This week, I covered the story of Casey Harrell—a man with ALS who is “the first power user” of a brain implant, according to the researchers who worked with him. Harrell is paralyzed and unable to speak coherently without the device. He has now spent almost three years using a brain-computer interface (BCI) that enables him to “speak,” surf the web, and perform his job as a climate activist, largely independently.
Since Harrell was implanted with the device, in July 2023, a team at the University of California, Davis, has worked with him to adjust and improve its offerings. They’ve refined its accuracy, for example. And they’ve introduced settings including a privacy mode and a “profanity filter” that lets Harrell talk to his daughter without risking accidental swearing.
Harrell told me that, for him, the device is “nothing short of revolutionary!” It has enabled him to maintain an income, reconnect with friends and family, and read to his daughter.
The team that developed his BCI is one of several working on ways to use technology to allow people with paralysis to communicate, engage with the online world, and regain some independence. And Harrell is one of a growing number of people volunteering their brains to, as he puts it, “pay it forward and do the scientific research … [and] get some personal benefit.”
Over the past couple of years, the number of BCI trial volunteers has soared. This year, China became the first country to approve a BCI for medical use. Advances in technology are allowing engineers to provide more features than ever. BCI research is properly taking off.
I should first point out that BCIs come in different forms. Harrell’s device includes a set of electrodes embedded in his brain that pick up the electrical activity associated with speech. Those electrodes are connected to two docking ports on top of his head that can be plugged into a computer.
That computer is loaded with software trained to decode his brain signals into phonemes (units of sound in speech) and predict what Harrell wants to say. He can then use an eye gaze tracker to make any corrections before the speech is played out loud.
But some BCIs don’t need to be “plugged in”—they’re fully implanted and wireless. Others are less invasive; they might involve placing wired electrodes on the surface of the brain or simply wearing a cap of electrodes, for example. There are trade-offs—the closer you get to the neurons you want to record from, the better your signal will be. But generally speaking, the more invasive the surgery, the higher the risk of complications.
BCIs can also have different functions. Harrell has ALS, but most BCIs in use today are sitting in the brains of people with spinal cord injuries. Typically, these individuals have some degree of paralysis; for example, they may be unable to move their arms and legs, but their face and ability to speak are unaffected. In those cases, BCIs can be used to control other kinds of devices that might help with mobility.
In 2024, Michelle Patrick-Krueger, then at the University of Houston, and her colleagues published a roundup of all trials of BCIs conducted between 1998, which is when they believe the first device was implanted, and the end of 2023. They identified 21 research groups that, among them, had trialed BCIs in a total of 67 volunteers.
“Since then, that number has increased a lot,” says Mariska Vansteensel, a BCI researcher at University Medical Center Utrecht. In January, Neuralink (the BCI company founded by trillionaire Elon Musk) announced that it has implanted 21 people with its device in the past two years.
Synchron, another BCI company, is currently testing its devices in trials in North America and Australia. Shanghai-based Neuracle has been trialing a BCI since November 2024, and it recently obtained approval for the device to be used outside of clinical trials. Precision Neuroscience, cofounded by a former co-creator of rival Neuralink, is also trialing its BCI, which sits on the surface of the brain.
At the same time, academic research has continued. The UC Davis team that worked with Harrell is part of BrainGate—a BCI research effort that has been running for the past two decades. Other academic teams are exploring a variety of devices, from the fully implanted to the minimally invasive.
Since 2024, when Patrick-Krueger’s paper was published, the number of people who have been implanted with a brain electrode has more than doubled, according to Vansteensel. “My current estimation would be around 150 people,” she says.
The technology is improving too. Take the BrainGate trial, for example. The first 17 years of that trial focused on the use of what researchers call “point-and-click” communication—allowing users to control a cursor and “click” with their brain activity. But in recent years the team has pivoted toward decoding speech, says David Brandman, the lead investigator on the team (and the person who implanted Harrell’s electrodes). Today, Harrell’s device uses a voice clone—the speech it produces is based on previous recordings of Harrell’s voice.
But BCIs are still experimental. And plenty of questions remain about who might benefit from them—and how long the devices will last. So far, most BCIs have been implanted in people with spinal cord injuries. We know even less about how they might benefit other people who have ALS, for example. In some cases where the devices initially helped people with ALS—even someone who was completely locked in—the BCIs eventually stopped working. And scientists don’t really know why.
The only way they’ll find out is through more research—and the participation of volunteers like Harrell. So it’s exciting to see trials truly take off. And I promise I’ll update you on where they stand two years from now.
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
In what’s shaping up to be a historic year for biotech initial public offerings, Parabilis Medicines (Nasdaq: PBLS) made its mark on Wall Street this past week by pricing the largest-ever IPO by a drug developer. This upsized offering raised an eye-popping $770.5 million in gross proceeds.
No sooner did Parabilis begin trading public shares on Wednesday, a day after offering 33.5 million shares of its common stock at $20 per share, than its stock price leaped 58% from the IPO price, closing its first full trading day at $31.60. Those shares slid 4% on profit taking Thursday, closing at $30.31, then fell another 10% Friday to finish the week at $27.26.
A day earlier, Parabilis announced the closing of its IPO, including a full exercise by underwriters of their 30-day option to buy an additional 5.025 million shares at the IPO price, less underwriting discounts and commissions. That added another $100.5 million to the initial $670 million in gross proceeds, which translates to another $93.5 million in net proceeds. When added to the $618.2 million net that Parabilis garnered from the original IPO, the company’s haul from the offering rises to a no-less-eye-popping $711.7 million, according to Parabilis’ IPO final prospectus.
Parabilis priced its IPO above its initial price range of $17–19 a share. The company initially planned to offer 25 million shares, then raised that offer to 33.3 million before adding 200,000 more shares to finalize its offering.
Parabilis’ IPO surpasses the $625 million IPO carried out in April by Kailera Therapeutics (Nasdaq: KLRA), which topped the previous record-high among U.S. biotechs, the $604 million offering of Moderna(Nasdaq: MRNA) in December 2018, two years before the messenger RNA (mRNA) vaccine developer won FDA emergency authorization for its COVID-19 vaccine.
Based in Cambridge, MA, Parabilis is a developer of drugs and antibody-drug conjugates (ADCs) targeting historically undruggable protein targets and based on stabilized helical peptides or Helicons. Parabilis says it has generated proprietary datasets, comprising millions of data points for hundreds of thousands of Helicons across dozens of drug-like properties, following a decade of Helicon drug discovery.
“Unlike Kailera, which formed in 2024 and quickly stockpiled private capital before going public, Parabilis took a longer and far less linear road,” commented Ben Zercher, senior biotech & pharma analyst with PitchBook.
Parabilis was founded in 2015 as FogPharma to commercialize technology developed in and in-licensed from the lab of Harvard University researcher and serial entrepreneur Gregory Verdine, PhD, who served as the company’s co-founder and CEO from 2015–2023.
Six venture rounds
While the company closed six venture rounds, Zercher noted, its valuation had fluctuated in the face of the post-pandemic period that saw private biotechs struggle, as well as leadership turnover and the rebrand through which FogPharma became Parabilis in 2024.
The rebranded company built momentum last year, according to Zercher, on the strength of its lead candidate zolucatetide (formerly FOG-001), a stabilized peptide built using the company’s Helicon platform. Zolucatetide is the first and only direct inhibitor of the elusive β-catenin:TCF interaction, according to the company.
Parabilis stated in its final prospectus that it plans to spend approximately $150 million in IPO proceeds toward continuing ongoing clinical development of zolucatetide in desmoid tumors, including continuation of dose expansion and the launch of a Phase III registrational trial to topline data.
Approximately $120 million is set to be spent on continuing the ongoing clinical development of zolucatetide across several additional indications, including dose escalation and expansion in familial adenomatous polyposis (FAP); hepatocellular carcinoma, the most common type of primary liver cancer; and other rare tumors, with the aim of collecting data to support a registrational trial.
Parabilis plans to use the largest share of its IPO proceeds, approximately $190 million, toward advancing its pipeline of additional programs—including its ETS-related gene (ERG) protein degrader, an allosteric androgen receptor in its active state (ARON), and beta-catenin degraders—to Phase I clinical data.
“Our current pipeline is focused on various cancers and tumor types; however, we believe Helicons could also have broad applicability against targets in many diseases with substantial unmet need outside oncology, and we plan to evaluate other therapeutic areas in the future,” Parabilis stated in the final prospectus.
The remainder of the proceeds would be used, Parabilis said, toward continued evolution of the Helicon platform for discovering and developing drug candidates, as well as toward general corporate purposes that include additional development efforts, working capital, and operating expenses.
Zolucatetide received the FDA’s Fast Track designation last year, followed in March by the agency’s Orphan Drug designation. In January, Parabilis closed on a $305.2 million Series F crossover financing round by selling 49,518,175 shares at $6.1644 per share to various investors, garnering $304.5 million in net proceeds. Parabilis finished the first quarter with $329.039 million in cash and cash equivalents as of March 31.
Fifteenth biopharma IPO so far in 2026
Parabilis is the 15th and latest biotech or pharmaceutical company to carry out an IPO this year, raising a combined $12.11 billion in proceeds, according to PitchBook data. Biotech and pharma accounted for 15 IPOs in all of 2025, raising a combined $10.49 billion—an improvement in dollars over 2024’s $8.83 billion, which was raised in 33 IPOs.
Seven of this year’s IPO companies have seen their shares rise since their initial offerings, led by the 466% share price increase of Veradermics (NYSE: MANE), a developer of treatments for dermatology and aesthetic conditions that closed Friday at $96.24 a share.
“With the biotech window reopened, the volume of IPOs reflects a backlog of quality companies that kept building through the biotech funding downturn rather than a wave of hype,” Zercher added. “Where the pandemic-era class sold preclinical optionality, Parabilis and the 2026 cohort are being priced on de-risked clinical programs with clear regulatory paths.”
In addition to its IPO, Parabilis said, it has also closed on selling 4,166,666 shares at $18 per share—90% of the IPO price per share—through a concurrent private placement to Regeneron Pharmaceuticals that has raised approximately $75 million in proceeds.
Parabilis’ initial IPO filing, dated May 19, came just a day after Parabilis inked an up-to-$2.3 billion-plus strategic research collaboration with Regeneron to discover and develop an initial five candidates encompassing “antibody-Helicon conjugates,” a new form of ADCs aimed at challenging and historically undruggable targets by combining the cell permeability of small molecules with the binding capabilities of larger biologics, in order to reach targets long considered undruggable.
Financial runway into H2 2029
Regeneron agreed to pay Parabilis $50 million upfront toward launching the collaboration. That upfront payment, plus proceeds from the IPO and the company’s existing cash and cash equivalents, “will be sufficient to fund our operations into the second half of 2029,” Parabilis stated in its IPO final prospectus.
According to that final prospectus, Parabilis ended the first quarter with a $45.316 million net loss, up 18% from its $38.326 million net loss of Q1 2025, as well as a net loss of $145.889 million for last year, up nearly 24% from its $117.914 million net loss for 2024. The company has no reported revenue.
Parabilis’ accumulated deficit rose 8% during Q1, to $586.82 million from $541.504 million at the end of 2025.
To fund its operations, Parabilis reported, it has raised a total of $876.8 million as of March 31. That total consisted of $811.8 million from sales of its convertible preferred stock, $15 million in borrowings under a term loan, and a $50 million Simple Agreement for Future Equity (SAFE).
Leerink Partners, BofA Securities, Evercore ISI, and Guggenheim Securities are acting as active book-running managers for Parabilis’ IPO, while LifeSci Capital is acting as a passive book-running manager.
Leaders and laggards
Propanc Biopharma (Nasdaq: PPCB) shares soared 80% from $1.35 to $2.43 Thursday after the Australian developer of therapies for pancreatic, ovarian, and colorectal cancers said it approved a share repurchase program authorizing the company to repurchase up to $5 million of its common stock. “The management team believes we are entering a transformative stage for the company,” CEO James Nathanielsz stated, citing recent progress by Propanc’s lead asset PRP, a first-in-class therapy designed to treat and prevent metastatic cancer from solid tumors, toward entering the clinic with a pivotal Phase Ib, first-in-human study in 30–40 advanced cancer patients. He also cited the company’s efforts to publish key scientific data, file patentable discoveries, and form partnerships with contract research organizations (CROs), contract development and manufacturing organizations (CDMOs), and suppliers: “The foundation is clearly there, and as a result, we believe we are undervalued significantly.”
Tango Therapeutics (Nasdaq: TNGX) shares rocketed 53% from $20.22 to $30.93 June 8 after the developer of precision oncology treatments based on synthetic lethality announced positive initial data from its ongoing Phase I/II trial (NCT06922591) assessing its next-generation, MTA-cooperative PRMT5 inhibitor candidate vopimetostat (TNG456) in combination with Revolution Medicines’ (Nasdaq: RVMD) RAS(ON) inhibitors daraxonrasib (RMC-6236) and zoldonrasib (RMC-9805) in patients with MTAP-deleted and RAS-mutant metastatic pancreatic ductal adenocarcinoma (PDAC). Tango reported that 92% of patients with PDAC in the trial’s vopimetostat plus daraxonrasib arm achieved an objective response, while patients with second and third line PDAC treated with the combination showed a six-month progression-free survival (PFS) rate of 90% (median PFS not yet reached), suggesting durability of clinical benefit. Tango said it plans to finalize the design of a Phase III randomized-controlled trial of the combination approach in front-line pancreatic cancer and disclose vopimetostat lung cancer monotherapy data in the second half of 2026.
Scientific publishing is facing a growing challenge from fabricated research produced by industrial-scale paper mills. But researchers and publishers are fighting back through technology and collaboration to protect the integrity of the scientific record.
Scientific publishing is based on the trust that the data are real and that peer review ensures quality. But that trust is being eroded by commercial enterprises known as paper mills—coordinated commercial operations that sell authorship slots in fraudulent or manipulated manuscripts, then submit those manuscripts to journals.
Unlike traditional misconduct, these are not lone researchers cutting corners but businesses producing research at scale, often tailored to meet the demands of specific fields, journals, and career incentives.
A recent analysis of almost 19,000 online adverts for paper mills revealed authorship slots being sold for between $36 to $5,600 depending on the position of the slot, highlighting how commercialized the market is. The average for a first author position was $1,030 and, although the study did not examine which adverts resulted in published papers, another investigation traced approximately 1,000 authorship adverts to more than 400 published papers.
The magnitude of the problem is difficult to estimate. A 2022 report by the Committee on Publication Ethics (COPE) and the International Association of Scientific, Technical & Medical Publishers (STM) found that the percentage of suspect papers submitted to journals was around two percent overall but increased sharply to as high as 46% in journals targeted by paper mills.
The pressure to publish
Adrian Barnett, PhD Professor Queensland University of Technology
For honest researchers, it might be difficult to understand why paper mills even exist. At the heart of the issue is what Adrian Barnett, PhD, a professor in the Australian Centre for Health Services and Innovation at Queensland University of Technology, described as the “publish or perish” phenomenon.
“If I could do one simple thing tomorrow, I would ban all the university league tables,” said Barnett. “They’re just encouraging corruption.” Ranking systems that prioritize publication volume can push researchers toward quantity over quality, making paper mills an easy way to meet expectations.
Furthermore, publication is often not just a measure of success but a requirement for career progression. “For the clients, it’s believed that they need publications that they can’t achieve through their own efforts, either because they don’t have the time, the facilities, the training, or the money to do research and yet, for whatever reason, their employers expect them to,” explained Jennifer Byrne, PhD, a professor of molecular oncology and lead of the Publication and Research Integrity in Medical Research group at the University of Sydney.
Jennifer Byrne, PhD Professor University of Sydne
Byrne has published extensively about paper mills and publication integrity; she got into the field accidentally when she came across some papers about a gene that her team discovered many years earlier. “In 2014–2015, we realized that five or six different groups suddenly published very similar papers about this gene in different journals,” she said. “And I just thought, that doesn’t really make a lot of sense.”
Upon investigation, Byrne found that the papers, and a further 48 similar publications, showed features consistent with mass production. She has since proposed that human gene research in general is highly vulnerable to paper mills. “You can hide fake research quite effectively in experimental fields, because it’s very difficult and time-consuming to reproduce experimental studies,” she said.
Why paper mills matter
Aside from the obvious fraud, paper mills are problematic for several reasons. Byrne describes them as “a billion-dollar problem” with few resources devoted to tackling it. And although she and others have advocated for scaled investments, progress so far has been slow.
The publishing system can also reinforce the problem. Paper mills are profit-driven, but journals also benefit through article processing charges and citations, creating what Byrne describes as a “circle” in which “everyone gets what they want.”
The consequences of paper mill papers being published can influence real research. The papers are cited, reused, and built upon, wasting both time and money for all involved.
More broadly, the erosion of trust can drive researchers away from entire fields. In Byrne’s case, she stopped doing preclinical cancer research. “I left because there were a lot of papers that I couldn’t trust. When you get to the point where you can’t trust most of the recent literature, it’s very difficult to continue,” she said.
There are also more sinister risks. Barnett recalled reports of paper mills exploiting their clients, including instances of potential blackmail. “If you’ve been a regular customer and then you suddenly stop, they might try and squeeze more money,” he said. “They’ve got absolutely no scruples.”
Despite these impacts, deterrents are limited. “There are almost none,” said Byrne.
Retractions are often slow, meaning damage is done before action is taken, and retraction rates are far below where they should be.
In an April 2026 report to a U.S. Congress hearing on the state of scientific publishing, Kate Travis, managing editor of Retraction Watch, showed that the retraction rate was around 0.2% in 2025, up from 0.02% in 2016. Yet, the report states that Retraction Watch “are confident that the rate […] should be about two percent—10 times what it is today.”
How to tackle the problem
Concerns about problematic papers are often raised by individual researchers or so-called science sleuths on platforms such as PubPeer. Although they have become skilled at spotting telltale signs of a paper mill, like manipulated images, distinct layouts, author affiliations that might not match the topic of the paper, unusual patterns of coauthors, and fake peer reviews, it is difficult for the untrained eye to detect problems from a single paper.
This is why there have been calls for increased awareness. “Awareness is always the first step,” said Byrne, who is working with The Lancet–World Conferences on Research Integrity Foundation commission to address critical issues related to research integrity.
Efforts to extend awareness are also being coordinated through initiatives such as United2Act, which brings together stakeholders from research institutions, publishers, sleuths, and universities to develop shared guidance and educational resources.
But even with greater coordination, human detection has limits. As paper mills scale, automated tools are becoming essential.
Earlier this year, Barnett, Byrne, and colleagues published a paper in the BMJ showing that their large language model (LLM) could flag papers suspected of being from paper mills by analyzing sentence-level patterns. The model identified 9.9% of more than 2.6 million cancer research papers for further review. Many of the papers were linked to regions with strong publication incentives, including China.
However, Barnett emphasized that the model “is not a 100% proof, it’s a quick and simple flag that should encourage reviewers to look at those papers and look for other signs of paper mill activity.”
Other paper mill detection technologies are also available. Platforms such as Clear Skies, which is used by the STM Integrity Hub, use machine learning to detect patterns across large bodies of literature, while image-forensics tools and cross-publisher data sharing help identify duplicated figures and submissions.
Alongside these tools, Barnett suggested that researchers may increasingly need to provide a “breadcrumb trail,” through preregistration of hypotheses and transparent workflows to demonstrate the authenticity of their work.
Platforms such as PubPeer and Retraction Watch also play a role, enabling researchers to flag concerns and share evidence about suspect papers after publication. These flags then prompt journal retractions and investigations, making it a critical component in the fight against paper mill activity.
A call for tighter regulation
Aside from technology, Byrne would like to see tighter regulation for the commercial publishing industry, akin to something like the ISO 9001 quality management standards that have been widely adopted across industries like manufacturing, engineering, and healthcare.
“We need a regulatory framework that rewards journals that do the right thing and that care about publishing quality,” she said. “And we need to disincentivize the current commercial drive towards publishing anything for money.”
Byrne believes that funders and researchers should be demanding these standards. “They pay for the research, the journal subscriptions, the article processing charges, and give their research for free,” she said. “They don’t ask anything in return, in terms of quality standards, and that’s unacceptable.”
Marie Soulière, PhD Elected Trustee COPE
Marie Soulière, PhD, an elected trustee of COPE and chair of the COPE Paper mill Working Group, acknowledged that “a standard such as ISO 9001 could help with process consistency, documentation, and accountability.” But she said, “it would not be a direct solution to publication fraud or paper mills” and “would need to sit alongside integrity-specific controls, not replace them.”
How publishers are responding
Publishers are increasingly shifting from isolated responses to coordinated action. Initiatives like the STM Integrity Hub and United2Act are driving cross-industry collaboration and shared detection approaches.
Soulière said that several recommendations from the COPE/STM 2022 “have been put into practice, particularly around cross-publisher collaboration, shared screening approaches, and investment in integrity infrastructure.”
A central strategy, highlighted in a publication from the United2Act working groups, uses the “Swiss Cheese Model,” a move toward layered screening that combines tools such as plagiarism screening, image forensics, citation analysis, and author verification. “Each safeguard has limitations, but multiple checks together make it harder for fraudulent papers to pass through,” said Soulière.
Adya Misra, PhD Associate Director Sage
Publishers are also strengthening internal processes. As Adya Misra, PhD, associate director of research integrity at Sage, described: “Our research integrity team acts centrally to support editors and internal journal teams with both prevention of suspicious or problematic research and the correction of the scholarly record … in line with COPE guidance.”
A spokesperson for Taylor & Francis highlighted their work on external collaborations designed to address the root causes of integrity issues. They are partnering with the National Science Library at the Chinese Academy of Sciences to develop research integrity and publishing ethics training programs, designed to ensure that students and researchers at all levels receive adequate support and to help them avoid exploitation by unethical third-party services such as paper mills.
AI changes the game
Even as safeguards improve, artificial intelligence (AI) is moving the goalposts. Many current detection strategies were developed to target structured forms of fraud; template-driven papers, recycled images, and repeated patterns across manuscripts. But these signals are beginning to disappear. “Our system worked because the paper mills would have a template, but now with AI, there is no template,” said Barnett. “It’s going to absolutely change everything.”
Barnett and his colleague Matt Spick, PhD, a lecturer in health and biomedical data analytics at the University of Surrey, recently demonstrated this by generating a complete scientific paper in just under 30 minutes using publicly available data and the OpenAI platform PRISM.
“All we did was give it the dataset and said write a paper for an Elsevier journal,” Barnett explained. “If an honors student had given me this paper, I would have been pretty pleased.”
Credit: Hispanolistic / Getty Images
Paradoxically, AI could also be bad news for paper mills as people realize they can create the papers themselves at little to no cost.
Reasons for cautious optimism
With AI adding to the challenges that publishers and researchers already face, the future could appear bleak. Barnett recalled an analogy describing the AI problem as an oil spill in a digital ocean, “We don’t know how deep it is, can’t get to the bottom of it, and it’s very difficult to clean up.”
Even removing a single problematic paper can require significant time and effort, while thousands more remain undetected. But Byrne remains positive that the work being done can have an impact.
“I’m actually really positive, because I think the biggest thing is awareness,” she said, noting that when she gives talks, she asks if the audience has heard of paper mills. “In 2023, that might have been five percent of people, and yet by 2025 it had increased to 30%–50%,” she said.
Soulière added that increased collaboration and transparency within scholarly publishing is another positive takeaway.
“Publishers, editors, institutions, and other stakeholders are no longer treating these issues as isolated problems,” she said. “They are investing in stronger screening systems, clearer policies, and better cross-sector coordination. In that sense, this moment is also driving progress and innovation.
“While the risks are serious, the response from the sector shows that trust can be reinforced, and that the system is becoming better equipped to detect problems earlier and protect the scholarly record more effectively,” Soulière concluded.
Laura Cowen is a freelance medical journalist who has been covering healthcare news for over 10 years. Her main specialties are oncology and diabetes, but she has written about subjects ranging from cardiology to ophthalmology and is particularly interested in infectious diseases and public health.
Background: People with intellectual disability experience rates of mental illness up to 3 times higher than the general population, yet face significant barriers to care, including limited clinician expertise, diagnostic overshadowing, and exclusion from key mental health services. Electronic mental health interventions have demonstrated effectiveness in the general population and may address these barriers for people with intellectual disability by providing accessible, tailored treatment. Objective: This study examined the ability of Healthy Mind, a self-guided, web-based transdiagnostic mental health program designed specifically for people with borderline to mild intellectual disability, to reduce symptoms of anxiety and depression and improve functioning in people with intellectual disability. Methods: In a single-arm uncontrolled design, Australian residents aged ≥16 years with a diagnosis of borderline or mild intellectual disability, and mild-to-moderate symptoms of depression or anxiety on the Anxiety, Depression, and Mood Scale (ADAMS) were recruited online and offered access to Healthy Mind. Assistance from a nominated supporter was optional. Primary outcomes were symptoms of depression and anxiety (ADAMS). Secondary outcomes were psychological distress (Kessler Psychological Distress Scale [K10]) and functional impairment (World Health Organization Disability Assessment Schedule 2.0 [WHO-DAS]). Outcomes were assessed at baseline, 8 weeks, and 3 months. In total, 80 participants (mean age 27.8, SD 7 y; n=37, 46% female; n=39, 49% identifying as Aboriginal and/or Torres Strait Islander) enrolled; 61% (n=49) nominated a supporter. Data were analyzed using multilevel models with random intercepts for participants. Results: No significant changes were found in ADAMS depression or anxiety scores from baseline to postintervention or follow-up. Similarly, no significant effects were found for K10 or WHO-DAS scores, except for an improvement in K10 scores between baseline and 3 months when controlling for cognitive functioning (n=15). Having a supporter was associated with lower baseline distress but did not moderate treatment effects. Engagement with Healthy Mind was low; 42.5% (n=34) did not access the program, and among those who did, the median number of completed modules was 7 (IQR 3-11). Greater module completion was associated with slightly higher WHO-DAS scores post intervention. Conclusions: This trial did not demonstrate significant improvements in mental health or functioning associated with Healthy Mind, likely due to low engagement, reduced statistical power, and the absence of a control group. Nonetheless, the study demonstrates the feasibility of recruiting and retaining people with intellectual disability in fully online trials and highlights the urgent need for strategies to improve engagement, including gamification, personalized content, and integrated social features. Electronic mental health remains a promising avenue for addressing the substantial mental health service gap for people with intellectual disability. Trial Registration: ANZCTR ACTRN12620000113954; https://tinyurl.com/2ecdmde8 International Registered Report Identifier (IRRID): RR2-10.3390/ijerph18052473
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/7e2e8f60171580f8872a038a0a1d42e0" />
BackgroundIn January 2023, following a 20-year ban, the New South Wales (NSW) Needle and Syringe Program (NSP) Guidelines permitted NSPs to provide winged infusion sets (‘butterflies’) and larger-volume syringes (‘barrels’) commonly used for injecting methadone liquid intravenously.ApproachThe Kirketon Road Centre (KRC) integrated the distribution of ‘butterflies and barrels’ (referred to as ‘butterfly packs’) into its service delivery in April 2023 and developed resources in collaboration with the Uniting Medically Supervised Injecting Centre (MSIC) and the NSW Users and AIDS Association (NUAA). This case report presents an audit of service delivery and self-reported client outcomes following the introduction of ‘butterfly packs’.OutcomesSince April 2023, KRC has been consistently supplying ‘barrels’ and ‘butterflies’ to clients who inject methadone. The proportion of NSP visits by clients who reported methadone as the last drug injected increased significantly after the program’s introduction (from 2.2 to 4.0 methadone-related attendances per month), and so did the amount of corresponding injecting equipment and verbal education sessions. Among 18 survey respondents, the majority reported improved health or safety since accessing butterfly packs (89%).ConclusionEquipment for intravenous methadone administration can be safely and efficiently distributed by NSP programs. Access to harm reduction services should be based on vulnerability and need, with services tailored accordingly. The policy reversal allowing ‘butterflies and barrels’ and service innovations such as KRC’s program have addressed a longstanding gap, advancing equity in harm reduction for people who inject methadone in NSW.
Testosterone. Methenolone. Nandrolone. Human growth hormone and EPO. Meldonium, modafinil, and mixed amphetamine salts. Clomiphene, anastrozole, levothyroxine, and liothyronine. Patches and capsules, creams and pills. A whole galaxy of steroids, metabolic modulators, and synthetic hormones coursing through the blood of a few dozen swimmers, sprinters, and weightlifters. And millions of dollars up for grabs for athletes who could break world records and usher in the age of superhumanity.
On Sunday, May 24, at a $50 million arena built in a casino parking lot in Las Vegas, I witnessed a libertarian thought experiment come to life. The inaugural Enhanced Games were the first sporting competition where participants were encouraged to take performance-enhancing drugs. The founders say they’re challenging dated sporting norms and helping to build a world where we can all live better, longer lives. Critics say the event is an embarrassment, that it glamorizes the use of dangerous substances and puts lives at risk.
The open-air venue was compact and decked out in bright blue, with a six-lane, 100-meter track down one side, a four-lane Olympic-length swimming pool down the other, and a weightlifting platform and stage at the front. You could see the golden façade of the Trump Hotel looming in the background. The scene had all the trappings of an NFL game, with the too-loud music and crowd work on the big screen—a “flex cam” gave the well-muscled an excuse to unveil their biceps. Between events, adverts flashed up for the line of performance products sold by Enhanced, the company behind the event: injectable peptides that supposedly support cellular energy and skin elasticity, daily supplement powders with names like “Stronger” and “Longer.”
SAEED RAHBARAN
SAEED RAHBARAN
Australian swimmer James Magnussen was the first athlete to sign up with Enhanced but hasn’t broken any world records. He finished last in his two events in Las Vegas.
The day started with the weightlifters, under the blazing sun. But by 4 p.m., only one of them had even attempted a world-record lift. Two had pulled out injured. Some athletes were competing without taking drugs because of the money on offer, and as the competition went on, they had the better of their enhanced peers: Hunter Amstrong, a 25-year-old American swimmer and triple Olympic medalist, won the backstroke by more than a second. In the men’s 100-meter sprint, the non-enhanced US athlete Fred Kerley romped to an easy victory. “Man, they gotta do better than that,” he said of his doped opponents in his post-race interview. “They need to train a little harder, get on that shit a little bit more.”
At the bar, bodybuilders swapped before-and-after pictures and talked about their stacks, and VCs and finance bros traded LinkedIn details. Lukas Lakutsin, a 6-foot-10, 354-pound Russian bodybuilder who was milling around the entrance to the VIP suites, initially told me he didn’t use any performance-enhancing drugs. Except testosterone replacement therapy, of course. But he didn’t think that really counted. “I’m almost 34 years old,” he said. “I need to do this to stay strong.”
The “protocol” for Enhanced athletes only includes FDA-approved drugs. While Enhanced’s team might make recommendations, individuals have the final say on what they want to take, if anything.
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Jeremy Sigal, an influencer and author, wore a USA tank top that showed off hugely muscled arms adorned with prison tattoos. He told me he was proudly natural, in both his health and his personal life. “I’ve got an exceptional credit score,” he said. He has written 12 books on marketing and leadership. Later, I looked up his most recent book online. It’s called Simp to Pimp: 10 Steps to Fix Why She’s Not Banging You and lists AI as a coauthor.
What I saw in Las Vegas probably wasn’t the future of sport. But it was a perfect encapsulation of our present moment, as Silicon Valley biohackers, alt-right looksmaxxers, Make America Healthy Again boosters, and longevity-obsessed scientists all vie to remake reality in their own image. For them, the Enhanced Games offered a glimpse of a future where medical advances push the human race to new heights, and where they never have to get old.
I’ve tracked Enhanced’s journey from a crazy idea scribbled on a napkin to a public company valued at $1.2 billion. Behind the scenes, there have been power struggles, life-changing victories, and moments of total farce. As I recently, finally, watched the games unfold, two questions bounced around my head: Were they right? And what does that mean for the rest of us?
In December 2022, the Australian entrepreneur Aron D’Souza flew to Miami to spend New Year’s Eve with his friend and mentor Peter Thiel. A decade earlier, D’Souza had helped Thiel orchestrate the lawsuit that bankrupted Gawker—a stunning revenge against the gossipy New York media blog that had outed him as gay. Now he was armed with a disruptive idea that he thought Thiel, the billionaire cofounder of PayPal and Palantir, would love. It was inspired by the buff bodies he’d been seeing at the gym, highlighting a disconnect between a workout culture where the use of steroids was an open secret and a sporting establishment where it was, at least on paper, an inviolable taboo.
His initial pitch was provocative and confrontational: a grand sporting event to rival the Olympic Games, where competitors could take any substance they wanted—their body, their choice. The first time I met D’Souza, in the spring of 2024, he had founded the company and attracted some initial investment but seemed obsessed with taking on the fat cats at the International Olympic Committee and reinventing sports (even though he didn’t seem to be a huge sports fan himself). On Enhanced’s Discord server, I found a folder full of memes with names like IOC Clowns.jpg. The whole thing felt very unserious.
That would change.
D’Souza told me that Thiel had previously introduced him to Christian Angermayer, a German biotech billionaire, who would come onboard at Enhanced. He’s funded clinical trials of psychedelics through his company Atai Life Sciences and is helping bring them into the medical mainstream as a treatment for depression and anxiety. Angermayer says he spotted an opportunity to do the same thing for steroids. What he really wants is to redefine medicine, he told me. Its focus has already changed from treating disease to trying to prevent it; actively enhancing people’s health, he says, is just the next logical step.
By early 2024, Angermayer had brought his own people into key roles. The team included Michael Sagner, an anti-aging expert and private doctor who works with many of Hollywood’s leading men, and Max Martin, who has the jawline and cheekbones of an Instagram looksmaxxing influencer and the boundless enthusiasm of a puppy. (He started his own enhancement program a few years ago, when he was just 27.) Sagner would head up Enhanced’s medical commission, making sure the games were safe for the athletes. It was Martin’s job to make sure they actually happened.
In early May, Enhanced began trading on the New York Stock Exchange with an initial value of $1.2 billion. Christian Angermayer stands far right with Max Martin to his left (front row), and Aron D’Souza next to him.
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Tensions sparked as D’Souza’s freewheeling style clashed with the more sensible image that Sagner and others were now keen to present. “It was not just his personality and his abrasive way of talking,” Sagner told me recently. “Even when he was briefed on a scientific fact, he would just completely ignore it and say something outrageous.”
But the more outrageous D’Souza got, the more attention his idea received. In February 2024, James Magnussen, a retired Australian swimmer, became the organization’s first official athlete, and Enhanced promised to pay a million dollars to him, or anyone else, who could break the world record in the 50-meter freestyle.
The notion of a “steroid olympics,” as many have dubbed the Enhanced Games, had been kicking around for decades—for instance, in a Wiredarticle from the early 2000s and an SNLsketch from the 1980s. Two things helped finally make the Enhanced Games a reality. First, in November 2024, Donald Trump was again elected president of the United States. The Biden administration had been actively hostile to the games, but the founders saw a more receptive political environment in Trump world. Not long after the election, Enhanced announced a new tranche of funding led by 1789 Capital, a venture capital firm whose partners include Donald Trump Jr.
And second, in February 2025, an enhanced swimmer finished the 50-meter freestyle faster than anyone in human history. It wasn’t Magnussen, though. He had been injecting himself with testosterone to grow muscle, plus a cocktail of peptides that aimed to speed up recovery—but his journey hadn’t quite worked the way he’d planned.
A combination of reputational issues (no pools wanted to host his training) and physical complications (the regimen did help him get stronger, but he packed on so much muscle that it slowed him down in the water) meant he watched from the sidelines as the Bulgarian-Greek swimmer Kristian Gkolomeev—who had finished fifth at the Paris Olympics in 2024—came in two-hundredths of a second under the record and won a million-dollar payout from Enhanced. The idea has always been that breaking records would effectively prove the legitimacy of this enhancement project: Look what we can do now.
Enhanced swimmers like Magnussen (right) wore supersuits to compete, though they’ve been banned by World Aquatics since 2010.
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Gkolomeev, though, had a different motivation for participating: “One successful year in the Enhanced Games and I could make as much as I would in almost 10 careers,” he told me not long after setting the new record (notably, wearing a kind of “supersuit” that’s been banned by World Aquatics since 2010). Enhanced was paying its athletes a regular salary, on top of any potential bonus. And he had a young family to support and feared that the four-year stretch to the next Olympics would be long and precarious.
In May 2025, with a world record in the bag and a friendly administration in the White House, Enhanced was ready to announce its first games: They’d take place in May 2026 at Resorts World in Las Vegas.
At the same time, D’Souza made another big reveal: Enhanced Performance Products, a line of supplements available for a monthly subscription. The Enhanced Games now seemed less like a sporting event and more like a loss leader for selling testosterone injections, GLP-1s, or a range of peptides that are claimed, with little scientific evidence, to improve sleep or skin elasticity. Perhaps it was all a brilliantly executed marketing stunt.
“The games themselves now seem almost secondary to what appears to be an online marketplace for hormones, peptides, and other performance-enhancing compounds,” says Astrid Kristine Bjørnebekk, a steroids expert at Oslo University Hospital. “From my perspective, this significantly changes the nature of the project. It is one thing to organize a closed sporting event built around controversial principles, but openly marketing and commercializing substances such as testosterone, hGH, GLP-1 drugs, peptides, and other pharmacological compounds is something else entirely.”
As the games approached, more athletes joined. Some were genuinely elite. The US sprinter Kerley—who is serving a two-year ban for missing three drug tests—had won silver in the 100 meters in the Tokyo Olympics and a bronze in Paris. Ben Proud, a British swimmer, had won silver at the Paris Olympics and dozens of medals at world and European championships and the Commonwealth Games. He had been mulling over joining the Enhanced Games ever since the idea first emerged, but the tipping point seemed to come when Gkolomeev’s record was announced.
Some participants, like Magnussen and another swimmer, Megan Romano, had been tempted out of retirement. Romano hadn’t swum competitively for almost a decade. Others were at the start of their careers but ready to cash in their chips and bid goodbye to Olympic dreams for a potential six-figure payday. The $1 million payouts were reserved for records in the two flagship events—the 50-meter freestyle and the 100-meter sprint—but winning any other event would mean a prize of $250,000, with an additional $250,000 bonus for setting a world record.
Athletes would get paid even if they just showed up and finished last—as much as $50,000. This is all on top of the salaries that stretched into six figures in some cases, making the payout from the games more than many athletes make in a year.
Sport’s governing bodies reacted to each new athlete announcement with fury. World Aquatics threatened to ban for life any athlete who participated in the games, even if they didn’t take any drugs. Enhanced responded with an $800 million antitrust lawsuit against the global swimming organization, the World Anti-Doping Agency, and USA Swimming, alleging misuse of monopoly power.
American Fred Kerley (right) won the 100-meter sprint without performance enhancing drugs.
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In November 2025, a court in New York dismissed the case. Three days later, D’Souza, the mind behind the entire project, was out. A notice on Enhanced’s website said he had “transitioned out of the company’s day-to-day operations.” Martin would take over as CEO. “The investors basically said we need someone a bit more serious,” Sagner told me. In conversations, execs at Enhanced played down any suggestion of a feud—D’Souza was simply the ideas man, with little interest in the day-to-day dreariness of actually running a company. (Enhanced spokesperson Chris Jones wrote in a statement that “there is no tension between Aron and Enhanced that I’m aware of.” D’Souza did not respond to a request for comment.)
I got the sense that Enhanced, in its new iteration as a pharmaceutical subscription company, was almost embarrassed by the games. When I visited enhanced.com a couple of months before the event, they had been relegated to a sub-heading on the home page. D’Souza’s showmanship had helped get attention for what was becoming a run-of-the-mill telehealth business like Hims & Hers—albeit one well timed to take advantage of a shifting regulatory landscape around peptides, which Robert F. Kennedy Jr., the US secretary of health and human services, has been pushing the FDA to approve despite a lack of evidence that they’re actually effective.
Sagner is still loosely involved with Enhanced, but he says the medical commission was not consulted before it launched its line of performance products. (Jones did not respond to a question regarding this claim.) Sagner is scathing about what he sees as the “hype” around peptides. “I can tell you already, peptides do nothing,” he says—with the exception of human growth hormone and GLP-1. “The peptides that people use, black-market peptides that they buy online—they do nothing. We have tested them; 80% of them contain nothing. It’s saline solution, salt water, and some of them are contaminated.”
At the end of January 2026, a group of around 40 swimmers, weightlifters, and sprinters arrived in Abu Dhabi to start their individualized enhancement “protocol,” as Enhanced calls it. Officially, they would be taking part in a clinical trial, pending approval by the Abu Dhabi government and overseen by Guido Pieles, a Qatar-based cardiologist who has taken over the reins of Enhanced’s medical commission from Sagner.
The day started with the weightlifters, but by late afternoon, only one of them had even attempted a world-record lift.
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They would be allowed to choose only from a menu of specific FDA-approved drugs. Pieles broke them down into five categories: testosterone variants and growth hormones, which can both boost muscle mass; metabolic modulators that can tweak how the body burns fat; stimulants like Adderall to improve focus; and EPO, which can increase the amount of oxygen the blood is able to carry. While Enhanced’s team might recommend particular things, the athletes would have the final say on what they wanted to take, if anything. (As Oslo University’s Bjørnebekk points out, FDA approval “does not mean the substances are inherently safe, particularly not when used for enhancement purposes.”)
There would be regular blood tests, heart scans, and brain scans and access to the best training facilities money could buy. Pieles and others say the clinical trial will help inform the line of supplements Enhanced is offering consumers, but there’s actually very little overlap between the drugs the athletes were taking and the substances the company is currently selling.
Not long after they arrived in the Middle East, the athletes were awakened by the sound of explosions at a military base near their hotel. The US and Israel had struck Iran, and the Iranian regime was responding by peppering the region with missiles. “It wasn’t a pleasant situation,” says Andrii Govorov, the world record holder in the 50-meter butterfly, who a year earlier had become one of the first swimmers to join Enhanced. Govorov had some experience in these matters—back in Ukraine, he’d had a business selling cars that helped fund his swimming career, but he’d lost it after the Russian invasion.
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Swimming, sprinting, and weightlifting were the focus of the first Enhanced Games but in many ways the sports were the sideshow.
The conflict exacerbated delays in getting approval for the clinical trial and sourcing the drugs, and as a result, what was supposed to be a 12-week enhancement protocol got cut down to eight weeks. The athletes didn’t actually start taking the drugs until toward the end of March. For those who had always been clean, that represented the irreversible crossing of a line. “The first injection was very emotional, very tricky to navigate,” says Proud. “For me, that was the day I went from the Ben Proud that I always knew to a new person.”
Proud was joined in the enhancement program by his girlfriend, Emily Barclay, who had swum at college level without ever appearing at a major international event; she was working as a swimming teacher at a school in England. After that first injection, they left Abu Dhabi and spent a few days in Dubai as they reckoned with what they had done. “I just couldn’t be around the team,” Proud says. “I wanted to be by myself and feel those feelings, because it is a big deal to make that step, and I felt it.”
Those feelings were soon forgotten, though, as the drugs kicked in. Proud says he had incredible energy, and a drive to train that he hadn’t experienced before. Shania Collins, an American sprinter, says she had “increased strength, increased recovery, and increased mental clarity at practice.” Sagner and several athletes admitted there were some side effects: acne and some swelling around the joints; unwanted hair growth for the women, unwanted hair loss for the men.
Like Kerley, sprinter Tristan Evelyn from Barbados competed without taking any drugs. She too won big in Vegas, besting her Enhanced peers in two events.
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One thing the athletes wouldn’t talk about, though, is what drugs they were actually taking. They all had the same reason: not wanting to encourage copycats who might take enhancements without a doctor on hand to tailor programs to their needs.
The one exception was Thor Björnsson (testosterone, deca-durabolin, anastrozole, halotestin), a hulking Icelandic deadlifter and former World’s Strongest Man who played The Mountain on Game of Thrones. Björnsson first heard about the games on Joe Rogan’s podcast and was immediately interested. The rules for strongman competitions are somewhat less stringent than those for Olympic sports, though, and he actually had to reduce the number of substances he was taking to meet Enhanced’s FDA requirements.
Icelandic strongman Thor Björnsson actually had to reduce the number of substances he was taking to meet Enhanced’s FDA requirements.
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There is some debate over how much doping some of the athletes were actually doing. In a conversation last year, Gkolomeev told me he’d only really been “microdosing,” and he confirmed that his 2026 enhancement program was largely the same. Sagner says the doses the athletes were taking were a fraction of the amounts some Olympic athletes had been caught using in the past. I heard that a few athletes had decided not to take steroids or growth hormones and were only using modafinil, a narcolepsy medication that’s thought to improve focus.
The day before the games, I asked Angermayer what it would mean if clean athletes like Kerley and Armstrong won their events—what impact it would have on Enhanced’s business model of using sports as a showcase for its line of performance products if the people using those products didn’t actually win anything. “I know what you mean, but mostly our business model is headlines to drive attention,” he said. “Any debate is good for us.”
In early May, Enhanced began trading on the New York Stock Exchange with an initial value of $1.2 billion.
That same week, it was finally go time. The athletes and coaches left Abu Dhabi and flew to Las Vegas, where they were put up in five-star luxury at the Conrad hotel inside Resorts World while they made their final preparations.
When I got there a few weeks later, toward the end of May, I found it jarring to see these hulking presences walking around the casino in their Enhanced sportswear, weaving their way through packs of half-drunk tourists, with slot machines flashing in the background and cigarette smoke hanging in the air. I had expected the games to be a bigger deal within the city itself, but they were just one of a thousand things happening in Vegas that weekend—drowned out by a series of BTS shows at the football stadium, by the Golden Knights in the NHL playoffs, by No Doubt’s residency at the Sphere.
If this was a sporting earthquake, it was one whose tremors were mainly being felt online, where bodybuilding influencers livestreamed to their followers on Kick and Twitch, and where thousands watched on YouTube and Rumble. (D’Souza once told me he’d had “every major sports broadcaster” vying for the rights; in the end, Enhanced struck an exclusive streaming deal with Roku in the US.)
No tickets were sold, so the crowd was a mix of invited guests, investors, and influencers, some of whom had reportedly been flown in on a chartered jet.
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On the morning of the games, Enhanced held a medical symposium that was supposed to provide a taste of the company’s long-term objectives. The first speaker was Bryan Johnson, the longevity-obsessed entrepreneur famous for plowing his personal fortune into wild attempts to reverse his aging: receiving transfusions of his teenage son’s plasma, measuring his nighttime erections, taking more than 100 supplement pills a day. He spends $2 million per year on all this, but he looked pale and vampiric as he delivered the slightly off-brand message that, really, the most important thing was getting a good night’s sleep: “You don’t need to chase IV infusions; you don’t need to chase crystals. You don’t really need to do much of anything.”
At 2 p.m., I took two escalators from the conference room down to the arena, where spectators were filtering in. Though it had cost $50 million, it had been constructed in just three and a half weeks, and it showed; on the media tour the previous day, there were still loose screws on the floor of the bleachers.
There were a few thousand seats in an open grandstand down one side, and two rows of VIP suites on the other. No tickets were sold, so it was a strange mix of invited guests, investors, and influencers, some of whom had reportedly been flown in from Los Angeles on a chartered jet. The rapper Tyga was the biggest name to grace the “blue carpet,” although I did also spot Fabio James, a Michael Jackson look-alike who has had surgery to make the resemblance even stronger. Rumors swirled that Peter Thiel might show up; they proved unfounded.
In attendance was Fabio James, a Michael Jackson look-alike who has had surgery to make the resemblance even stronger.
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A few hours before the doors opened, journalists got a stern message from the organizers trying to bar us from interviewing guests. Still, I talked to a Cambridge professor who wanted to use Enhanced as a case study in innovation for his MBA students, a retired Brazilian swimmer with the Olympic rings tattooed on his forearm, and a biotech investor wearing an Enron hat. Proud’s family and friends were sheltered from the blazing sun in the shadow of the big screen.
D’Souza was nowhere to be seen. Nor was he really mentioned at all—not during the introductory press conference, where Martin was introduced as the “founder of the Enhanced Games,” nor during the event itself, where the athletes showered praise on Angermayer and Martin. But the tens of millions D’Souza had banked from the stock listing likely softened any blow. Plus, he’s already moved on to his next provocative venture: an AI-powered arbitration platform designed to scrutinize the work of journalists on behalf of the rich and powerful.
As the sun set behind the hills, casting the arena in soft gold light, there were still no world records. That and the wins for clean athletes seemed to put the whole Enhanced project in jeopardy—the knives were already being sharpened online. I asked the organizers whether this threatened the legitimacy of the project.
German swimmer Marius Kusch was among the dozen or so athletes who hit personal bests in Vegas.
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“Our response is that enhancements help athletes improve and, in some cases, break records. And yes, some non-enhanced athletes also won—because talent and ability also matter,” Enhanced’s Jones emailed last week. “Breaking world records is incredibly hard as the margin is infinitesimal, as we witnessed. Ignoring that 13 athletes some of whom 10 years later broke personal bests is disingenuous and selective reporting.”
Megan Romano was one of them, swimming faster in the 50-meter freestyle at 35 than she had at 22. And Emily Barclay knocked two seconds off her fastest time in the 100-meter freestyle, coming in second in that event and winning the 50-meter freestyle; she went home with a check for $375,000. “No one’s ever heard of this girl,” said Enhanced swim coach Brett Hawke afterwards. “She’s retired; she’s a nobody. She comes out tonight and swims a time that would have got a bronze medal in Paris.” For all the talk of “superhumanity” and pushing the boundaries of performance, making a 35-year-old feel 22 again is probably the perfect marketing message for the products Enhanced wants to sell.
Angermayer cheers on swimmer Megan Romano, who swam faster in the 50-meter freestyle at 35 than she did at 22.
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Enhanced’s executives say people should take enhancements only with medical supervision, but price could be a barrier to heeding that advice. The battery of health tests the company was giving its athletes in the run-up to the games cost $25,000 per athlete per month. The drugs themselves start at $75 a month and go up toward $200. While Jones says the products “are in line with industry price points,” there were almost certainly people watching who saw the drug-altered physiques of athletes like Gkolomeev or Magnussen and decided to find cheaper, less safe alternatives on unlicensed websites.
“Many of these substances require medical supervision and prescriptions, and several are associated with potentially serious long-term health consequences,” says Bjørnebekk. “Presenting them in this lifestyle-oriented and commercial format risks normalizing use while downplaying the medical risks and uncertainties.”
Although his world record-breaking time won’t stand as the official record, swimmer Kristian Gkolomeev will walk away from the Enhanced Games with a million dollar prize in the 50-meter freestyle.
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Before the night was over, Gkolomeev again had the chance to right the Enhanced ship. The final event of the night was the men’s 50-meter freestyle swim. His 2025 time had been surpassed by the Australian swimmer Cam McEvoy (without a supersuit) at the China Swimming Open a couple of months before, so he needed to lose another two-hundredths of a second to beat the new record of 20.88 seconds.
Gkolomeev was wearing the same supersuit he’d used the previous year, and he’d shaved off his mustache for a little extra streamlining. But he messed up his start—doing four kicks instead of five—and was trailing Proud at the halfway mark. His long arms levered him forward, though, and he reached the wall in 20.81. The spectators were on their feet as “WORLD RECORD” flashed red on the big screen. Martin vaulted over the glass partition from the VIP suites, beaming, to embrace Gkolomeev. They had their record.
Or did they? Online, people shared screenshots from the video feed, purporting to show that the clock had stopped before Gkolomeev’s hand touched the pressure sensor at the end of the pool. An Enhanced spokesperson gave a statement to the Guardian dismissing this as “completely unfounded internet drivel.” But hey—live by the sword, die by the sword. It’s quite possible Gkolomeev didn’t care. He had another million in the bank.
It remains to be seen if it’ll work out so well for the other athletes. Enhanced organizers recently announced a prize of $10 million for anyone who can break Usain Bolt’s 100-meter world record in 2027. They are adamant that the games will happen again next year. If they don’t, dozens of sporting careers will be over, and the athletes will join the long list of victims of VC-backed disruption.
My personal prediction is that Enhanced will pivot away from the risk and uncertainty of a flagship event—the company’s valuation plunged by almost $800 million when markets opened after what was perceived as an underwhelming set of results in Vegas. I expect you’ll see individual stunts and challenges, tightly controlled and filmed for virality and probably featuring your favorite YouTubers—think Björnsson bench-pressing Jake Paul.
D’Souza’s initial idea has served its purpose by capturing the world’s attention. But that won’t necessarily translate into success either. Though the company has had plenty of hype over the last 12 months, SEC filings published as part of its stock exchange listing reveal that it generated only $2,755 in revenue from its enhancements business in the first three months of 2026. Would what happened in Vegas be enough to juice sales?
Martin, Enhanced’s CEO, cheers on athletes from the stands. Company leadership insists the competition will take place again next year.
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As the athletes gathered on the stage to receive their prizes, Martin took the microphone and addressed the crowd. “Enhanced is culture,” he said. “We are at the pulse of where the world is going.” On this, at least, he’s probably right. Testosterone replacement therapy is rapidly moving into the mainstream, and while the science may still not be there on peptides, they have certainly exploded in popularity in the two years since Enhanced launched. And there are undoubtedly more substances yet to be discovered that will promise to improve people’s lives, or at least hold their appearance in stasis. The enhanced age is upon us, whether we want it or not.
As the fireworks went off and the Killersclosed out the event with “When You Were Young” (“Congratulations to … whoever deserves it,” said frontman Brandon Flowers), I wondered what that might mean for us mere mortals. Invoking Hunter S. Thompson’s Fear and Loathing in Las Vegas in a story about drugs and Las Vegas may be a cliché, but it struck me that fear played a big part in all of this. Fear of missing out. Fear of getting old. Fear of never making a dime on your life’s pursuit. Fear of waking up one morning and seeing your flabby, sunken face in the mirror while everyone around you shines and grins and thrives with white-toothed, alien smiles.
Before joining Enhanced, Romano had not swum competitively in almost a decade.
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But the big problem with Enhanced’s vision of superhumanity is the question of who gets to join in. “People will be able to enhance themselves if they have enough money,” Sagner had told me the night before the games. The rest of us, I fear, will just have to function as normal human beings.
Amit Katwala is a journalist and author covering science, culture, and where they collide. His latest book is Tremors in the Blood: Murder, Obsession and the Birth of the Lie Detector. He is based in London.
The horses in America are getting fat. They are trying to tell us something.
Fifty-one percent of mature light-breed horses in the United States are obese — a rate that ranks among the world’s highest, slightly above Britain and nearly twice that of Australia or Denmark. That figure comes from a peer-reviewed prevalence study, and it sits alongside a number that should give any clinician pause: The U.S. also leads the G7 in human obesity. The same country. The same epidemic. A completely different species.
This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.
China has approved the world’s first invasive brain-computer chip—here’s what’s next
Sitting in the courtyard of his house in China’s Henan province last October, Dong Hui decided to try holding a pen. Six years after a car accident left him paralyzed from the neck down, he slowly wrote his name, “Thank you,” and the date.
The breakthrough was made possible by a brain implant called NEO. In March, it became the world’s first invasive brain-computer interface approved for use beyond clinical trials. The approval is expected to accelerate China’s push to become a global leader in brain implants.
I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.
1 Nvidia is launching its first AI chip for personal computers The RTX Spark will power laptops from Dell, HP, Microsoft, and others. (BBC) + They’re being designed specifically to run AI agents. (WSJ $) + The first devices are set to launch on Windows PCs in the fall. (CNBC) + The move marks a challenge to Apple and Intel. (FT $)
2 The US is stopping exports of AI chips to Chinese firms abroad It’s closed a loophole allowing exports to Chinese subsidiaries. (Reuters $) + Which may have enabled unlicensed access to Nvidia chips. (Al Jazeera) + Export curbs have led China to redesign its chip industry. (MIT Technology Review)
3 Surgeons have transplanted pig liver and kidneys into a living person The clinically dead recipient’s organs worked for almost five days. (Nature) + Pig organs could ease transplant shortages. (Guardian) + Putin says organ transplants could grant immortality. (MIT Technology Review)
4 The US, Australia, and UK will defend seabed cables with underwater drones They’re developing the vehicles via the trilateral AUKUS defense pact. (CNN) + Undersea internet cables face growing threats. (BBC)
5 A new study has revealed chatbots’ manipulative ‘dark patterns’ It found they prey on emotions to encourage harmful behavior. (404 Media) + They can also sway voters better than political ads. (MIT Technology Review)
6 Apple plans to disrupt the traditional glasses market Its smart glasses target the broader spectacles industry. (Bloomberg $) + Smart glasses are also gaining traction in warfare. (MIT Technology Review)
7 AI super PACs are dueling over the midterms Split between Anthropic and OpenAI, they’re fighting to shape AI regulation. (NYT $)
8 SoftBank has overtaken Toyota as Japan’s most valuable company The AI boom pushed SoftBank’s market value above $305 billion. (Bloomberg $)
9 A botnet of more than 17 million devices has been dismantled in Europe Dutch authorities linked the network to a Russian proxy service. (Ars Technica)
10 Tech leaders are uniting around a transhuman vision for AI They’re working toward a post-human agenda. (Guardian)
Quote of the day
“It’s just been shoved down their throats in secrecy. And that makes them upset.”
—Legendary environmental activist Erin Brockovich tells “The Jim Acosta Show” why citizens are angry about data centers expanding into their communities.
One More Thing
MIKE BELLEME
What happens when you donate your body to science
Rebecca George doesn’t mind the vultures. At Western Carolina University’s body farm, forensic anthropologists monitor donors—sometimes for years—as they become nothing but bones.
Around 20,000 people donate their cadavers to scientific research and education each year. At anatomy labs and body farms, they help train doctors, advance research, and teach scientists more about the human body long after death.
One day last October, sitting in the courtyard of his house in China’s Henan province, Dong Hui decided to see if he could hold a pen to write.
Dong, 39, had sustained spinal cord injuries in a car accident six years earlier that left him paralyzed from the neck down. Slowly but determinedly, he wrote his name, “Thank you,” and then the date. This was the result of an 11-month-long rehabilitation enabled by an implant in his brain. Before that process, Dong could move his arms slightly but wasn’t able to use his fingers.
“I couldn’t believe I was able to write again. I was so excited I even missed a stroke in my name,” he told MIT Technology Review on a video call.
In November 2024, Dong became one of the first people in China to be given an invasive brain-computer interface (BCI) through brain surgery. He had signed up for a clinical trial with the device’s developer one month after seeing on TV how a BCI had apparently enabled another paralyzed Chinese man to hold his granddaughter.
This March, the implant Dong uses became the first invasive BCI product in the world to be approved for use beyond clinical trials. It’s now available to some patients with paralysis in their limbs due to spinal cord injuries. We spoke to a range of experts to understand why the device was able to reach this global milestone, what makes this moment so significant, and what to expect next.
A world first
Dong’s brain implant is a coin-size device called NEO. It was developed by Neuracle Technology, a Shanghai-based startup, together with researchers at Tsinghua University in Beijing.
During a procedure that took just over an hour and a half, the device’s sensors, which collect Dong’s brain signals, were placed on his dura mater, the tough outer layer of tissue that covers and protects the brain. The signals are transmitted to a computer by an implant placed on Dong’s skull. The computer then translates the signals into commands for a soft robotic glove Dong wears during the 2.5-hour training sessions he completes each day to help him learn to grab.
Dong started his rehabilitation around a week after surgery. “On the ninth day of my training, my right hand successfully grabbed a ball without the glove,” he says. “That was a miraculous moment.”
Now he continues with his training at home. He wants to be able to control his hands better in order to put on clothes, eat, and do other daily tasks without troubling his aging parents.
A growing number of people with traumatic injuries in China are now poised to tread a similar path thanks to NEO’s recent approval. According to China’s National Medical Products Administration, the bureau responsible for drug supervision, the product is suitable for patients between 18 and 60 who have paralysis in all limbs due to spinal cord injuries but still have some residual function in their arms.
NEO beat several other BCIs to approval, including one from Neuralink, a California-based company founded by Elon Musk. Since October 2023, Neuracle has conducted 36 clinical trials using NEO, including the one on Dong. Thirty-two of them took place in the space of a few months in 2025, with the details about one of the four first in-person trials published in a preprint paper last July. Neuracle did not reply to a request for comment from MIT Technology Review.
One reason for NEO’s fast approval could be that it has a “relatively less invasive” design than counterparts such as Neuralink’s N1 brain chip, says Avinash Singh, a BCI researcher at the University of Technology Sydney. NEO’s eight sensors sit on top of the brain’s protective membrane while Neuralink’s N1 chip directly penetrates the cortex, the outermost layer of the brain itself. Neuracle’s device faces fewer regulatory constraints because it presents a lower risk of hemorrhage, glial scarring, and long-term signal degradation, Singh says.
China’s strong support for its BCI industry also means that NEO was put on an expedited regulatory pathway; in comparison, the approval process of the US Food and Drug Administration can take several years, Singh adds.
A big boost for BCIs
NEO’s approval is hugely important for the global BCI industry, says Wang Shouyan, a neuroscientist at Fudan University in Shanghai who was not involved in research or trialing for NEO. Even though research and development on BCIs has taken place for several decades, most of it happened in the lab. The news means that BCIs are now ready for large-scale manufacturing and clinical use in China, Wang says.
For Dong, however, it means something much more personal. “Now, it will be able to help not only me, but also thousands and thousands of other patients suffering from spinal cord injuries in China who are tortured by despair each day,” he says of NEO. “It will bring them hope and change their lives.”
Days after NEO was approved, China started incorporating it into the country’s health insurance system by assigning it a unique code. This is one of the first steps toward a future where eligible Chinese patients pay a certain percentage of the BCI’s price if they need it during their treatment.
The growth of China’s BCI industry is expected to accelerate thanks to the government’s policy support and financial backing. The country’s latest five-year plan, published on the same day Neuracle received its approval, lists BCI as one of six key industries important to China’s future tech competitiveness, alongside quantum technology, humanoid robots, and others. Several Chinese startups, including NeuroXess and StairMed, have already worked in the field for many years.
“China’s decision to double down on becoming a global leader in the field owes in part to what these companies have already accomplished,” says Meicen Sun, an information scientist at the University of Illinois Urbana-Champaign who studies information and technology policy.
But, Sun says, the biggest advantage China may have is that Chinese people, particularly patients like Dong, tend to welcome this technology and are genuinely enthusiastic about it. In comparison, in the US and Western Europe, testing technologies on human bodies elicits an “ick factor,” triggering concerns and even resistance, she says.
Cooperation in a cold climate
NEO has become the world’s first invasive BCI to go commercial, but scientists interviewed by MIT Technology Review caution against comparing Chinese and US efforts through the lens of a race.
A race implies an endpoint, but it is hard to say where that is for the development of BCIs, says Nick Ramsey, a neuroscientist at Radboud University Nijmegen in the Netherlands. Also, the US and China have fundamentally different visions, Sun says. The US is primarily concerned with being the first to do something and achieving state-of-the-art performance, while winning to China means capturing more consumers and using technology to deliver solutions on a societal scale.
“Being exceptional and being accessible are two diametrically opposed definitions of winning,” Sun says.
In fact, neurotechnology has emerged as a rare tech sector where US-China collaboration is still happening despite geopolitical tensions. The US company Axoft, based in Cambridge, Massachusetts, says it has teamed up with a Chinese company and a hospital in Shanghai to test its BCI on four patients in China and has plans to expand its trials in the country.
Looking forward, China’s BCI industry is expected to speed up its growth over the next five years thanks to strong government support. “There is no comparable national-level ambition or coordinated map elsewhere in the world at the moment,” says Singh.
More BCIs are also in the pipeline for domestic approval in the country, including Beinao-1, developed by the Chinese Institute for Brain Research in Beijing and its affiliated startup, NeuCyber NeuroTech. The device, which sits on the dura mater, is designed to help those who have movement and speech difficulties due to spinal cord injuries or amyotrophic lateral sclerosis. These candidates could get the green light as early as 2028, Singh says.
. Parabilis says it has generated proprietary datasets, comprising millions of data points for hundreds of thousands of Helicons across dozens of drug-like properties, following a decade of Helicon drug discovery.
