Evaluating Postpartum Hemorrhage Transfusion Risk With a Machine Learning Model for Informed Consent: Retrospective Cohort Study

<strong>Background:</strong> Postpartum hemorrhage requiring a blood transfusion is a concern for patients and clinicians; its risk and the mode of delivery are important points of discussion before labor. Many high-risk factors associated with postpartum hemorrhage are known prior to delivery and are often unpreventable. Delivery plans are influenced by the patient’s medical history, their preferences, and clinical decision-making. Informed consent regarding known risk factors for postpartum hemorrhage will help guide delivery care plans and mitigate risk. Machine learning models have been used to predict postpartum hemorrhage; however, translation into clinical support tools is challenging. Shared decision-making discussions can be facilitated with machine learning model–based clinical support tools predicting postpartum hemorrhage requiring a transfusion. <strong>Objective:</strong> We sought to develop a machine learning model for prediction of postpartum hemorrhage requiring a transfusion. Specifically, we sought to evaluate the model’s accuracy in predicting a patient’s postpartum transfusion risk based on delivery mode, whether labor was induced, and the delivery indications for the purpose of antenatal clinical decision support. Model performance was evaluated on existing structured data and physician-reviewed datasets. <strong>Methods:</strong> A 10-year retrospective cohort of 62,521 births in a community health system was sampled. A convenience sample of 1734 patients was analyzed to predict blood transfusion rate based on delivery mode and delivery indications. XGBoost, random forest, and generalized linear models were trained and compared for performance. Datasets were evaluated using the best-performing XGBoost machine learning model. A prototype clinical support app for physician-patient transfusion risk assessment was developed using the best-performing clinically relevant XGBoost model. <strong>Results:</strong> A generalized linear model, random forest model, and XGBoost model were evaluated. The XGBoost model was trained with an existing dataset extracted from electronic medical records (n=1734). The area under the curve (AUC) was 0.71, precision-recall receiver operating characteristic curve (PR-ROC) was 0.82, and <i>F</i><sub>1</sub> score was 0.80. Performance on a physician-reviewed dataset (n=1734) was as follows: AUC=0.705, PR-ROC=0.78, and <i>F</i><sub>1</sub> score=0.809. Feature importance ranking and prediction were not clinically accurate for the pre-review dataset. <strong>Conclusions:</strong> Machine learning models are useful to determine an individual’s postpartum transfusion risk based on clinically variable and potentially modifiable factors, such as delivery mode, whether labor is induced, and delivery indications. In this study, the XGBoost model had a slightly higher AUC on structured data extracted from electronic medical records than the same dataset after physician review (AUC=0.71 and PR-ROC=0.82 vs AUC=0.705 and PR-ROC=0.78), but a slightly lower <i>F</i><sub>1</sub> score (<i>F</i><sub>1</sub>=0.80 vs <i>F</i><sub>1</sub>=0.809). XGBoost machine learning models trained on clinician-reviewed data can be used to predict postpartum transfusion. Clinically relevant, physician-labeled datasets are important for supervised machine learning model training for use in clinical decision support tools. Further study and external validation are needed prior to clinical use.

Automated Machine Learning Frameworks for Radiomics: Comparative Evaluation Study

<strong>Background:</strong> Automated machine learning (AutoML) frameworks can lower technical barriers for predictive and prognostic model development in radiomics by enabling researchers without programming expertise to build models. However, their effectiveness in addressing radiomics-specific challenges remains unclear. <strong>Objective:</strong> This study aimed to evaluate the performance, efficiency, and accessibility of general-purpose and radiomics-specific AutoML frameworks on diverse radiomics classification tasks, thereby guiding researchers and highlighting development needs for radiomics. <strong>Methods:</strong> A total of 10 public and private radiomics datasets with varied imaging modalities (computed tomography and magnetic resonance imaging), sizes, anatomies, and end points were used. Six general-purpose and 5 radiomics-specific frameworks were tested with predefined parameters using standardized cross-validation. Evaluation metrics included area under the receiver operating characteristic curve, runtime, and qualitative aspects related to software status, accessibility, and interpretability. <strong>Results:</strong> Simplatab, a radiomics-specific tool with a no-code interface, achieved the best overall balance between performance and computational efficiency, recording the highest average test area under the receiver operating characteristic curve (mean 78.46%, SD 12.22%) with a moderate runtime (1.1 h). However, its performance was not statistically superior to the most intensive general-purpose solutions. Most radiomics-specific frameworks were excluded from the performance analysis due to obsolescence, extensive programming requirements, or computational inefficiency. Conversely, general-purpose frameworks demonstrated higher accessibility and ease of implementation. <strong>Conclusions:</strong> While no single framework demonstrated absolute predictive superiority, Simplatab provides an effective balance of performance, efficiency, and accessibility for radiomics classification problems. However, continued efforts are needed to further mature AutoML solutions in the radiomics domain.

Educational Intervention on Environmentally Responsible Inhaler Prescribing Among French General Practitioners: Pilot Pre-Post Study

<strong>Background:</strong> Climate change is expected to cause more than 250,000 deaths annually by 2050 and could increase the prevalence of asthma and chronic obstructive pulmonary disease (COPD) by up to 30%. Pressurized metered-dose inhalers (pMDIs), primarily delivering short-acting beta-2 agonists, generate 15 to 30 times more greenhouse gas emissions than dry powder or soft mist inhalers. In France, short-acting beta-2 agonist pMDIs account for 95% of reliever therapy prescriptions, despite their limited effectiveness in controlling disease symptoms. <strong>Objective:</strong> This study aimed to evaluate the preliminary educational impact of a single educational session on French general practitioners’ awareness and intended prescribing of lower-carbon inhaler alternatives. <strong>Methods:</strong> We conducted a multicenter, single-group pre-post pilot study among 34 general practitioners from 10 multiprofessional health centers in Eastern Occitanie, France, between March and October 2023. Participants were recruited through convenience sampling. The intervention consisted of a one-time 25-minute face-to-face educational session on environmentally responsible inhaler prescribing, aligned with Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease guidelines. Data were collected using self-administered online questionnaires before the intervention and approximately 3 months later. The questionnaires included 2 clinical vignettes, one on asthma and one on COPD, with 3 prescribing questions each. Responses were categorized according to whether they included a pMDI. Changes in responses between baseline and follow-up were analyzed using the Fisher exact test or chi-square test, as appropriate. <strong>Results:</strong> A total of 34 participants completed the baseline questionnaire. Responses including a pMDI decreased from 70.6% (48/68) to 4% (3/68) for reliever therapy (<i>P</i>&lt;.001) and from 21.3% (29/136) to 4.4% (6/136) for maintenance therapy (<i>P</i>=.003). In asthma scenarios, adherence to GINA recommendations improved, with increased responses including inhaled corticosteroid-formoterol for reliever therapy (6%, 2/34 to 38%, 13/34; <i>P</i>=.001) and maintenance therapy (35%, 24/68 to 56%, 38/68; <i>P</i>=.02). No significant improvements were observed for COPD-related prescribing scenarios. The proportion of participants reporting environmental impact as a factor influencing inhaler choice increased from 3% (1/34) to 51% (18/34). Satisfaction was high, with 93% of participants reporting being very satisfied with the intervention. <strong>Conclusions:</strong> This pilot study suggests that a brief educational intervention may improve general practitioners’ knowledge and intended prescribing of lower-carbon inhaler alternatives, particularly in asthma scenarios. However, the outcomes were based on theoretical clinical vignettes rather than real-world prescribing data, and the study was not designed to assess the safety or clinical effectiveness of changing inhaler prescriptions. Future studies should evaluate sustained changes in real-world prescribing while ensuring individualized, clinically appropriate, and safe inhaler choices.

Google DeepMind is worried about what happens when millions of agents start to interact

Google DeepMind is funding research into the potential dangers of situations where millions of different AI agents interact with each other online.

According to Rohin Shah, who directs the company’s AGI safety and alignment research, the mass-market arrival of agents that can carry out tasks without human oversight and follow instructions given to them by other agents creates a whole new class of risk.

In an effort to address this, Google DeepMind—which made agent-based tools a centerpiece of Google I/O last month—has teamed up with several other organizations to announce a $10 million funding pot for researchers to study the behavior of multi-agent systems and come up with ways to prevent unsafe scenarios. Joining Google DeepMind are Schmidt Sciences, a philanthropic foundation set up by Eric and Wendy Schmidt; ARIA, the UK government’s moonshot agency; the Cooperative AI foundation, a UK-based nonprofit research outfit; and Google’s charitable arm, Google.org.

I asked Shah and James Fox, who leads the Science of Trustworthy AI program at Schmidt Sciences, what they hope to achieve with that $10 million. It’s no small sum, but it’s dwarfed by the budgets commanded by Google DeepMind’s own research teams.

The aim is to kick-start research outside tech companies, says Shah: “The strength of academia is that it can look really quite far into the future and do the kind of work that isn’t top of mind at industry labs.”

“The main issue is that there just isn’t really a field of research for multi-agent safety yet,” he adds. “And we would like there to be.”

The concern is that as more and more AI agents get deployed and begin working together, we could hit a tipping point where imagined scenarios become real. “We see this with humanity, too,” says Shah. “Our institutions can accomplish things that no individual human can.”

Shah thinks that we have a few more months to go before agents are deployed throughout the economy in numbers that make potential risks a real concern. He wants to get ahead of that moment.

Risky business

What risks are we talking about, exactly? The possibilities that Shah and Fox have in mind mostly boil down to supercharged versions of bad things that happen on the internet already: scams, prompt injections (where an AI agent is fed malicious instructions, turning it into a self-guiding piece of malware), other forms of cyberattack. We look at what humans do now and ask what the agent version of that would be, says Shah.  

“We’ve got this digital commons that is integral to how society works, and you really want to ensure that this doesn’t descend into just absolute anarchy,” says Fox.

(I asked Shah if they were considering any worst-case scenarios more on the doomer end of the spectrum, such as widespread economic collapse. “Certainly not if we’re talking by the end of the year,” he said. That’s only six months away! He laughed. “Okay, a while after that.”)

Shah and Fox both think that the only way to understand what might happen when large numbers of multi-agent systems interact with each other is to run realistic simulations. They want researchers to drop AI agents into sandboxes and study what they do.

You can’t predict what’s going to happen by studying single agents, or even small groups of agents, in isolation. You can’t assume that AI agents underpinned by LLMs will always act rationally, says Fox. And the complexity comes from having huge numbers of interactions at once.

Some researchers, including a team at Google DeepMind, have argued that artificial general intelligence (if possible at all) could come not from a single super-smart model but from a kind of agent hive mind, where the capabilities of the whole add up to more than the sum of its parts.  

Lack of trust

Google DeepMind is not the only top AI firm warning about the risks of the technology it is building. A couple of weeks ago, Anthropic published guidelines for deploying AI agents based on an approach to cybersecurity known as zero trust, which starts with the assumption that a computer system is vulnerable, an agent is an attacker, and a breach will happen.

Refael Angel, cofounder and CTO of Akeyless, a cybersecurity firm based in Tel Aviv, agrees that understanding the new risks introduced by agent-based systems is crucial.  

Every approach to security in the past has assumed that the machine in question was software written by a human, doing fixed things on fixed paths, says Angel: “An agent breaks all of those assumptions. It reasons, it improvises, and it can be hijacked by a single sentence buried in a document it was asked to read.”

Angel welcomes this new funding. “No single lab should author the safety standards everyone else has to trust,” he says. But he cautions that safety researchers can overlook boring problems that are already here in favor of more exotic hypothetical ones.

And yet, Fox notes, risks that were hypothetical a few years ago are now very real: “The future’s come more quickly than perhaps expected.”

Why China is betting on big nuclear reactors

It’s a tale of two nuclear industries.

In China, large reactors are coming together at a stunning pace. The country has nearly doubled its nuclear fleet since 2016, reaching nearly 60 gigawatts of total power capacity. The new facilities are nearly all gigawatt-scale pressurized-water reactors.

Meanwhile, the US has built just two reactors in that time—Unit 3 and Unit 4 at Plant Vogtle in Georgia. Smaller reactors are attracting a lot of excitement and investment, though. A microreactor developer just saw its reactor reach criticality in a new Department of Energy pilot program.

The world is racing to meet rising electricity demand, and many countries are interested in energy sources, like nuclear power, that don’t come with greenhouse-gas emissions. The key question: Which of these strategies will really pay off in terms of getting electrons on the grid quickly?  

Today, the US and France are known as leaders in the nuclear industry. The US has the world’s largest fleet, with France coming in second. France is heavily dependent on nuclear for its grid—about two-thirds of the country’s power comes from nuclear reactors.

But they have hardly added any new reactors to their fleets in recent years. The US can point only to Vogtle, and France connected its latest reactor to the grid in December 2024—the first in over 20 years. 

It’s incredibly difficult to build the massive projects that dominate the nuclear industry today. Up-front investment can run well into the billions, so investors need to wait decades to break even. Designs are complex and can often change during the regulatory process, tacking on cost and time. 

Many are hoping that the key to turning things around in these countries could be smaller reactors.

The idea is that shrinking the footprint of a reactor cuts down the initial investment needed to prove out the new technology. The reactors could even be put together in a factory rather than being built on-site, allowing for a lower price over time.

These smaller reactors are the target of tons of interest and investment in the US, including a new Department of Energy pilot program. The department set a goal last year of having three test reactors reach criticality by July 4, 2026, the nation’s 250th anniversary. (Criticality is the point at which a reactor achieves a self-sustaining chain reaction that can release energy.)

Last week, California-based Antares hit the milestone with its Mark-0 reactor. 

The company plans to eventually build microreactors, designed to produce between 100 kilowatts and 1 megawatt of electricity (large reactors on the grid today are at least 1,000 times that size). The core design is a sodium-cooled reactor, and it uses TRISO fuel, self-contained graphite-coated spheres of a more concentrated fuel than what most reactors use today. 

But there is still a long way to go before it can actually produce power—the Mark-0 doesn’t have any power conversion or heat removal systems. The company plans to produce electricity in late 2027 and deploy in the field by 2028, CEO Jordan Bramble told the Associated Press.

The private sector is interested—and invested—too. Big Tech companies are throwing money at new reactors they hope can help power data centers. 

But look to the other side of the globe, and others are sticking with the established blueprint: China is absolutely churning out large nuclear reactors. Construction started on six new reactors there in 2025, and two more got underway in the first five months of 2026. The country is on course to overtake both the US and the European Union in installed nuclear capacity by 2030.

The speed here is staggering. As of 2024, the average time to build a new reactor in China came in at between five and seven years. The global average is about nine years, and the two most recent reactors in the US took about 15 years.

One key to this speed is standardization: China has set up a uniform project management system to design, license, and build new reactors. They’re built in batches of six or more to take advantage of economies of scale.

It’s one of the ideas meant to give the edge to smaller reactors, but China is working to realize the same benefits for larger projects. A huge amount of government investment is certainly helping.

Larger reactors generally provide more electricity to the grid for a lower price, a key consideration in view of China’s steeply increasing electricity demand. While smaller reactors require less up-front investment than larger ones because of their size, they’ll actually be more expensive per unit of electricity produced. 

That’s not to say China is exclusively focused on big reactors: the country is also expected to see its first operational small modular reactor, the Linglong-1, start sending power to the grid this year.

But looking ahead, it’ll be interesting to see if smaller reactors can help the West keep building new nuclear power. At the moment, with China’s quick progress, it’s looking as if bigger might just be better. 

This article is from The Spark, MIT Technology Review’s weekly climate newsletter. To receive it in your inbox every Wednesday, sign up here

Inside soccer’s data renaissance

Imagine tuning in to the opening kickoff of a World Cup match and seeing a player intentionally send the ball all the way down the pitch and right out of bounds on the opponent’s end. Casual fans might scratch their heads. Where’s the logic in surrendering possession seconds into a game? If you were Jesse Davis, though, you’d know that this play could be a prime setup to score. 

Davis is a professor of computer science at KU Leuven in Belgium and head of its Sports Analytics Lab, which has been at the vanguard of a data awakening in soccer since its inception more than a decade ago. Though the research group brings machine-­learning models to bear on a variety of sports—including basketball, volleyball, and field hockey—nowhere is its impact felt more than on the soccer pitch. 

Davis and his team of researchers employ advanced data analytics to reveal a range of (beg your pardon) game-changing findings that are shifting pro clubs’ decision-making. “His lab is the most influential sports analytics lab in soccer,” says Hugo Rios-Neto, data recruitment lead for Royal Sporting Club Anderlecht in Belgium. They’ve helped teams better evaluate their rosters, conceived ways to assess how efficient (or not) strategies are, and developed algorithms that uncover hidden tactical patterns.

Like, for instance, the value of kicking the ball out of bounds close to the goal and letting your opponent throw it back into play—a move that’s been popping up in some of the world’s top leagues over the last few years.

To make the statistical argument for this seemingly counterproductive move, Davis’s group built a training data set composed of more than 1.4 million passes and some 60,000 throw-ins—partly from the 2022 World Cup. They used tree ensemble models (essentially a mashup of decision trees) to simulate the tactic. The conclusion, which the researchers presented in a 2024 paper under the apt title “Boot it”: When the ball is in the middle third of the pitch, kicking it out of bounds on your opponents’ side of the field can put you within 10 actions (think passes and dribbles) of a goal. That can be a big deal in a game that has 1,500 or more actions per match and very little scoring. The idea, Davis explains, is that you’re setting yourself up to recover the ball in an advantageous situation.

Beyond providing discrete game-day insights, Davis also occupies a unique niche in the world of sports analytics, where many clubs now hire their own internal data teams to maintain a competitive edge. He makes most of his research freely available via open-source analytics tools, but the academic life also affords him the freedom to tackle more complex problems—like standardizing in-game data, a project that will make it easier to parse game footage and come up with winning strategies. 


Davis, 45, grew up in Wisconsin and spent his childhood enraptured by basketball and (American) football. Soccer was largely a nonentity to him until college, when the 2002 World Cup—in which Brazil famously swept the tournament—reeled him in. But the notion of going on to dissect the sport never crossed his mind. His doctoral studies in computer science at the University of Wisconsin–Madison had him working with radiologists to analyze mammography reports. 

In October 2010, he joined KU Leuven as a computer science professor looking at the intersection of AI and health care, with a focus on monitoring athletic performance. His research team studied, for instance, combining things like heart rate with other metrics to determine whether someone was overtraining. They also dove into the biomechanics of running.

The tactical and technical aspects of sports, and soccer specifically, became the subject of Davis’s professorial work when he hired Jan Van Haaren, an engineering student focused on artificial intelligence and a self-described soccer fanatic. He wondered if data analysis could be used to study things like passing, shooting, and ball progression—metrics the game was only just beginning to digitally crunch at the time. 

Davis realized that machine learning and other artificial-intelligence tools lent themselves well to the complexity, fluidity, and speed of soccer.

You need not be well versed in the moneyball-ization of pro sports to see that it’s relatively easy to apply deep statistical work to baseball or basketball. You can isolate actions like jump shots and assign value to ones taken close or far away. Soon a basketball coach realizes that a player who can’t make a layup, but shoots roughly as well from the three-point line as on mid-range jumpers, might as well go for the shot that gets more points. 

Soccer, by comparison, seemed like a poor candidate for that kind of analysis. “The vast, vast majority of actions really don’t lead to the outcome of a goal or even a shot,” says Rios-Neto. “So it’s hard to elaborate or derive a winning strategy from the data.”

But Van Haaren’s love of the sport, and Davis’s love of sports in general, inspired them to try. Over time, Davis realized that machine learning and other artificial-intelligence tools lent themselves well to the complexity, fluidity, and speed of soccer. In 2014, he officially stood up the Sports Analytics Lab. 

With a stable of about 10 students and postdocs at any one time, the lab began laying what Van Haaren calls the “intellectual foundations of how the game is analyzed today.” The researchers picked apart in-game actions, and suddenly they were valuing ball possession, penalty-kick strategy (aim for the center), and the merits of long shots on goal (take them). “One of the trends that’s been in soccer over the last five to 10 years is that the number of long shots has dramatically increased,” says Davis. “What the data let you do is really quantify what the probabilities of those things are.”


In the years since Davis and his team started untangling individual soccer tactics, their ideas have started to permeate clubs across Europe, like Belgium’s Club Brugge KV, as well as national soccer organizations in the US and Belgium. “The work coming out of the lab is genuinely useful,” Rios-Neto says, “and clubs apply it for a range of purposes.” 

Van Haaren, who’s now the director of football intelligence at Club Brugge, is one of many in-house analysts adapting the lab’s work to the pro game. “Our collaboration with the lab is centered on translating [the team’s] football philosophy into measurable, data-driven outputs,” he says. When a club wants to assess, say, how well a center-back is moving the ball down the field, it aims to tally how many times the ball ended up in the part of the pitch closest to the opposing team’s goal. It does this by combining event data, which records actions on the ball, with tracking data, which records player movement. This shows how well players fulfill their roles, which is useful in development and also when scouting for new recruits. 

Davis’s lab, meanwhile, is continuing to ask questions that apply to the game writ large. To determine if there’s an advantage to taking more long shots, for instance, postdoc Maaike Van Royand colleagues modeled the behavior of English Premier League teams using a Markov decision process—a computational framework in which some actions are under a person’s control while others are random. (That duality is particularly useful for soccer, where movement can feel anything but linear.) The results, presented in 2021 at the MIT Sloan Sports Analytics Conference, showed that Chelsea could gain 1.6 more goals per season by shooting from distance 20% more often.

Despite those kinds of insights from Davis’s lab and similar research groups that have sprung up over the last decade at institutions like MIT and Carnegie Mellon, soccer somewhat lags behind many other pro sports when it comes to collecting the data that analysts need. All teams employ people to watch video and use software to annotate specific in-game tactics—the details of which may make sense only to the most devoted fans. It’s a mostly manual process, one that can take up to six hours per game. “It’s a complete nightmare as a data analyst to work with,” says Davis.

So while the lab plays on, Davis has also joined up with researchers from other institutions in an effort to standardize data across all matches. The group is experimenting with transformers, the neural network architecture that underpins large language models like ChatGPT. If you can bring that to the world of soccer, a human game annotator could tag a tactic—a three-on-two breakaway, say—a few times, and that could train the model on the concept so it could tag subsequent instances on its own. “There’s been a lot of progress,” Davis says. “But it still remains quite hard.”

If we’re keeping score, though, the lab’s work has already made the analytics process easier thanks to open-source tools it’s put out there—some of which clock thousands of downloads a month. One is a framework called VAEP, a model that assesses the effects of all actions on the ball. Another is an xG (expected goals) model, which looks at the quality of a scoring chance. Still another is a package to synchronize event data with tracking data. “Lots of people in industry use our code in their daily workflows,” Davis says.

For him, the practical application of having their code out there is important, but the real (ahem) kick is watching theory become practice. As he says, “I’m really motivated to solve problems that arise in real settings and see my work have an impact.” 

Andrew Zaleski is a contributing writer at Washingtonian magazine. 

Job titles of the future: Nature’s drug designer

In 2018, after nearly two decades working in Big Pharma, chemist Tim Cernak was ready to put his skills to a new use. 

For Merck, he’d developed precision therapies for cancer, HIV, and diabetes that could target disease while minimizing harm to healthy cells. But as a lifelong nature lover, he was increasingly concerned about the health of ecosystems and wondered whether his expertise could transfer. Animals, he learned, are often treated with pharmaceuticals formulated for humans, which affect them like old-school cancer drugs: Though intended to kill abnormal cells, they’re indiscriminate in the harm they cause. For instance, the standard of care for frogs infected with a deadly skin infection is itraconazole, an antifungal that is often lethal for the amphibian.

Cernak imagines a world where “the patient was always meant to be a frog in the first place, from the beginning to the end.” Now an associate professor at the University of Michigan, he’s worked on all types of creatures, from a Gila monster with a parasite to bald eagles with avian flu. Here’s what it takes to treat nature’s patients.

Experience with protein-modeling software 

Developing any type of drug is extremely expensive, failure-prone, and slow-going. But AI can speed up the entire drug-­design workflow, says Cernak. Google DeepMind’s AlphaFold model allows him to visualize a mutant protein’s three-­dimensional structure on a screen—rather than growing it on a plate, the traditional methodology—and then quickly generate possible new drugs that would latch onto that structure. The next step is to run a series of reactions and see which potential drugs may be effective; with the help of robots in the lab, he can speed through as many as 1,500 per day. 

Curiosity about creatures of all sizes

Cernak isn’t selective with his patients. For example, he worked on a treatment for loggerhead sea turtles after he was shocked to learn that the iconic species suffered from contagious tumors. He feels especially drawn to creatures that have helped humans, like the Gila monster, whose hormones have informed popular weight-loss drugs like Ozempic. And it’s not just animals; he’s also developing a precision insecticide to treat hemlock trees under attack from invasive species. 

A pioneering spirit

Cernak refers to this new discipline as “conservation chemistry.” It’s a combination of words with a loaded history, from DDT decimating US bald eagle populations in the 1960s, to cow painkillers killing millions of Indian vultures in the ’90s. He recognizes the risks, but Cernak feels that excluding chemists from conservation is a missed opportunity. 

“I’m just sick of looking at the chemical tools that are used in the conservation space, and they’re not cutting-edge,” he says. “It’s like, how do you have this super high-tech engine over here for making human medicines, while we’re living through a mass extinction?” 

Anna Gibbs is a journalist who covers the intersection between science and society.

Opinion: We published in Nature Medicine in 2025 for free. In 2026, it cost us $12,850

In June 2025, I led a study that was accepted for publication in Nature Medicine. The cost to publish this manuscript, which reported the results of a randomized clinical trial, was zero dollars. The paper underwent rigorous peer view and extensive edits and copy editing by the editorial staff. This study was the result of years of work by a large team of staff and investigators at Johns Hopkins and was funded by a combination of philanthropy and grants from the National Institutes of Health (your and my tax dollars).

In 2026, I was part of a group that published in Nature Medicine a different NIH-funded study — also the results of years of hard work supported by your and my tax dollars. To comply with the 2024 NIH Public Access Policy that went into effect on July 1, 2025, we paid $12,850 to the publisher. This charge was for open-access fees, now required by the publisher, and was non-negotiable.

Read the rest…

Opinion: How long Covid’s scientific stalemate made it politically erasable

Mitchell Miglis had two months left. The Stanford University neurology professor had spent two years studying what long Covid does to the human nervous system — why patients’ hearts race when they stand, why their blood pressure collapses, why their bodies lose the ability to regulate themselves. His National Institutes of Health RECOVER grant was weeks from completion, data collected, analysis underway.

On March 25, 2025, a termination notice arrived. The grant was “incompatible with agency priorities.” No modification could bring it into alignment. “This is not only disappointing and demoralizing from a scientific perspective,” Miglis wrote in the Sick Times, a publication about long Covid, “but in a broader sense, as a clinician who sees these patients every day, a much larger disappointment to the patient community.”

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