Determination of the Solar System contribution to the soft x-ray sky
STAT+: HaloMD’s legal win highlights the difficulty of challenging arbitration decisions
Arbitration decisions, it turns out, are like cockroaches. They’re very hard to kill.
It’s a long held truism in the legal world, and it was underscored this week when a federal judge shot down a health insurer’s lawsuit challenging No Surprises Act arbitration decisions. The ruling doesn’t bode well for other pending lawsuits challenging awards doled out under the 2020 law’s arbitration process, known as independent dispute resolution.
“You can’t second guess the arbitrators,” said Chris Deacon, a health policy consultant and former lawyer. “That’s the whole point of arbitration.”
Trump taps former public health leader Erica Schwartz to run CDC
President Trump nominated Erica Schwartz on Thursday to be director of the Centers for Disease Control and Prevention, tapping a former public health leader for a position that has been filled mostly on a part-time or interim basis during the second Trump administration.
Schwartz was deputy surgeon general during the first Trump administration and spent much of her career in health roles in the U.S. military.
A pancreatic cancer breakthrough, and new hope for an off-the-shelf CAR-T treatment
On this week’s episode of the Readout LOUD: a pancreatic cancer breakthrough and new hope for an off-the-shelf CAR-T treatment in lymphoma.
Your favorite biotech podcasting crew is back to full strength this week, and we’re bringing you two newsy guest interviews. First, we’ll talk with Allogene Therapeutics Chief Medical Officer Zach Roberts about new study results that bolster the company’s efforts to develop an off-the-shelf CAR-T therapy for B-cell lymphoma, a type of blood cancer.
STAT+: Kennedy focuses on affordability, combating fraud in Capitol Hill hearings
WASHINGTON — Health Secretary Robert F. Kennedy Jr. returned to Capitol Hill Thursday, where he defended the administration’s efforts to fight health care fraud and improve affordability — and worked to avoid discussions about vaccine policy.
An hours-long Ways and Means hearing Thursday morning covered a wide range of topics related to Kennedy’s Department of Health and Human Services and kicked off a marathon series of testimonies about the president’s proposed budget.
Later, during a hearing with the House Appropriations health subcommittee, Kennedy said the president would release the name of the nominee to lead the Centers for Disease Control and Prevention before the end of the week. (Soon after, Trump announced the nominee.)
Brain Gene Variations Help Explain Neurological and Psychiatric Sex Differences
Thousands of genes are expressed differently in the brains of men and women, researchers have discovered.
The findings could help explain differences in neurodevelopmental, psychiatric, and neurodegenerative disorders between the sexes.
While men are more likely to experience schizophrenia, attention deficit hyperactivity disorder, and Parkinson’s disease, women are more prone to mood disorders and Alzheimer’s disease.
The U.S. study, in Science, is the first systemic single-cell survey of sex differences in gene expression across multiple regions of the human brain.
“Together, these findings provide a comprehensive map of molecular sex differences in the human brain and offer initial insight into their underlying mechanisms and potential functional consequences,” Alex DeCasien, PhD, from the National Institute of Mental Health in Bethesda, Maryland, told Inside Precision Medicine.
DeCasien and co-workers conducted a high-resolution analysis of gene expression in tissue samples from the brains of 15 men and 15 women using single-nucleus RNA sequencing.
They then used data from earlier large neuroimaging studies to select six cortical regions to sample, four of which showed sex-related differences in grey matter volume and two in which no such differences were found.
The team found subtle but widespread differences in gene activity between men and women. Biological sex explained very little of the variance in gene expression across the brain, at less than 1%, but differences were widespread—with more than 3000 genes showing different expression according to sex in at least one cortical region.
The greatest sex-related differences in gene expression were on the sex chromosomes. However, most of the genes showing sex-related variations in expression were autosomal—carried on one of the 22 numbered non-sex chromosomes.
The predominant driver for sex-biased expression of genes on these autosomal chromosomes were sex steroid hormones such as estrogen and testosterone.
Surprisingly, more than half the X chromosome genes in women were expressed in both alleles for at least one cell type. This indicated that many had escaped X chromosome inactivation—a female phenomenon in which one of the two X chromosomes is switched off early in development to stop women producing double the number of X-linked gene products to men.
“That finding has implications for understanding sex-biased disease susceptibility because several genes implicated in neurodevelopmental disorders reside on the X chromosome,” commented Jessica Tollkuhn, PhD, from Cold Spring Harbor Laboratory, and S Marc Breedlove, from Michigan State University, in an accompanying Perspective article.
They noted that autosomal genes showing sex-biased expression were substantially enriched for extracellular matrix components, hormone signaling pathways, and metabolic processes. “Genes with greater expression in women were enriched for mitochondrial and synaptic functions, whereas male-biased genes were associated with metabolic and structural pathways,” the editorialists added.
“By pinpointing these sexually differentiated processes, the data provide a treasure trove for the discovery of biomarkers of and/or therapeutic targets for differential disease risk in men and women.”
DeCasien and team added: “These findings raise the possibility that sex differences in gene expression modulate the magnitude of genetic effects at risk loci, contributing to differences in disease vulnerability and to reduced portability of polygenic risk prediction across sexes.”
The post Brain Gene Variations Help Explain Neurological and Psychiatric Sex Differences appeared first on Inside Precision Medicine.
STAT+: Researchers behind GLP-1 obesity drugs advance new approach: Drop GLP-1 as a target
The scientists whose work spurred the development of powerful obesity drugs like Eli Lilly’s Zepbound are now raising a provocative hypothesis: Perhaps targeting the GLP-1 hormone is actually not necessary to achieve effective weight loss.
A group of researchers led by Richard DiMarchi and Matthias Tschöp has created an experimental drug that activates receptors of the GIP and glucagon hormones. They propose — based on rodent and monkey studies — that this kind of molecule, when administered at high enough doses, may result in weight loss comparable to the weight loss seen with drugs that include GLP-1 as a target, and without the tolerability issues like nausea and vomiting that often come with the approved treatments, according to a peer-reviewed draft paper published this week.
The research, funded by a biotech called BlueWater Biosciences, would still need to be confirmed in humans; oftentimes results seen in animals don’t translate in the clinic. But the proposed approach, outlined in the journal Molecular Metabolism by some of the most well-known scientists in the field, is likely to stir controversy, as it challenges a central notion underpinning not just the development of approved obesity products but also next-generation versions.
Treating enterprise AI as an operating layer
There’s a fault line running through enterprise AI, and it’s not the one getting the most attention. The public conversation still tracks foundation models and benchmarks—GPT versus Gemini, reasoning scores, and marginal capability gains. But in practice, the more durable advantage is structural: who owns the operating layer where intelligence is applied, governed, and improved. One model treats AI as an on-demand utility; the other embeds it as an operating layer—the combination of operation software, data capture, feedback loops and governance that sits between models and real work—that compounds with use.

Model providers like OpenAI and Anthropic sell intelligence as a service: you have a problem, you call an API, you get an answer. That intelligence is general-purpose, largely stateless, and only loosely connected to the day-to-day operations where decisions are made. It’s highly capable and increasingly interchangeable. The distinction that matters is whether intelligence resets on every prompt or accumulates over time.
Incumbent organizations, by contrast, can treat AI as an operating layer: instrumentation across operations, feedback loops from human decisions, and governance that turns individual tasks into reusable policy. In that setup, every exception, correction, and approval becomes a chance to learn—and intelligence can improve as the platform absorbs more of the organization’s work. The organizations most likely to shape the enterprise AI era are those that can embed intelligence directly into operational platforms and instrument those platforms so work generates usable signals.
The prevailing narrative says nimble startups will out-innovate incumbents by building AI-native from scratch. If AI is primarily a model problem, that story holds. But in many enterprise domains, AI is a systems problem—integrations, permissions, evaluation, and change management—where advantage accrues to whomever already sits inside high-volume, high-stakes operations and converts that position into learning and automation.
The inversion: AI executes, humans adjudicate
Traditional services organizations are built on a simple architecture: humans use software to do expert work. Operators log into systems, navigate operations, make decisions, and process cases. Technology is the medium. Human judgment is the product.
An AI-native platform inverts this. It ingests a problem, applies accumulated domain knowledge, executes autonomously what it can with high confidence, and routes targeted sub-tasks to human experts when the situation demands judgment that the system can’t yet reliably provide.
But inverting human-AI interaction isn’t just a UI redesign—it requires raw material. It’s only possible when the platform is built on a foundation of domain expertise, behavioral data, and operational knowledge accumulated over years.
The three compounding assets incumbents already own
AI-native startups begin with a clean architectural slate and can move quickly. What they can’t easily manufacture is the raw material that makes domain AI defensible at scale:
- Proprietary operational data
- A large workforce of domain experts whose day-to-day decisions generate training signals
- Accumulated tacit knowledge about how complex work actually gets done
Services companies already have all three. But these ingredients aren’t moats on their own. They become an advantage only when a company can systematically convert messy operations into AI-ready signals and institutional knowledge—then feed the results back into operations so the system keeps improving.
Codifying expertise into reusable signals
In most services organizations, expertise is tacit and perishable. The best operators know things they cannot easily articulate: heuristics developed over the years, edge-case intuitions, and pattern recognition that operate below the level of conscious reasoning.
At Ensemble, the strategy for addressing this challenge is knowledge distillation. The systematic conversion of expert judgment and operational decisions into machine-readable training signals.
In health-care revenue cycle management, for example, systems can be seeded with explicit domain knowledge and then deepen their coverage through structured daily interaction with operators. In Ensemble’s implementation, the system identifies gaps, formulates targeted questions, and cross-checks answers across multiple experts to capture both consensus and edge-case nuance. It then synthesizes these inputs into a living knowledge base that reflects the situational reasoning behind expert-level performance.
Turning decisions into a learning flywheel
Once a system is constrained enough to be trusted, the next question is how it gets better without waiting for annual model upgrades. Every time a skilled operator makes a decision, they generate more than a completed task. They generate a potential labeled example—context paired with an expert action (and sometimes an outcome). At scale, across thousands of operators and millions of decisions, that stream can power supervised learning, evaluation, and targeted forms of reinforcement—teaching systems to behave more like experts in real conditions.
For example, if an organization processes 50,000 cases a week and captures just three high-quality decision points per case, that’s 150,000 labeled examples every week without creating a separate data-collection program.
A more advanced human-in-the-loop design places experts inside the decision process, so systems learn not just what the right answer was, but how ambiguity gets resolved. Practically, humans intervene at branch points—selecting from AI-generated options, correcting assumptions, and redirecting operations. Each intervention becomes a high-value training signal. When the platform detects an edge case or a deviation from the expected process, it can prompt for a brief, structured rationale, capturing decision factors without requiring lengthy free-form reasoning logs.
Building toward expertise amplification
The goal is to permanently embed the accumulated expertise of thousands of domain experts—their knowledge, decisions, and reasoning—into an AI platform that amplifies what every operator can accomplish. Done well, this produces a quality of execution that neither humans nor AI achieve independently: higher consistency, improved throughput, and measurable operational gains. Operators can focus on more consequential work, supported by an AI that has already completed the analytical groundwork across thousands of analogous prior cases.
The broader implication for enterprise leaders is straightforward. Advantages in AI won’t be determined by access to general-purpose models alone. It will come from an organization’s ability to capture, refine, and compound what it knows, its data, decisions, and operational judgment, while building the controls required for high-stakes environments. As AI shifts from experimentation to infrastructure, the most durable edge may belong to the companies that understand the work well enough to instrument it and can turn that understanding into systems that improve with use.
This content was produced by Ensemble. It was not written by MIT Technology Review’s editorial staff.

