally wake up to how long you actually sleep, your schedule holds clues about your heart, hormones, mental health, and longevity
Making Our Own Luck
We are cross-posting a piece that former NIH official Kris Willis wrote for Macroscience. Kris is now the President and Founder of the Woodley Park Institute, for which I’m a board member. Picking winners or hedging bets? Federal science agencies have long wrestled with the question of how to ensure their billions of dollars of grants and contracts result in maximum benefits for Americans. On the surface, it might seem that a goal-oriented, interventionist style of management would be the best policy: prioritize our most pressing problems and distribute funding accordingly.This top-down strategy creates a unique hazard, though: bad choices can send resources in the wrong direction, resulting in slow progress that impedes the delivery of tangible benefits to citizens. Moreover, if decision makers pursue an applied advance when the underlying scientific principles remain poorly understood, they risk costly failures and a loss of support for the research enterprise at large. Examples include Nixon’s 1971 War on Cancer, undertaken on the premise that a cure could be achieved in less than a decade, the drive to build an operational commercial fusion plant by the mid-1990s, and the National Plan to Address Alzheimer’s Disease, which failed to produce the effective treatments and prevention strategies promised by 2025. The contrasting laissez-faire approach is to hedge your bets. If the path to an advance is impossible to predict, then the wisest choice might be to distribute funding to as widely as possible. The main risk of this strategy is that spreading funding thinly may limit the resources available to the most promising research, resulting in the same negative outcomes as the interventionist approach: limited support for the most promising topics, slow progress, and delayed returns. In reality, at science agencies like the National Science Foundation and National Institutes of Health, program managers navigate between these two extremes, setting some funds aside to target high-priority areas and using the rest to cover the widest possible range of meritorious proposals. This middle path seems like the most rational way to proceed, but it still requires making choices. How much should be set aside for high priority topics? What should those topics be? How should we define merit? Expert opinion can provide a helpful guide, but leading experts can have remarkably different opinions about what matters and what should be prioritized. Moreover, experts and administrators alike can be risk averse, giving an edge to high-profile, well-established concepts. What’s really needed is a data-driven framework to help guide decision-making, one that doesn’t simply repackage prestige or incumbency. Recognizing breakthroughs years in advance Many breakthroughs fail to attract funding or recognition at the earliest stages of development. Katalin Karikó, for example, spent years struggling to win grants for work on mRNA that would eventually win her and Drew Weissman a Nobel Prize. Similar stories can be told about Jim Allison’s groundbreaking studies leading to the development of cancer immunotherapy, Stan Pruisner’s demonstration that prions can self-replicate without DNA, or Robin Warren and Barry Marshall’s proof that Helicobacter pylori, not stress, causes ulcers. Yet at some point, the scientific community recognizes and responds to transformative breakthroughs like these. How does that change happen? And what if science funders could identify the areas that are on the cusp of a breakthrough? Those questions led my collaborators and me to study how scientists responded to past breakthroughs. Based on patterns in that data, we developed a means of predicting future breakthroughs, using biomedicine as a proof of concept. It’s worth taking a moment to describe how our approach works. Briefly, our prediction process begins by grouping the 18 million or so peer-reviewed papers in PubMed, the authoritative database of biomedical research, into roughly 50,000 unique topics. A small subset of these topics are so widely acclaimed as breakthroughs that they have been recognized with a major prize like a Nobel or a Lasker Award. We theorized that studying the development of these outliers over time, especially before they gained acclaim, was the key to identifying future instances of them. After defining topics, we chose 21 representative breakthroughs and asked what they looked like before they won prestigious prizes. To answer that question, we re-ran our topic-mapping algorithm repeatedly, winding back the clock one year each time, stringing together the years to follow the progress of each field as it grew and advanced. We found that in each case, the years leading up to a discovery followed a pattern: a burst of papers on a new, rapidly evolving topic, many of which quickly became influential. These characteristics—the percent of papers that are new, the percentage of papers that are brought in from other topics, and the influence of each individual paper—can all be measured separately for any given topic. Together, they act as a predictive signal that is detectable an average of five years before a transformative discovery is made, and up to thirty years before the discovery receives a major prize. Scanning the current research landscape for topics that display this signal allows us to predict what work will likely produce a future breakthrough. Each year we analyzed includes four or five signals, a number that appears to have remained constant across a twenty year time frame. In their classic work on the sociology of science, Bruno Latour and Steve Woolgar established that the desire to participate in a major discovery is an important motivator for scientists as they consider whether they should take up (or abandon) a research problem. Although further work is needed, the simplest explanation for our results is that this behavior is widespread enough to detect at scale. A foundational advance, or something like it, draws the attention of scientists and causes them to change the direction of their research. They vote with their feet, staking their own reputation and careers by publishing on and citing the new idea. That upswell of interest is the foundation of our breakthrough signal. What kind of research does our model identify as a breakthrough? After building a model based on the patterns in our 21 preselected breakthroughs, we tested it by identifying all early signals of discovery from 1994 through 1997. Of the 18 signals we found in that time period, 17 can be traced forward in time to a breakthrough. Examples include super-resolution fluorescence microscopy (see the image above), the directed evolution of proteins and enzymes (Chemistry Nobel, 2018), and sequencing the human genome (National Medal of Science, 2008). The discovery of the role of leptin signaling in obesity is a particularly interesting case study. Around 1950, scientists noticed the existence of a type of lab mouse that suffered from a unique inherited form of obesity. When given the freedom to choose their own diet, these mice ate more than normal and preferred food that was high in fat. Researchers had few clues as to why the animals overate; early experiments pointed to the existence of a soluble ob factor found circulating in the bloodstream that regulated appetite, but its identity was unknown. In 1994, Jeffrey Friedman and colleagues identified and sequenced the ob gene, noting that the protein it encoded appeared to fit the profile of a circulating factor. A year later, a trio of high-profile publications demonstrated that ob was a hormone that regulated body weight and fat deposition by regulating appetite. One of these was co-authored by Friedman, who christened it leptin from the ancient Greek word for thin. Using our model, the data from 1996 make it clear this advance would become a breakthrough. Scientists had flocked to study the biology of the new hormone, generating the flurry of new papers and citations required to produce a signal. One of these demonstrated that serum leptin concentrations reflected the amount of adipose tissue in the human body, providing clinical validation of the earlier mouse studies. Before the identification of leptin, scientists were unable to point to a specific molecule that controlled appetite and adiposity, so that it was impossible to rule out non-physiological causes of obesity; its characterization fundamentally changed our concept of weight gain. In 2010, Friedman and fellow pioneer Douglas Coleman were awarded a Lasker for the discovery. Our work also identifies breakthroughs in clinical practice and behavioral and social sciences, even though these areas are less likely to draw the attention of major prize committees. One example that falls into this category is the introduction of endovascular aneurysm repair, a minimally invasive surgical procedure for the treatment of abdominal aortic aneurysm, a leading cause of death among Americans over the age of 65. Relative to the previous standard of care, it reduces in-hospital mortality by almost four-fold. In 2017, Timothy Chuter received the American College of Surgeons’ prestigious Jacobsen Innovation award for his multiple refinements to the technique. Another under-recognized breakthrough identified by our model is the development of standardized survey instruments to assess the quality of life for HIV+ patients. The antiretroviral cocktails introduced in the mid-1990s reduced AIDS mortality, but treatment came with serious side effects. The new evaluations showed that patients whose disease progressed had worse physical functioning than Americans with other chronic diseases, while those who were asymptomatic maintained a health-related quality of life on par with the overall US population. This evidence made it possible for patients and activists to argue that even in the absence of a total cure, and in spite of the side effects, alleviation of symptoms was a worthwhile priority for clinicians. My colleagues and I have failed to identify any significant recognition for the physicians and health policy experts who pioneered this advance, although in 2016, researchers called for the World Health Organization to set targets for good health-related quality of life as part of its framework to end the AIDS pandemic. From forecasting to funding How should science funders use our predictions? Any serious discussion of what we should do with this new capability needs to begin with an understanding of its limitations. We can’t (and shouldn’t) invest all of our resources in the small number of topics predicted to produce breakthroughs. Innovative new fields are born from existing ones; they rarely arise de novo. If funders don’t maintain a diverse portfolio, the breakthroughs of tomorrow will have no antecedents. Think of this as eating the seed corn, or killing the goose that lays the golden egg. There are also multiple goals of funding beyond basic scientific discovery, including translating discoveries into clinical practice, developing new technologies, supporting economic development, and training new scientists. The investments needed to accomplish these goals are likely different from those required to support emerging breakthroughs. Finally, we must be aware that we may not capture every instance of a breakthrough. The concept is fuzzy, and not every significant discovery is recognized with a major award. Further, breakthroughs are rare, meaning that our dataset is, by necessity, small. This makes formal estimates of accuracy challenging. Although our overall success rate appears to be high, any one signal may turn out to be a false positive. We found one apparent example: the development of the third generation COX-2 inhibitors, Vioxx and Celebrex, which were much celebrated in the early 2000s as effective but non-addictive pain relievers, meets all the algorithmic criteria of a breakthrough. Five years after it received FDA approval, researchers demonstrated that Vioxx was associated with serious cardiovascular complications, and the manufacturer voluntarily pulled the drug from the market. Celebrex remains available, although like other NSAIDs, it carries an FDA warning for increased cardiovascular risk. Decision makers who were overly focused on the breakthrough potential of this research might have wasted substantial resources nurturing an area that ultimately proved to be a failure—but so would those who relied on expert opinion at the time. That said, the potential benefits of funding the next mRNA vaccine or cancer immunotherapy years earlier than we might have are large. When we can’t assume the outcome of an action, it’s worth conducting an experiment. Can targeted support for areas that are poised to produce a breakthrough increase the return on scientific investment without cannibalizing future advances? With the necessary administrative infrastructure in place, conducting this experiment would be straightforward. First, identify all the breakthrough signals between 2018 and 2023, select half at random, and commit to a decade of investment. For biomedicine, a six year window should yield about 30 topics with the potential to produce a breakthrough. Providing strong support to half of these might be accomplished for $300 million a year. That’s roughly half of the recent annual budget of the NIH Common Fund or around 20% of the fiscal year 2025 budget for ARPA-H. After five years, then again at ten, compare to see which group — the one that was actively managed, or the control — produced more breakthroughs, and on what timescale. Although we used biomedicine as an example, the same experiment could just as well be run for physics, materials science, or any other discipline. Any attempt to undertake such an experiment should keep three points top of mind. First, we can predict the topic of future breakthroughs, but the people and vision for how to move the work forward are still important. In practice, this means success requires active program managers with the expertise to develop the science and the authority to do so, including by recruiting investigators. Second, we would be wise to learn from the failures of past attempts to fund transformative research. High among these are funding modestly repackaged work, confusing the genuinely novel with the merely unfamiliar, and relying too much on incumbent investigators. All of these risks can be mitigated by thoroughly and intelligently integrating high quality data into portfolio management. Finally, we need to have patience. Even with strong funding support, producing a breakthrough takes time. If supporting breakthroughs is the best way to nurture the birth of new fields, we also need to accurately describe and properly manage the other two stages, so that we invest wisely throughout the productive lifetime of ideas and divest once they reach the point of diminishing returns. We would benefit from more study of all of these phases, especially the transition from one to another. More research could answer questions like: When does a breakthrough become an established field? How do the availability of funding, the size and characteristics of the available workforce, and the accumulation of evidence that disagrees with prevailing models affect a field’s decline? Exactly how do old ideas give birth to new ones, and can we speed up the process? The more we understand about the dynamics of scientific progress, the better we can maximize the odds that our curiosity leads to results. I’d call that finding a way to make our own luck.
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