Opinion: I led the U.S. CDC response to the 2014 Ebola epidemic. The new outbreak needs massive, immediate, meticulous action

By the time the world began responding to the West Africa epidemic in 2014, which killed more than 11,000 people before it ended in 2016, there were 40 to 50 suspected cases.

The current outbreak in the Democratic Republic of the Congo had approximately 10 times that number by the time the response started. Three weeks in, it has spread from three health zones to 25, with new areas added almost daily. National, provincial, and local health staff are responding intensively, but fewer than half of known contacts are being traced nationwide, laboratories are backlogged, no Ebola treatment center is ready, few health workers have been trained, there’s insufficient protective equipment for health workers and few medications for patients, and burial teams have come under attack.

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Oral small molecule GLP-1 receptor agonist aleniglipron in people with overweight or obesity: a randomized, double-blind, placebo-controlled phase 2b trial

Nature Medicine, Published online: 05 June 2026; doi:10.1038/s41591-026-04476-6

As presented at the American Diabetes Association Meeting: this randomized phase 2b trial in 230 adults with overweight or obesity shows that aleniglipron, an oral small-molecule GLP1-RA, led to up to 11.3% body-weight loss compared with placebo after 36 weeks of treatment.

CDC: Ebola outbreak in Central Africa could reach 20,000 cases without strong countermeasures

NEW YORK — The Ebola outbreak in Central Africa could grow to 20,000 cases or more, depending on how quickly infected people are isolated to slow the spread, according to a new analysis by U.S. health officials.

The Centers for Disease Control and Prevention published a range of scenarios generated by computer models Friday, spanning from 10,000 cases to more than 20,000. If accurate, a worst-case scenario could approach the worst Ebola outbreak in history, the West Africa epidemic in 2014-2016 — which resulted in more than 28,000 reported cases and more than 11,000 deaths.

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STAT+: Newer GLP-1s, pushback on research cuts, and a protest 

You’re reading the web edition of STAT’s ADA in 30 Seconds newsletter from the American Diabetes Association’s annual conference. Sign up here

This is Elizabeth Cooney saying hello from New Orleans, where the weather is warm, the conference center is cool, and debates can be fiery. Welcome to the first of three ADA in 30 newsletters, in which my colleague Elaine Chen and I curate some of the news and analyses circulating here near the banks of the mighty Mississippi.

First up, thoughts from Rick Woychik, a senior adviser to NIH chief Jay Bhattacharya who subbed for him as keynote speaker, plus some background from our STAT colleague Anil Oza. Then, what the weekend will bring.

If you are here too, come say Hi, or reach me at elizabeth.cooney@statnews.com.

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Evaluating an Abbreviated Internet-Delivered Stress Recovery Intervention for Health Care Workers: Pre-Post Feasibility Study of Outcomes, Usability, and Acceptability

<strong>Background:</strong> Health care workers face numerous occupational stressors that place them at heightened risk for burnout and poor mental health. Internet-delivered interventions have shown promise in reducing stress and related symptoms, yet adherence is often low, and users do not complete programs. Abbreviated interventions may help address engagement barriers such as high workload, limited time, and varying user preferences. There is a need to evaluate brief, accessible formats of internet-delivered programs for this population. <strong>Objective:</strong> This study aimed to examine the initial outcomes, usability, and acceptability of a 4-week abbreviated internet-delivered stress recovery intervention for health care workers. Specifically, it evaluated changes in stress recovery, perceived stress, depression and anxiety symptoms, and psychological well-being. The study also sought to understand participants’ experiences with the brief format to determine whether it meets their needs. <strong>Methods:</strong> This single-arm pre-post study examined a 4-week abbreviated version of the online guided cognitive behavioral therapy-based stress recovery program FOREST among self-enrolled health care workers recruited through professional networks (N=52; mean age 39.31, SD 11.31 years; 49/52, 94.2% women). Outcomes included stress recovery (the Recovery Experience Questionnaire), perceived stress (the Perceived Stress Scale-4), depression and anxiety symptoms (the Patient Health Questionnaire-4), psychological well-being (the World Health Organization Well-being Index), and usability and acceptability ratings. <strong>Results:</strong> We found that after the abbreviated version of the FOREST intervention participants showed moderate improvements in stress recovery (<i>d</i>=0.54, 95% CI 0.25-0.83); reductions in stress (<i>d</i>=–0.43, 95% CI –0.72 to –0.14), anxiety and depression symptoms (<i>d</i>=–0.51, 95% CI –0.80 to –0.22); and increase in psychological well-being (<i>d</i>=0.39, 95% CI 0.08-0.70). The majority (37/52, 71.2%) accessed all 6 modules. Users reported high satisfaction with the abbreviated program. <strong>Conclusions:</strong> While preliminary and limited by the pre-post design, these findings indicate that abbreviated internet-based stress recovery programs are a promising and practical tool for supporting the mental health of health care workers. Future research should examine the long-term effects, compare the abbreviated and standard versions, and explore implementation in routine practice. <strong>Trial Registration:</strong>

STAT+: What stripping civil service protections for thousands of federal workers will mean for HHS

Thousands of Health and Human Services Department staff who shape policy, including on public health, federal health insurance programs, and health data privacy, have had their employment status changed to a designation that makes it easier for them to be fired, and thus makes them more vulnerable to political pressure from the White House. 

The reclassification of roughly 8,000 employees across the federal government, outlined in an executive order President Trump issued late Wednesday, also impacts some National Institutes of Health workers who oversee grant funding.

On the whole, health policy experts said, the shift toward a more politicized workforce is part of a broader goal of the Trump administration to shift power away from Congress and toward the executive branch. The policy, known as “Schedule F,” dates back to Trump’s first administration and would create a new class of federal employees that are not political appointees but could be fired at will.

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Senior NIH official pushes MAHA strategy to skeptical ADA audience

NEW ORLEANS — A senior adviser to the leader of the National Institutes of Health opened his speech to a national gathering of diabetes researchers with a full-throated endorsement of the Make America Healthy Again movement. Then, during the fireside chat that followed, he withstood sustained cheers for criticism of deep funding cuts to the nation’s biomedical research enterprise that he was asked to explain.

“I could have written the MAHA agenda,” Richard Woychik, who works closely with NIH Director Jay Bhattacharya, said Friday, recalling when he first learned last October of the policy embraced by Health and Human Services Secretary Robert F. Kennedy Jr. 

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How Germinal Centers Generate Antibodies Through Noisy Rounds of Mutation and Selection

A study tracking thousands of B cells across more than 100 germinal centers (GCs) in mice has revealed how the system consistently produces highly effective antibodies. The findings overturn longstanding ideas about how germinal centers function, revealing that they are far more selective than once thought, and challenge the idea that antibody improvement is driven mainly by rare growth “bursts” among the most successful B cells. The discovery could have implications for immune cell evolution, and ultimately guide the design of vaccines against rapidly mutating pathogens like influenza. It could also lead to new ways of studying evolution itself.

“The traditional, mechanistic view of germinal centers is to think of them as selection machines sorting out the best antibodies,” said research lead Gabriel D. Victora, PhD, head of the Laboratory of Lymphocyte Dynamics at The Rockefeller University. “But when you look very, very closely, you see a process that’s almost essentially random—a little bit better than a coin toss—which repeats many times until the immune system arrives at the right answer consistently. That’s much more akin to how evolution operates than the way a machine does.”

Victora and colleagues reported on their findings in Cell, in a paper titled “Replaying germinal center evolution on a quantified affinity landscape.”

Inside germinal centers, B cells rapidly mutate and compete to produce antibodies that bind successively better to pathogens. “Darwinian evolution of immunoglobulin genes within germinal centers (GCs) underlies the progressive increase in antibody affinity following antigen exposure,” the authors wrote. That puts B cells under intense pressure to optimize a single trait: binding affinity, or how well an antibody recognizes its target.

But how they accomplish that feat has very much remained an open question, the team noted. “Whereas the cellular mechanics of how competition between B cells increases affinity are well established, the evolutionary dynamics of this process are less clear.” Because weak and strong B cells often coexist side by side in the germinal center, scientists have long wondered whether the immune system temporarily preserves weaker cells in case they later acquire useful mutations. The phenomenon of clonal bursts, in which the descendants of a single B cell rapidly take over an entire germinal center, are also poorly understood.

The authors explained that GC B cells evolve by rapidly mutating only two Ig genes, which are the heavy chain (Igh) and light chain (either Igk or Igl). Victora’s team engineered mice in which all competing B cells began with the same antibody sequences, allowing them to replay a single evolutionary process across more than 100 germinal centers at once. “… we established a system in which GCs are composed entirely of B cells carrying the same pre-rearranged Igh and Igk genes, ensuring identical starting specificity and affinity,” they explained. Victora added, “We simplified it to the bare bones, and asked how repeatable is the exact sequence of mutations that leads to stronger antibodies.”

Once each of the B cells was primed with the exact same unmutated antibody sequence, the team triggered germinal center formation through immunization. They then tracked the resulting sprint toward immune efficiency with multiphoton microscopy and laser-based photoactivation, and sequenced thousands of individual B cells across 119 germinal centers.

With this data, the team managed to construct a detailed family tree that mapped how different lineages of B cells had developed. They also built a mutational dictionary, using deep mutational scanning (DMS), a technique that links almost every possible amino-acid change to antibody performance. This advance allowed the team to determine how mutations affected binding strength and structural stability simply by reading a cell’s DNA sequence.

“DMS was the big technical advance here,” says first author Ashni Vora, PhD, a graduate fellow in the lab. “With it we could determine the affinities of thousands of cells just by looking at their sequence, without having to produce an antibody.”

The researchers compare the resulting picture to a casino game. Watching a single B cell evolve inside a germinal center looked almost random, with some cells rapidly expanding, others disappearing, and even promising mutations failing as if random chance ruled the day. Some germinal centers were overtaken by clonal bursts while others contained many competing lineages with no clear winner. The differences had little to do with affinity or merit. “We find that, even in this simplified setting, GC selection yields widely divergent tree topologies, ranging from clonal-burst-type structures to multi-pronged GCs where multiple line ages evolve in parallel,” they noted.

But the team discovered that the germinal center game is rigged. In a casino, the house always wins not because of the odds on any individual game, but because a slight statistical bias is built into the system and repeated thousands of times. Germinal centers appear to operate similarly. Each round of cellular competition is only slightly biased toward cells carrying beneficial mutations, and random chance means that there is often little correlation between affinity and success. But by repeating that same noisy, almost random process over and over across many germinal centers, the immune system ultimately produces stronger antibodies.

“If you see someone get a jackpot, you might wonder how the casino makes money,” Victora says. “The answer is that the casino puts in a little bit of bias, so that you win and you lose, but on average, you lose more than you win. If there are just one or two people playing, the casino might lose money due to random chance. But if there are a thousand people playing, it’s going to average out and the house wins. That’s essentially how germinal centers work.”

The researchers also found that the immune system favors mutations that are easiest for its cellular machinery to generate, rather than the mutations that would produce the strongest antibodies. And by tracking B cell lineages over time, they also showed that germinal centers are far more selective than previously thought, rapidly eliminating inferior B cells. “By combining phylogenetic reconstructions with a fitness landscape inferred from populations sampled over time, we show that both the apparent permissiveness of GCs to low-affinity lineages and the apparent early plateau in affinity maturation are best explained by survivorship biases that distort the histories of lineages present at sampling,” the investigators wrote in summary.

Taken together, the findings overturn several longstanding ideas about how germinal centers function and may provide new tools for vaccine developers hoping to steer antibody evolution against influenza and HIV. “What was once theoretical speculation about what must happen in the germinal center, we are now showing in action—the real thing,” Victora says.

At the same time, this work also illustrates how germinal centers could become a powerful model for studying evolution more broadly. Scientists have long relied on bacteria grown in the lab over many generations to plumb the depths of evolutionary biology and determine how much of evolution is driven by random chance. In clarifying the rules governing germinal centers, the researchers revealed why the immune system could offer a potentially more tractable experimental avenue: Unlike bacterial evolution, which centers around adapting to many possible survival strategies, B cells are all aiming for the same target. “I see this as an opening salvo in a longer effort to understand evolution by using the immune system as a model,” Victora added.

The post How Germinal Centers Generate Antibodies Through Noisy Rounds of Mutation and Selection appeared first on GEN – Genetic Engineering and Biotechnology News.

Using Social Media to Maximize the Research Impact of Surgeons: Exploratory Linguistic Analysis

Background: Surgeons work in a progressive field where communicating research is vital to advancing health care and enabling meaningful interactions among clinicians. It also contributes to societal impact, increases access to information, and reduces misinformation. Additionally, there can be barriers to accessing papers. Social media enhances research impact through sharing scholarly work and improving its translation into clinical practice, but little is known about how to design specific posts to maximize research impact through language. Objective: The purpose of this study was to determine the linguistic cues that optimize research impact among surgeons through Twitter (subsequently rebranded X). Additionally, this research combines the linguistic features of the posts and article access to determine their unique contributions. Methods: An exploratory linguistic analysis of 84 posts extracted from Twitter was conducted, which shared scholarly activity by 17 of the most-followed surgeons. The linguistic cues were measured on a continuous scale, computed from the percentage of each linguistic cue used in the text, and reported as mean (SD). Regression analysis and analysis of covariance were conducted to determine which cues influenced research impact and to estimate the potential association with study accessibility (open vs restricted access). Results: Analyzed tweets were highly analytic (mean 94.77, SD 9.00), moderate in clout (mean 42.69, SD 19.84), low in tone (mean 20.06, SD 33.91), suggesting negative tone use, and low in authenticity (mean 19.52, SD 24.50). Results suggest that a high use of formal language negatively impacts readership and citations. Analytical language was indirectly associated with readership (β=−0.296, 95% CI −423.57 to −59.95; =.01) and citations (β=−0.524, 95% CI −0.442 to −0.187; <.001). Linguistic clout had a positive association with readership (β=0.260, 95% CI 8.58-186.91; =.03), and tone in tweets had a negative association with readership (β=−0.317, 95% CI −138.52 to −5.39; =.04). Negative language tone was found to increase the impact of research. With respect to linguistic cues and study accessibility, the results also suggest that the number of citations was impacted by readership (=4.11, 95% CI 2.459E-06 to 0.003; =.047) and analytic linguistic cues (=18.77, 95% CI −0.402 to −0.149; <.001) used in the post, but the association of open (mean 3.04, SE 1.062) versus restricted access (mean 1.83, SE 0.716) was not statistically significant (=0.877, 95% CI 0.405-3.266; =.352). Conclusions: This research is the first to explore article accessibility and linguistic cues used in creating posts that share research on social media to determine their influence on research impact, making this study both innovative and unique relative to existing studies in the surgery field. Through language, the medical field can expand its impact and encourage dialogue between scientists and the public, thereby increasing scientific and societal contributions while reducing the negative effects of limited article access.