STAT+: Trump’s Medicaid work requirements have an unwelcome surprise for some states and patients

Medicaid leaders and advocates say they’re shocked by the Trump administration’s harsh directives for implementing Medicaid work requirements, which they say mark a pivot from how federal officials had characterized their plans just weeks ago. 

Much of the conversation around the nearly 400-page rule that the Centers for Medicare and Medicaid Services released Monday afternoon centers on one of the ways that people can be exempted from work requirements: medical frailty. Getting that exemption will be more difficult than most people had expected, meaning that more sick and disabled people are likely to lose their Medicaid coverage. 

“This is where we’ll see large and harmful coverage losses,” said Benjamin Sommers, an economics professor at the Harvard T. H. Chan School of Public Health. “This is a population that has high medical needs and is at major risk for harm if they lose coverage. That is the headline implication of the new rule.”

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GAIP ASD Research Study

Conditions: Autism Spectrum Disorder; Autism; ASD; Autism Spectrum Disorder (ASD)

Interventions: Biological: Umbilical Cord Blood-Derived Stem Cells and Exosomes; Drug: Glutathione

Sponsors: Greater Atlanta Integrative Pediatrics

Recruiting

Regulating Together for Intellectual Disability: A Group Behavioral Therapy for for Emotion Dysregulation in Autism and Intellectual Disability

Conditions: Autism; Intellectual Disabilities With Other Behavioral Symptoms; Intellectual Disability

Interventions: Behavioral: Regulating Together group therapy

Sponsors: Children’s Mercy Hospital Kansas City; National Institutes of Health (NIH); National Center for Advancing Translational Sciences (NCATS); Frontiers Clinical & Translational Science Institute

Recruiting

NeuroFinance Human Stress Trial During Financial and Informational Volatility

Conditions: Psychological Stress; Anxiety; Emotional Stress; Autonomic Nervous System Dysfunction; Sleep Disturbance; Insomnia; Behavioral Health; Cognitive Fatigue; Occupational Stress; Financial Stress; Burnout Syndrome; Heart Rate Variability; Neurobehavioral Manifestations

Interventions: Device: Wearable Physiologic Monitoring Platform

Sponsors: Truway Health, Inc.

Not yet recruiting

Effectiveness of a culturally adapted psychoeducational intervention for family caregivers of children with hematologic malignancy: a randomized controlled trial

ObjectiveThis study aimed to develop and evaluate a culturally adapted psychoeducational intervention to address the severe psychological distress and caregiving burden commonly experienced by caregivers of newly diagnosed pediatric hematologic malignancy patients during the early stages of illness.MethodsAmong 116 randomized caregivers, 90 completed all three assessments and were included in the complete-case analysis. The intervention group received a 4-week psychoeducation program delivered by medical social workers, whereas the control group received routine care. Outcomes were assessed at baseline, post-intervention, and 48-day follow-up.ResultsCompared with controls, caregivers in the intervention group showed greater reductions in depressive and post-traumatic stress symptoms after the intervention, and these reductions were maintained at follow-up. Caregiver burden showed a delayed reduction, with between-group differences becoming apparent at follow-up. Anxiety levels decreased over time in both groups, but the group × time interaction was not statistically significant.ConclusionThe culturally adapted psychoeducational intervention was associated with reductions in depressive and post-traumatic stress symptoms and a delayed reduction in caregiver burden, but did not show an additional effect on anxiety beyond routine care. These findings provide preliminary support for structured, culturally responsive psychoeducational support in pediatric hematology settings.

Clinical correlates and cognitive associations of the neutrophil-to-lymphocyte ratio in first-episode psychosis and at-risk mental states

ObjectiveClinical high-risk for psychosis (CHR-P) and first-episode psychosis (FEP) individuals present immune alterations that precede treatment initiation. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a simple, accessible marker of systemic inflammation. This study investigates differences across CHR-P, FEP, and healthy control (HC) populations and explores peripheral associations between NLR and demographic, clinical, and cognitive variables.MethodsData were collected from 63 FEP, 56 CHR-P, and 27 HC individuals from two early intervention services in Spain. Socio-demographic, clinical, and neurocognitive data were collected from all participants, along with peripheral blood samples for NLR calculation. Correlations between NLR and clinical and neurocognitive variables were analyzed using multivariate models to control for potential confounders.ResultsNo significant differences in NLR were observed between the FEP, CHR-P, and HC groups (F = 1.04; p=0.36). In the FEP population, NLR was positively correlated with higher levels of positive symptoms (β=0.035; p=0.01) and longer duration of untreated psychosis (β=0.003; p=0.04) after adjusting for sex and age. In CHR-P individuals, NLR was negatively correlated with antidepressant use (β=-0.664; p=0.02). No significant associations were found between NLR and neurocognitive performance or antipsychotic treatment in any clinical group.ConclusionsOur findings do not support the utility of NLR as a diagnostic biomarker in early psychosis. However, the observed association between elevated NLR and positive psychotic symptoms in FEP suggests that NLR could serve as a state biomarker, reflecting inflammatory status related to symptom severity. Further research is needed to explore NLR dynamics in larger samples and its potential role in monitoring clinical progression in psychosis.

Senior NIH scientist, research fellow charged with bringing deactivated mpox virus into U.S.

DETROIT — Two scientists at a U.S. government lab were charged with smuggling vials of deactivated mpox virus into the country from Africa and lying about it during interviews with investigators at a Michigan airport, authorities said Tuesday.

A criminal complaint was unsealed in federal court in Detroit against Vincent Munster, who is chief of the virus ecology section at Rocky Mountain Laboratories in Hamilton, Montana, and Claude Kwe, who works with him as a research fellow.

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