Researchers at Google DeepMind have unveiled a new AI model designed to unravel how changes in our DNA affect different cells, giving scientists a more detailed view of a notoriously difficult problem that could hold important clues to the causes of disease - and point the way to new treatments.

AlphaGenome 2 is the successor to DeepMind's genome-predicting AI model AlphaGenome, which was released last year. While nearly every cell in the human body carries the same DNA, different types of cells - from heart muscle cells and skin cells to immune cells fighting an infection - switch different genes on and off, and those patterns can change d …

Read the full story at The Verge.

The idea that external forces are causing internal anxiety that manifests physically in your body isn’t exactly new. But a new study published in PNAS found that stress from the pandemic rapidly aged people at an epigenetic level, meaning they aged more quickly at a genetic level.

But it really affected only one group: young people, particularly teenagers.

Teens, with their still-forming brains, had such a hard time processing the traumas of not being able to go anywhere to protect the health and safety of themselves and those closest to them that the biological timers deep down in their DNA sped up.

Lead author Alicia Schowe and researchers at the Max Planck Institute of Psychiatry analyzed saliva samples from over 1,000 German participants using four different epigenetic clocks. They tracked DNA methylation, the chemical tags along your genetic strands that regulate gene activity.

Pre- and post-lockdown data revealed that while physical health hits like weight gain and smoking bumped up aging metrics across the board, adolescents were the sole group whose subjective mental anguish directly turbocharged their biological clocks.

The Pandemic Did Some Real Damage to Teenagers

Puberty is already a dramatic mess of hormonal angst, but stripping away real-world social interaction made it all the worse on a biological level, leaving measurable genetic scars.

The broader Takeaway is one we knew before the pandemic, met face-to-face during it, and one many people refuse to acknowledge post-pandemic: large-scale societal crises hit vulnerable populations hardest. People already struggling in the lower socioeconomic strata or people with poor health suffered the worst epigenetic hits.

Scientists don’t yet know if this accelerated cellular aging leads to an earlier onset of age-related illnesses like cancer or diabetes. For now, keep an eye on your teenager and ask yourself: Are they acting like a divorced 45-year-old accountant more than usual? Because that might be the rapid biological aging at work.  

The post Did the COVID-19 Pandemic Really Make Teenagers Age Faster? Here’s What a New Study Found. appeared first on VICE.

Are you a manly man who has spent the past several years basing your entire personality on your militant meat consumption out of the odd belief that eating more animal flesh will supercharge your testosterone and turn you into a turbo dude whose cup runneth over with dude juice? Well, you might want to brace yourself. A study from Finland, published in the International Journal of Food Sciences and Nutrition, just might be the keystone that brings your tower of fragile masculinity crumbling down.

That meat ain’t raising your testosterone levels. If anything, it’s doing the exact opposite.

Eating Lots of Meat Isn’t Good for Your Testosterone Levels, According to New Study

Researchers at the University of Eastern Finland examined dietary intake and blood samples from 2,546 men aged 42 to 60. The dudes packing their plates with animal protein had lower levels of total and free testosterone in their blood.

On the other hand, men getting their protein from non-grain plant sources, like legumes, nuts, and vegetables, actually clocked higher levels of circulating free testosterone. Eating the most meat translated to roughly an 8 percent drop in testosterone compared to average levels, while those who returned to plant-based proteins enjoyed a 7 percent testosterone boost.

The researchers acknowledge the shifts were modest and mostly observational, but the findings do a lot to topple the myth of animal flesh as a magical testosterone elixir. The maligned plant proteins your average crazed, testosterone-obsessed TikTok influencer avoid like the plague actually reduce systemic inflammation, whereas diets heavy in meat carry with them a ton of saturated fats, which lead to higher BMIs and a suppression of hormone production.

You don’t need to choke down steaks to feel like a man. A bowl of lentils or some beans will get you the testosterone numbers you’re looking for. Those guys on TikTok are on steroids anyway.

The post Does Eating More Meat Raise Your Testosterone Levels? Here’s What the Science Says. appeared first on VICE.

Paul Boakye was 22 when he was diagnosed with HIV. It was winter 1986, five years after the world first became aware of the deadly disease that would become known as acquired immune deficiency syndrome (AIDS). After receiving the news, Boakye was certain he was going to die young. “I distinctly remember a doctor telling me that I probably wouldn’t live to see 30,” he said. 

Years passed, and Boakye watched as both his former partner and many of his friends died of complications from HIV, which infiltrates immune cells and weakens the body’s defenses. During the early days of the HIV pandemic, a diagnosis was essentially a death sentence. Without getting treatment, HIV infections can eventually develop into AIDS — the stage in which a person’s immune system has deteriorated to the point that they become vulnerable to typically harmless infections and rare cancers. Once AIDS manifests, life expectancy drops to just a few years. 

But Boakye was an exception. 

Now four decades after his diagnosis, at age 63, he remains symptom-free. He is one of the rare people with HIV whose immune systems can fight off the virus without treatment. These individuals, known as “elite controllers,” make up less than 0.5 percent of those who get infected with HIV.

For many scientists, this group of people provides a roadmap for a so-called functional cure, a state akin to cancer remission, where the infection is under control, but not completely eliminated. 

A cure for HIV is still much needed. In 2025, approximately 1.2 million people around the globe became newly infected and around 570,000 died from HIV-related causes. Today’s clinicians now have an arsenal of effective medications to both prevent and treat HIV infections. “There are a lot of tools to fight HIV, but it’s also evident that this is not enough,” said Asier Saez-Cirion, leader of the Viral Reservoirs and Immune Control Unit at the Pasteur Institute in Paris. 

To keep HIV as a survivable disease, people with the virus must take treatments for life, which brings up widespread issues of cost and access. When those become a barrier, it ends up costing lives. But researchers have been working on deciphering the lasting secrets of elite controllers like Boakye, in hopes of one day developing a functional cure for millions more people living with HIV. This work has led to many new strategies for fighting the virus — and several new treatments are now being evaluated in clinical trials. 

The elite controllers of HIV 

Joel Blankson, an associate professor of medicine specializing in infectious diseases at the Johns Hopkins University School of Medicine, remembers when he encountered an HIV elite controller for the first time. It was 1998, and a woman had come to the clinic after testing positive for HIV. That test result showed that her immune system had encountered the virus and produced antibodies to fight it. 

But further tests revealed something baffling. Normally, as an HIV infection progresses, the virus infiltrates key immune cells, known as CD4 T cells, hijacking their internal machinery to make more copies of itself, and killing the host cells in the process. This patient, however, had no detectable levels of virus in her blood and appeared to have a healthy number of CD4 T cells. “That was fascinating,” Blankson said, since clinicians at the time did not think that could be possible. 

Starting in the 1990s, researchers in the US and elsewhere in the world started documenting such cases. A few years earlier, Bruce Walker, a physician-scientist and director of the Ragon Institute of Mass General Brigham, MIT, and Harvard, had been similarly astounded by a patient who had been HIV positive for 16 years with no signs of disease. “I thought initially he couldn’t possibly be infected because everybody we saw had progressive illness,” Walker said. 

For any virus, whether it’s HIV or influenza or Covid-19, people have a range of responses — some people become severely ill while others may have no symptoms at all. But HIV is exceptionally good at evading the immune system’s defenses, so the research community was glad to see that there were some people who seemed to be able to naturally fight off HIV. “It was particularly exciting to see that they were able to maintain this control in the long term,” Saez-Cirion said. 

So the natural question was: What made these people different from those who became severely ill from HIV? 

Some researchers hypothesized that these elite controllers had been infected by a defective version of HIV. Early evidence appeared to support this claim: In 1992, researchers described a small group of long-term, symptom-free HIV-positive individuals who had all been inadvertently infected through blood transfusions from an asymptomatic individual. The transfusions had occurred in 1985, before blood was routinely screened for HIV. Both the donor and the recipients harbored a strain of the virus with genetic mutations that hindered its ability to replicate. 

But this incident turned out to be the exception. Later studies found that most people who survived for many years without disease progression did not carry weakened versions of HIV. For example, when Blankson and his colleagues isolated HIV from elite controllers’ cells, they found that the virus was able to multiply effectively in a lab dish just as well as the virus from people who became ill from HIV. And when they used the virus from these elite controllers to infect mice engineered to have human-like immune systems, the pathogen was still able to spread through the animals with ease. All of this suggested there was something unique not about the infecting strain of the virus but instead about these individuals’ immune systems. 

As the tests for detecting the virus in blood samples improved, researchers found that there were even different levels of how much some people could control the virus. There were, for example, “viremic controllers,” who are often defined as those with less than 2,000 copies of HIV within a milliliter of blood, and “elite controllers” who have less than 50. For comparison, a typical HIV-positive person can have anywhere from tens of thousands to more than 1 million HIV particles in a milliliter of blood, depending on the stage of their infection.

More recently, another group of intriguing patients has emerged: post-treatment controllers, who, after taking antiretroviral treatment for many years, become capable of controlling HIV without medication.^.This group is giving even more hope that controllers may hold a clue to finally creating a lasting cure for the disease. 

Unraveling the mechanisms of elite control 

Once people who seemed to be beating back HIV on their own began to emerge, researchers went searching for more of them. Eventually, several research teams were able to assemble large cohorts of these patients: Walker and his colleagues, for instance, found around 1,000 elite controllers to begin to study them en masse to search for trends.  

Some of the earliest studies looked into elite controllers’ genetics. Using a technique known as genome-wide association, which involves screening the genetic material of many people for links to disease, scientists discovered that a large proportion of elite controllers possessed variants of genes that code for structures responsible for presenting antigens — the fragments of viruses and other substances that immune cells use to detect pathogens. 

Researchers have drawn inspiration from these studies to develop new strategies for fighting HIV.

This led scientists to zero in on cytotoxic T cells, immune cells that zero in on these fragments to identify foreign and infected cells to attack. In elite controllers, these cellular soldiers appeared to be exceptionally good at seeking out and eliminating HIV. How these individuals’ immune responses accomplish this has been a matter of intense investigation: Some researchers, such as Mark Connors, an HIV researcher at the US National Institute of Allergy and Infectious Diseases, and his team have found that elite controllers’ cytotoxic T cells increase the production of a specific molecule that pokes holes in infected immune cells to kill them — something that the same type of cells in other HIV-positive people are unable to do. Other groups, such as Walker’s team, have found that cytotoxic T cells are able to launch highly specific attacks on vulnerable regions within the virus’s structure. 

Over the years, scientists have found that there is likely no one-size-fits-all explanation for why elite controllers’ immune systems are such formidable opponents for HIV. Studies have also found that these individuals also appear to possess exceptionally robust natural killer cells, which are immune foot soldiers that are some of the first to find and kill invading pathogens. 

Other investigations have looked beyond specific cells to the aftermath of an elite controllers’ immune response. Xu Yu, an HIV researcher at the Ragon Institute, along with Walker and their colleagues, have found that immune systems of some elite controllers keep HIV locked away in so-called gene deserts, where it is unable to make more copies of itself — an essential task for the virus’ success. 

Yu says that this is likely the result of unusually strong immune surveillance. Elite controllers’ immune systems were likely able to kill off the cells in which the virus had integrated itself into parts of the genome to multiply. This left only those cells with ineffective viruses behind. How the immune system actually does this remains a mystery, but according to Yu, it’s likely that multiple parts of controllers’ immune systems work together to launch particularly powerful responses. 

In addition to uncovering how, exactly, the immune system accomplishes this feat, Yu is also hoping to replicate this process in people who aren’t elite controllers. The good news is, evidence so far suggests that this may indeed be possible: In a 2023 study with eight people who had been on long-term anti-retroviral therapy, Yu’s team found that it was also possible for non-elite controllers to lock HIV away in these gene deserts — but only after more than two decades of treatment. 

The next step is to determine how to make people reach this state faster, so that they can one day stop needing treatment altogether, Yu says.

Researchers have drawn inspiration from these studies to develop new strategies for fighting HIV. Several are currently being tested in people with the virus. Walker’s team, for example, has developed a trial vaccine designed to train a person’s T cells to attack the most vulnerable parts the viruses’ structure — both as a way of preventing and of treating infection, in an early-stage trial. Saez-Cirion and his team have several ongoing trials, including one effort that involves administering immunotherapy in combination with antiretrovirals in people with newly diagnosed infection to try to coax their immune systems into developing the potent immune response found in elite controllers. 

The elite road to a cure? 

Experts are generally reluctant to say that elite controllers — even those who have lived symptom-free for decades — are “cured” of HIV. The main reason is that HIV is notorious for hiding in so-called reservoirs, cells in which HIV lingers without replicating. 

The virus in these reservoirs escapes detection from a person’s immune system and from current HIV medicines. From here, it can then become active after remaining quiet for years. Because HIV infects immune cells, which travel all around the body, the virus can hide in deep tissues, such as the brain, that are extremely difficult to probe in living people. 

And there are documented cases of the virus eventually breaking through an elite or viremic controller’s immune defenses, kick-starting disease progression — even if they have lived symptom-free for years or decades. It’s still unclear what factors determine when that point will come. So, many controllers are also on antiretroviral therapy.

There are, however, two elite controllers who are widely considered to be cured. One is the “Esperanza patient,” named after the Argentinian city where she lived, for whom researchers analyzed more than a billion cells and found no intact HIV. And the other, Loreen Willenburg, a Californian woman, kept the virus at bay for more than three decades without treatment — even while receiving immune-suppressing treatment for lung and brain cancer. Before she died in April, Willenburg donated her body to science; Yu and her colleagues have been carefully analyzing autopsy samples to determine whether there are intact viruses hidden somewhere within her body. 

But these are the incredibly rare known examples among the 92 million people who have acquired HIV since the virus was first described. So even the elite controllers must stay vigilant for the virus’s reemergence. Boakye regularly gets his blood screened to make sure that HIV has not begun to spread. Today, he lives in the UK working as a playwright, and he remains active and healthy — and HIV remains undetectable in routine tests, even after four decades without treatment.

For years, he has tried to enroll in a study in hopes of helping scientists understand how his immune system has managed to fight HIV all these years, and last year, he became involved in three research projects. One of these is at the Ragon Institute, where Yu’s team analyzed more than 1 million cells in Boakye’s blood and found only a tiny number of HIV fragments — and only one that appears to be intact. Whether this fragment is capable of replicating remains unknown.

“They believe that my immune system is ignoring all the defective fragments and just controlling the one fragment that could replicate,” Boakye said. How his immune system does this is still a mystery, but Boakye hopes that by studying him and other elite controllers, scientists will be able to reverse engineer new treatments. 

While a cure for HIV remains elusive, this research is bringing us closer than ever to that goal. There are multiple trials trying to mimic the responses found in elite controllers around the world, and the results of these efforts will emerge over the next five years or so, which is quite an exciting prospect, Saez-Cirion said. “We need additional tools that will allow people to live with HIV but without antiretrovirals. And if we can cure it — even better,” Saez-Cirion said.

Oura announced its quarterly earnings today and said it agreed to acquire Counsel Health for $625 million, after adding the company's AI chatbot to its app earlier this year. Counsel Health calls itself an "AI-native primary care company," using the app to deliver AI-generated responses and insights based on users' health data reported from their wearables that can then proceed to a conversation with one of its in-house physicians.

Oura says it expects the deal to close before the end of the year.

Oura CEO Tom Hale said in an interview with Bloomberg that the acquisition is part of a plan to connect wearables, clinical AI, and access to do …

Read the full story at The Verge.

Former SignalFire investor Sahir Raoof raises $27.5 million for new fund targeting AI in pharma.

BRUSSELS — Royalty descended on the European Parliament on Tuesday as Prince Harry slammed Big Tech for creating a world of “chaos.”

“A handful of very powerful people … would like to see the world as a social media world: lawless, no consequence, complete chaos, division,” the Duke of Sussex said at an event on online safety for children.

Speaking in a room packed to the brim with journalists and photographers, Harry called for stricter rules on social media platforms to protect kids from content that could lead to suicide or self-harm.

He expressed reservations about the privacy policies of social media platforms, which he said bar parents from knowing how their children died. “That cannot be right,” a visibly upset Harry said.

His wife, Meghan Markle, was present but withdrew from an address on Tuesday’s panel.

The European Commission regulates online platforms through its Digital Services Act and is planning a special regime for minors under the Kids Act.

The burden of proof that platforms are safe should be on the companies rather than on parents, and “the EU Kids Act is exactly that,” said the prince, praising an EU proposal that would bar access to social media for under-13s.

The couple brought an air of celebrity to the Parliament, with heightened security and a clamoring press pack, including many journalists from the U.K. Dozens of parliament employees and lobbyists gathered outside the room, phones in hand, to catch a glimpse of the pair.

Meanwhile, the internal market committee, which is leading negotiations for the Parliament on the Kids Act, was meeting in a far less crowded room. MEPs from the committee — including Hungarian conservative Dóra Dávid and Slovak liberal Veronika Cifrová Ostrihoňová — attended the royal event.

“Wait, I can feel that?” Ami Brasure remembers thinking.

For most of us, the experience that dazzled her couldn’t be more ordinary: You’re standing around, maybe in your kitchen or living room, drinking something a little too carelessly, and before you know it, the liquid is dribbling down your chin and trickling down your chest — and you can feel it. It’s a familiar sensation (in this case, perhaps an embarrassing one). But for Brasure, a 50-year-old retail sales manager from the Washington, DC, area, it was life-affirming. 

At the time, she was recovering from a double mastectomy in the wake of a stage one breast cancer diagnosis. She vividly remembers the chill from her spilled drink as it snaked its way inside the compression garment she was wearing as part of her recovery process. The sudden dampness came as a shock — not because it was unpleasant, but because she never expected to feel anything in that area at all, certainly not so soon after surgery. 

As Brasure knew, many people who get mastectomies are left with little to no feeling in their chests. That loss of sensation can affect a patient’s psychological well-being, sometimes actively alienating them from their bodies as they adjust to life after treatment. 

“Every patient will have their own surgical goals. And mine was to look and feel as close as I did to how I looked and felt before I went into that operating room,” Brasure told me.

So when Dr. Lucy De La Cruz, chief of breast surgery at MedStar Georgetown University Hospital, offered Brasure the chance to be the hospital’s first patient to undergo a surgery that deployed a new robotic nipple-sparing mastectomy technique, she was enthusiastic. Especially because it was a procedure that some surgeons and studies have suggested leads to better preservation of feeling. 

Using a robot to aid a mastectomy is not entirely novel — surgeons around the world have been experimenting with this technique for the past decade. 

But what is new is that De La Cruz’s novel surgical plan combined several procedures into one operation. Using the da Vinci single-port robotic surgical system, she removed the breast tissue while preserving the nipples and skin. In the same operation, her team checked the lymph nodes, reconstructed the breasts with implants, and reconnected the nerve to the nipples to help restore sensation. In most robotic nipple-sparing mastectomies, the surgical incision is made along the armpit or the side of the chest. But here, De La Cruz and her team did everything through a single, 4-centimeter incision on each breast, naturally hidden under its fold. The hidden surgical scar and shorter recovery period, along with the possibility of having sensation back in her breasts post-surgery, were alluring for Brasure.

Normally, surgeons performed nipple-sparing mastectomies through more conventional “open” techniques, typically through a long incision at the bottom of the breast. It is a technically challenging operation. Breast tissue extends all the way up to the collarbone, and surgeons have to reach it through a tight space with limited visibility, relying on their hands and eyes to look and feel their way around the breast. An assistant often uses large metal retractors to lift the skin around the incision to keep the area exposed and visible. 

The procedure also carries a known risk of injury to the skin and nipple, sometimes severe enough that patients can lose the nipple and surrounding skin. These challenges led some surgeons to explore whether a robot-assisted surgery could help mitigate certain risks of open nipple-sparing mastectomies. But it was only in December 2025 that the Food and Drug Administration specifically cleared the use of the da Vinci single-port machine to perform mastectomies in the United States. 

And at least for Brasure, it seems to have made all the difference, helping her feel better connected to her body after a procedure that might, under other circumstances, have left her with a radically altered sense of it.

In theory, robotic nipple-sparing mastectomies sound like an amazing example of where surgical technology can take us. The American Cancer Society estimates that, in 2026, about 321,910 new cases of invasive breast cancer will be diagnosed in women. Many women opt for mastectomies not just as an active cancer treatment but also preventatively to reduce their risk, especially when they have a BRCA mutation — which indicates a very high likelihood of developing breast cancer — or a family history of the disease. A surgery with the potential to preserve more sensation, leave fewer surgical scars, and allow patients to recover more quickly promises to be a boon to women’s health. 

Instead, robotic nipple-sparing mastectomies have proved extraordinarily divisive among oncological surgeons. Some, including De La Cruz, have embraced them. Others worry that the technology has gotten ahead of the evidence, especially on one of the most important measures in cancer treatment: making sure that the cancer doesn’t come back.

The case for robotic mastectomies

Maleeha Aziz, a 33-year-old deputy director at an abortion fund in the Dallas-Fort Worth area, grew up around breast cancer. 

Aziz was 3 years old when her mother was first diagnosed. As a child, even though she couldn’t completely understand what was happening, she remembers her mother slowly losing her luscious, thick hair and how she could no longer pick Aziz up after the double mastectomy surgery. 

It was clear that there was a family history, and Aziz felt like the cancer wasn’t skipping a single person. Her nani, or maternal grandmother, and her aunt had been diagnosed with ovarian and breast cancer, respectively. But the last straw was when her 32-year-old cousin — as close to her as a sister — received a stage three breast cancer diagnosis while she was pregnant. 

Having seen the ravages of the disease firsthand and knowing from genetic testing in her early 20s that she was a BRCA carrier, Aziz ultimately decided that it would be better to get a preventative double mastectomy and reduce her cancer risk rather than live with pervasive anxiety from screening to screening. 

“Preventative care is not radical. What is radical is to get cancer,” she told her family when they worried that it was an unnecessary medical intervention. A preventative mastectomy can lower the risk of breast cancer by close to 90 percent. 

Aziz, like Brasure, was keen on sensation preservation. She remembered hating the numbness on her abdomen after her C-section delivery when she had her daughter, and couldn’t imagine the same around her breasts. 

So in 2023, at the age of 29, Aziz opted for a preventative robotic nipple-sparing mastectomy at the University of Texas Southwestern Medical Center as part of surgical oncologist Dr. Deborah Farr’s study on the feasibility of using the da Vinci single-port machine to perform the procedure. Farr was one of the few who were approved by the FDA to research and perform the robotic nipple-sparing mastectomy before it was officially cleared in 2025. More than three years later, Aziz has no regrets about her decision, especially since she has “pretty decent sensation” in her breasts, unlike her cousin who underwent a traditional mastectomy.

Aziz isn’t alone in her desire to preserve sensation in her breasts. 

Breast cancer, like all cancers, can prove to be a psychological malady as surely as it is a physical one. Body image is about much more than just appearance, said Danielle Saff, an oncological social worker at CancerCare, a nonprofit providing support and counselling for people diagnosed with cancer. Body image is also about familiarity with one’s body, connections and sensations. 

Saff told me that she often encounters patients who feel guilty for caring about things like how their breasts will look or how their body will change, fearing that such considerations are trivial when their lives are on the line. But patients must be allowed to ask these questions, Saff said, because they are important to their life after treatment. 

“When treatment ends, [that] doesn’t mean that one’s life goes back to quote unquote normal,” Saff said. “There’s so much adjustment that happens and so much grief throughout the process.”

Losing sensation in the breasts or nipples can also affect how some patients experience intimacy, Saff said, because the surgery can affect how they feel about their changed bodies. 

But for De La Cruz, however, sensation preservation goes beyond helping patients still enjoy intimacy after mastectomies — it is also about safety. What if boiling water splashes on you while you’re cooking or you accidentally hit yourself with a curling iron while doing your hair in the bathroom, she noted by way of example. Being able to feel external stimuli like pain, heat, cold, or pressure on your body is key to protecting it. 

How robotic surgery works

In a robotic mastectomy, the surgeon sits at a console a few feet away from the patient and controls every movement of the machine’s instruments with their hands. The da Vinci single-port robot, the version cleared for nipple-sparing mastectomies, has one arm that enters the body through a single small incision usually along the side of the chest or, in some cases, in the fold beneath the breast. The arm has three multi-jointed instruments at one end, which the surgeon can use to bend, grasp, and dissect breast tissue, nerves, and blood vessels much like they would with their wrists and fingers in a traditional non-robotic (“open”) surgery. Usually, a plastic surgeon is also in the operating room ready to begin reconstruction once the cancer is removed.

Because these robots also have an endoscope — a medical device with an attached light used to look inside body cavities — the interior of the breast is visible to the surgeon in great three-dimensional detail and size on a display screen outside the body. This makes it much easier for surgeons to navigate complicated tissue and nerve structures once they have been properly trained on the robot.

Aziz’s surgeon, Farr, a surgical oncologist who specialises in breast cancer at the University of Texas Southwestern Medical Center, believes that the robotic nipple-sparing mastectomy is essentially the same as the open one, but with much better control and visibility. 

At UT Southwestern, she often taught doctors how to perform procedures like the open nipple-sparing mastectomy.

“It is a procedure that is technically challenging for breast surgeons, and it’s really difficult for us to teach because really the only person who can see anything is the operating surgeon,” she said, adding that it’s difficult to communicate the steps and what the trainee should be doing if they can’t see inside the body.

In a traditional mastectomy, the surgical cut is held physically open with instruments called retractors, which can cause considerable physical trauma and pressure in the area around it. By contrast, in robotic surgery, carbon dioxide gas is used to open up the space in a much gentler manner. Farr believes that reduced trauma to the skin and better visualization of structures (and hence increased ability to avoid critical nerves) in robot-assisted surgery could be the reason that some patients report more sensation after nipple-sparing mastectomies performed with the da Vinci single-port machine. 

Notably, in her own patients, she did not see a difference in pain or other recovery metrics for those who opted for robotic surgery compared to those who opted for an open surgery instead. That makes sense to her because, as far as she’s concerned, she is doing the same surgery, open or robotically, just using a different tool. 

Nevertheless, the enhanced three-dimensional visualization, better likelihood of preserving breast sensation, and the ability to more easily teach the operation to trainees make it worthwhile for her to continue practicing and studying robotic nipple-sparing mastectomies.  

Why is the procedure so divisive?

Despite all of that — the potential for patients and the advantages for surgeons alike — robotic nipple-sparing mastectomies remain controversial. 

Surgeons we spoke to who remain cautious about adopting robotic nipple-sparing mastectomies are worried about one thing in particular: No study has yet shown clinical evidence that, in the long term, the patients who have undergone robotic nipple-sparing mastectomies have the same cancer survival outcomes as compared to open nipple-sparing mastectomy patients. 

Their fear appears to have a valid basis. 

In the United States, robot-assisted or laparoscopic surgery began to be broadly adopted around 2006 as a minimally invasive method to perform radical hysterectomies, a surgery in which the uterus, cervix, both ovaries and fallopian tubes, and nearby tissues are removed, usually as a treatment for early-stage cancers. There was limited research at the time to show that doing it this way produced long-term survival outcomes for patients that were equivalent to open radical hysterectomies — the existing, accepted standard of care.  

Then, a randomized controlled trial published in 2018 found that patients who underwent the minimally invasive version of the radical hysterectomy had lower rates of disease-free survival as well as overall survival. In other words, the more traditional, non-robotic approach was better for patient health in the long term. The researchers note that the study was not designed to establish what is causing this result and that it is still unclear.    

While robot-assisted hysterectomies may or may not be the most appropriate analog for nipple-sparing mastectomies, it remains true that it is a robotic procedure that received widespread attention, was adopted quickly, and ultimately seems to have had worse outcomes.    

In fact, the FDA referenced that radical hysterectomy study when it published two warnings in 2019 and 2021, cautioning against the practice of robotic breast surgery without a proper randomized controlled trial with long-term evidence on cancer metrics. The FDA asked that anyone experimenting with robotic nipple-sparing mastectomy should do so only within the boundaries of a clinical trial that it approved. 

Soon after, Intuitive — the company that manufactures the single-port da Vinci machine — sponsored a randomized controlled trial that was set to wrap up in 2031 and even published data from the initial 74 participants this year. It concluded that using the da Vinci single-port machine was feasible for robotic nipple-sparing mastectomies and that its safety was comparable to the open procedure in terms of early outcomes after the surgery and the ability to neatly remove tumors. It is worth noting that the robot-assisted surgery takes longer than the open one — so the patient spends more time under anesthesia — but the researchers largely attributed that to the unfamiliarity of surgeons with robotic surgery. They believed that operating time would reduce with better training and exposure to the machine. 

The researchers themselves acknowledge that published results from this study were focused on safety and early post-surgical outcomes, and they say that long-term oncological outcomes will likely be published later. The study was also statistically underpowered due to the small number of participants — enrollment of patients was stopped after FDA clearance was granted in December 2025. 

In a written statement to Vox, an Intuitive spokesperson said, “Da Vinci SP’s clearance for NSM was supported by a robust evidence package for this indication, including a U.S. randomized controlled trial comparing da Vinci SP with open surgery and global evidence from some of the regions where da Vinci SP was already approved for NSM — Europe, Japan, Korea and Taiwan.” They added that the FDA cleared the device after stringent review of the evidence. 

The company also said that patient safety is their top priority and noted that they will continue generating evidence for both short- and long-term outcomes in patients undergoing robotic nipple-sparing mastectomy using the da Vinci single-port machine globally.

The FDA cleared the da Vinci single-port for use in nipple-sparing mastectomies under what’s known as the 510(k) process, which is used for “low to moderate risk” devices if they are “substantially equivalent” to another device that has already been cleared by FDA before. In a written statement to Vox, the FDA said that the clearance reflects their evaluation of the evidence submitted by Intuitive and available scientific evidence under the “applicable regulatory framework.”

“Importantly, the clearance is based on the device’s use as a surgical tool, meaning the sponsor demonstrated that the device can be used safely as a tool in performing nipple-sparing mastectomy procedures,” said the FDA. “This differs from evaluating the device as a potential treatment for cancer, which would require evidence supporting its effectiveness in treating the disease.”

In other words, the FDA found that the device was safe for surgery, but it withheld judgment on whether performing robotic nipple-sparing mastectomies with the da Vinci single-port surgical system would lead to optimal cancer outcomes. In their statement, the FDA also said that they would continue keeping an eye on it (along with other devices they have cleared) and may take additional regulatory action if patient safety is affected. 

Despite the initial data and what Farr describes as “favorable” evidence from studies outside the United States, some critics strongly believe that no conclusive long-term evidence is available to show that robotic mastectomies are at least as effective as open mastectomies in treating cancer. 

Dr. Laurie Kirstein, surgical oncologist at Memorial Sloan Kettering Cancer Center, said that most of the studies done to date establish that robotic nipple-sparing mastectomies are technically safe, which is the first level of evidence needed to evaluate whether they can be more widely performed. For example, such studies consider metrics like whether patients experience bleeding complications or abnormal levels of skin or tissue death called necrosis. 

But, she also notes, the evidence still doesn’t move beyond that to establish strong cancer outcomes, either because the clinical studies are not designed to test for those outcomes or because there isn’t data on long-term outcomes from a randomized controlled trial in a well-defined patient population. 

“After a mastectomy, you’re only going to be getting a physical exam twice a year, right? So there’s no imaging screening,” Kirstein said. “So the mastectomy has to be good enough oncologically to reduce the amount of breast tissue left behind, and that has to be done and proven without a shadow of a doubt, and unfortunately right now those studies don’t exist.” 

What Kirstein is getting at is that the mastectomy surgery, which removes most or all breast tissue, is meant to be the ultimate safeguard. Once the patient undergoes that procedure, regular breast cancer screenings like mammograms generally stop, unless the doctor or patient feels something is abnormal, and the patient is instead monitored through physical exams. If any breast tissue is accidentally left behind, it could be harder to catch a cancer recurrence early. 

In contrast, people who opt for a lumpectomy — a surgery to remove breast tumors while preserving the remainder of the breast tissue — keep getting regular breast image screenings. That’s why surgeons are asking for irrefutable proof that the robotic approach removes the breast tissue just as thoroughly as open surgery does. In the absence of that certainty, some worry that the possibly more selective excisions in robot-assisted surgery may leave an opportunity for cancer to spring up, possibly unmonitored.  

A medical catch-22

Bringing exciting new medical technologies to the market in a responsible manner almost inevitably invites a paradox of sorts. Irrefutably showing that a new surgery is at least equivalent to existing methods and safe, requires performing it on real patients to gather data. And yet without data, there is considerable risk in subjecting patients to it.  

Clinical trials are meant to resolve that tension by testing a new technique under close oversight before it becomes routine. In this case, though, the FDA cleared the robot before Intuitive’s trial was complete, and the trial stopped enrolling patients soon after.

“I truly believe it is a better surgery when done properly,” Farr said. “It was a blessing and a curse that it was approved when it was.” 

For years, only her own study team could use the robot for these surgeries. Now she can teach it to her residents, fellows, and surgeons around the country. But once a device is cleared, “there’s really no further regulation in terms of who can do it and who can’t,” she said. That decision now rests largely with hospitals and with patients. 

Dr. Rosa Hwang, a surgical oncologist at the University of Texas MD Anderson who worked on Intuitive’s US trials, said surgeons will need dedicated training to learn how to perform robotic nipple-sparing mastectomies safely. She chooses her own robotic nipple-sparing mastectomy patients carefully. 

“I err on the side of being conservative for the robotic nipple-sparing mastectomy,” she said. Someone who might be a reasonable candidate for an open nipple-sparing mastectomy, for example, isn’t automatically one for the robotic version.

Farr said that she can understand why critics are skeptical about the existing data on robotic nipple-sparing mastectomies and while she believes the surgery needs more study, she doesn’t think that’s a reason to abandon it. She believes that criticism is healthy for the field, ultimately helping surgeons learn more and better test for the best outcomes.  

“I have a lot of respect for the people who have criticized me,” Farr said. “The response to critics,” she said, “should be not with defense but with data.”

If there is one thing that surgeons on both sides of the robotic mastectomy debate agree on, it’s that patients are asking for this. For women like Brasure and Aziz, beating breast cancer or avoiding it altogether was never the only goal. They also wanted to come out the other side living normal, safe lives in bodies that still felt like their own. The robot may or may not turn out to be the best way to get there — only long-term data will tell. But what’s already clear is that for many women, sensation is no longer an afterthought.

“Nothing feels the same,” Aziz said, “but I have feeling pretty much everywhere, and I feel good.”

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Energy drinks and stimulant-containing supplements have now been linked to an increased risk of heart problems, including but not limited to heart attacks and cardiac arrests, especially in young adults. This dreadful news comes courtesy of the American Heart Association. Their study may be new, but it may confirm the brutal truth that many of us have heard before and chosen to sweep aside.

The specific menaces believed to be contributing to declining heart health are caffeine (of course), methylxanthines, guarana, yerba mate, synephrine, yohimbine, etc. The AHA not only kept an eye on their consumption in soft drinks, meal replacement shakes, and smoothies, but also in protein bars, vitamins, etc.

“Cardiac arrest appeared in reports involving caffeine– and stimulant-containing products about 11 times as often as in reports involving products without those ingredients.”

The AHA study in question examined over 28,000 reports of cardiovascular events, as submitted to the FDA. A portion of these reports could have been imperfect, but the mode of analysis was still a decent one overall. Fox News penned:

“Cardiac arrest appeared in reports involving caffeine– and stimulant-containing products about 11 times as often as in reports involving products without those ingredients. Heart attacks were reported about 4.5 times as often, while ventricular arrhythmias (abnormal heart rhythms) or palpitations were reported about four times as often, according to the AHA.”

On the more mild end of the issues arising, we have fainting, chest pain, and elevated heart rate, but such symptoms still shouldn’t be ignored.

About 45% of the heart problems possibly triggered by the dangerous products occurred in those between 18 and 34. One might ask: How is this age group supposed to have the willpower to stop abusing caffeine when their teachers and professors frequently overload them with work, sometimes making sleep an impossibility? Obviously, taking energy drinks at the same time as psych meds or combining them with alcohol can both be very dangerous, and these are the types of pressing facts that students can forget.

Popular Energy Drinks Are Being Linked to Serious Heart Problems in Young Adults, New Research Finds

While the AHA says it’s usually safe for adults to have about five 8-ounce cups of coffee a day, it’s easy to lose track of exactly how much you are drinking. When I make coffee at home, for example, I leave little room for water in my cup. In 2022, a personal trainer named Tom Mansfield tragically passed after miscalculating the amount of caffeine powder he added to his drink, and there are plenty of other similar stories.

Along those lines, the caffeine levels in energy drinks can be obscene. Fox reported last year that emergency room visits associated with energy drinks rose by 890%, with children proving more vulnerable.

As a Diet Coke and coffee addict, I often feel I will have a heart attack if I do not manage to procure those two daily staples. According to the famous Father Chad Ripperger, however, soda addiction is a more grave moral issue than it might initially appear. He has boldly stated that it can open the door to (Gasp!) demonic possession.

If you feel bad about yourself for sharing in my vice, know that great men like Honoré de Balzac could sympathize. The French writer is one of history’s most famous coffee addicts, having consumed up to 50 cups a day. While Balzac ultimately died of gangrene associated with congestive heart failure, some have pointed the blame for his death at coffee.

The post Addictive Drinks Are Triggering Heart Issues in Young People, According to New Study appeared first on VICE.

With temperatures rising to the 90s in Los Angeles, avoiding the heat wasn't exactly an option while I was at a relative's outdoor party in August. So I sat beneath a patio umbrella with a powerful fan nearby, figuring I was protected from the sun and heat. Half an hour later, I felt exhausted, dizzy, nauseous, and generally unwell, symptoms consistent with heat exhaustion.

Around the same time, I received a notification from an app used by the $249 ($149 at the time of publication) UV-tracking necklace I'd been wearing, called Gem, from a company called The90. It warned that my UV exposure had climbed considerably. It turns out UV radiatio …

Read the full story at The Verge.

In the early 1990s, I was an editor at Wired. It was an exciting time because the internet was new to most people. My colleagues were young, creative, curious, and smart, but two of them stood out: Gary Wolf and June Cohen. — Read the rest

The post Gary Wolf and June Cohen on cold plunges, self-tracking, and the science of ancient practices appeared first on Boing Boing.

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The European Commission has accused TikTok of violating its online platforms rules for having designed algorithms that lead users down so-called rabbit holes.

The preliminary findings announced Friday mark the first time the Commission has focused on a social media platform’s recommender systems as a breach of its powerful Digital Services Act, under which it can issue fines up to 6% of a company’s annual global revenue.

“This is the first time that we are really tackling head-on the engagement-based recommender system model,” said one Commission official, who was granted speaking anonymity to speak freely.

This is the fifth case of the EU executive accusing TikTok of breaching EU rules, even though it has issued no fines against the Chinese-owned platform.

In Friday’s announcement, the Commission says the company didn’t adequately consider the risk of sending users down “rabbit holes” through a “continuous stream of personalised videos, even when those are related to mental health struggles and body image.”

The investigation focused on mental health impacts because “the evidence was strongest,” when asked about how these rabbit holes contribute to radicalization, said another official.

The more users interact with content, even if it’s potentially harmful, the more of that content they are recommended, the Commission said in its press release, which noted that the measures TikTok has put in place to curb the rabbit hole effect have not been effective.

TikTok should take into account “explicit” signals like buttons that say “I’m not interested” more than implicit ones, like engagement, said the first Commission official. Engagement metrics measure how much users interact with content, such as how much time they spend watching a video or the content they like. Talking about mitigation of these risks, the official said that remedies have to be effective and that TikTok’s current measures are not.

“To say ‘I’m not interested’ has to have a meaning, an effective meaning, and not only should not only be an afterthought, and then you go back to the old recommender system,” the official said.

The DSA also foresees a non-personalized feed for all users, but only 0.2% of TikTok users actually select that option, one of the officials said.

A TikTok spokesperson pushed back against the accusation, saying the company “has a strong record” of protecting its users. “The Commission has made a series of statements that are fundamentally inaccurate and distort our platform’s architecture and our commitment to user safety,” the spokesperson said

The company now can examine the evidence, defend its practices and try to come up with a plan to remedy issues that is acceptable to the regulator to avoid fines.

TikTok has managed to close a DSA investigation on advertising transparency by agreeing on fixes with the Commission.

The article has been updated with a statement from a TikTok spokesperson.

Just as the wrinkles on your face denote age, your testicles also have their own way of showing their age, and it has nothing to do with their wrinkliness.

As testicles age, DNA incurs damage and sperm loses some of its function; we know that much, but why it happens is less understood. Researchers in China may have found a molecule that speeds up testicular aging.

According to a study published in the Journal of Molecular Cell Biology, scientists at the Chinese Academy of Sciences and the Naval Medical University analyzed over 10,000 cell nuclei from young and old donors. Unlike ovaries, which run on a strict, finite egg timer, testicles operate a self-renewing stem cell bank that keeps the factory running well into a guy’s senior years.

But around age 45, while still functional, the machinery starts to show its age.

Scientists Found a Surprising Connection Between Aging Testicles and a Little-Known Protein

Researchers say testicular aging comes down to a communication breakdown between two vital parts of the process: Leydig cells, which pump out testosterone, and Sertoli cells, which support developing sperm. In young testicles, these two are in constant communication. In older testicles, the pair have developed the kind of communication issues that usually lead to couples therapy.

Sertoli cells start cranking out massive amounts of a protein called WLS, the villain of the story, which plays a big role in pathways run by a transporter called Wnt, essentially the master switchboard regulating cell survival, renewal, and metabolism.

When researchers artificially cranked up WLS levels in lab-cultured cells, those cells rapidly aged, proving WLS is actively aging testicles.

One major caveat is that the team examined only four human donors, since high-quality tissue samples are hard to come by. They’re going to need a lot more samples to confirm their findings, but the team has already made big strides just in identifying WLS as the source of testicle aging, which is knowledge that may one day help an entirely different team of researchers develop a fertility treatment for aging men.

The post Scientists Think They’ve Discovered What Makes Men’s Testicles Age Faster appeared first on VICE.

Gym guys have never met a recovery shortcut they didn’t want to inject.

The latest is the “Wolverine shot,” named after the X-Men character who can recover from just about anything. It’s a combination of two synthetic peptides, BPC-157 and TB-500, that fitness enthusiasts are using in hopes of recovering faster from injuries and punishing workouts. BPC-157 is based on a substance found in the stomach, while TB-500 is derived from a protein involved in tissue repair.

The injections have some famous supporters. Joe Rogan claimed his elbow tendinitis disappeared within two weeks of using BPC-157, and Health Secretary Robert F. Kennedy Jr. has spoken about using the peptide to treat a muscle injury.

The enthusiasm is running well ahead of the science. Most research comes from animal experiments, and there’s little reliable human evidence that either peptide helps people heal. FDA scientists have raised concerns about allergic or immune reactions and impurities, with too little information to know how safe these substances are. Buying injectable vials from an overseas supplier adds the possibility of contamination or getting something entirely different from what you ordered.

Access is getting easier anyway.

The ‘Wolverine Shot’ Claims to Help Your Body Heal Like a Superhero. Does It Actually Work?

On October 28, HHS announced that it wouldn’t pursue enforcement against certain licensed pharmacies and physicians compounding six unapproved peptides, including BPC-157 and TB-500, provided they meet strict conditions. Kennedy’s administration argues that supervised compounding offers a safer alternative to the online gray market. Critics worry that patients will mistake easier access for evidence that the drugs work.

There’s another catch. The policy allows each peptide to be compounded individually, not combined into the Wolverine stack. Neither has FDA approval. Competitive athletes also have reason to steer clear. Both substances are prohibited under the World Anti-Doping Agency’s rules.

Actual human research is still catching up. A small, placebo-controlled trial of BPC-157 after shoulder surgery is planned for 2027. Researcher Shiloah Kviatkovsky told Business Insider that the popularity of these treatments before proper testing is frightening, especially when buyers can’t always know what’s in their injections.

Wolverine also has an unbreakable metal skeleton and a team of comic book writers looking out for him. The rest of us have to deal with actual consequences.

The post The Truth About the ‘Wolverine Shot,’ the Viral Recovery Hack That Has Doctors Concerned appeared first on VICE.

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Sometimes, a brisk cold shower is exactly what you need to kickstart your day. But what if that shower also reduced your total number of sick days? It sounds like one should have nothing to do with the other, and yet, a team of Swiss researchers found that regularly taking cold showers led to a 26 percent drop in sick days.

According to research from the University of Basel, psychologist Dr. Lena Glaser gave herself a difficult task for her doctoral dissertation: so many of our modern routines are environmentally harmful, but there had to be some kind of advantages to doing the environmentally friendly thing, right?

Everyone loves taking a hot shower, but if you needed to take a cold one to protect the environment, could you reap any physiological benefits from making that switch? Turns out, yeah, they’re kind of is.

People Who Took Cold Showers Reported 26% Fewer Sick Days in a New Study

Glaser asked 719 healthy participants to blast themselves with ice-cold tap water every day for 12 weeks. As expected, a lot of them tapped out within two weeks because it sounds absolutely miserable. But those who remained reported 26 percent fewer sick days and a 31 percent drop in missed workdays compared to those who took warm showers. They also reported better overall mental health.

The study relied on self-reported data, so it had no physiological component. For instance, no bloodwork was done. This means much of it could be the placebo effect; it could be the knowledge of having survived a frigid blast first thing in the morning. Over the course of the trial, the participants saved around 8.8 metric tons of carbon dioxide, the equivalent of driving a car 36,000 miles, and all by refusing to take a hot shower, though none of this was based on a reading of a home’s energy meter.  

Luckily, according to Glaser, there is a middle ground between an environmentally unfriendly, soothing hot shower and an environmentally friendly but teeth-chattering cold shower: just turn down the heat a little. Ensuring that your water isn’t scalding hot every time can cut emissions, save you money, and maybe tack on a few healthier days.

The post Does Taking Cold Showers Really Prevent You From Getting Sick? Here’s What the Science Says. appeared first on VICE.

On election night in Texas, the impossible became possible. Democrats won the governor’s seat for the first time since the 1990s and appear to be on their way to securing control of the state House too. Those massive, unexpected wins have now opened the window for a major policy change that has long been closed: expanding Medicaid to more than a million low-income Texans.

The Affordable Care Act offers generous funding for states to expand Medicaid eligibility to 133 percent of the federal poverty level, which is about $21,000 for one person or $44,000 for a family of three. But the Supreme Court ruled in 2012 that states should have a choice about whether or not to accept the expansion. And even though many other GOP-led states decided to adopt it, Texas is one of the 10 that have steadfastly refused to extend Medicaid coverage to many of its poorest citizens — and it’s by far the biggest. KFF estimates that 1.1 million people in Texas would be eligible for Medicaid expansion, including 605,000 who have no other insurance options without it. In resisting expansion over the years, Republicans have argued that the Medicaid program was broken and already too expensive and that uninsured people should instead be able to get coverage by finding a job that offers health benefits. 

New Democratic Gov.-elect Gina Hinojosa pledged to pursue expansion if elected, framing it as a way to help the state’s children. If she can find a way to get the state legislature on board, Medicaid expansion in Texas would be one of the biggest direct consequences of 2026’s blue tsunami. Texas has the highest uninsured rate of any state in the country at 19 percent.

“We expect expansion to be a priority in the next legislative session. It’s a life-saver in the short term and a money-saver in the long term,” Lynn Cowles, director of health and food justice at the advocacy group Every Texan, told me in an email. “We’re excited to work with our next state legislature that convenes in January to make expansion a reality.”

There is still work to do. But Democrats are in the strongest negotiating position they’ve ever had in the Lone Star State. As of Wednesday afternoon, Dems had clinched control of the Texas House for the first time in more than 20 years. That will allow them to force a more serious conversation about expansion.

“You should expect to see Medicaid expansion bills filed on November 9, which is our first day for early bill filing,” said Bee Moorhead, executive director of Texas Impact. “Absolutely, it will be on the table.”

It’s not a guarantee because Republicans retain control of the state Senate. Still, there is some optimism that the sweeping Democratic victories in Texas and across the country could make the GOP more amenable to compromise. 

Democrats will have one important ally in their fight: Texas hospitals, which have long supported expansion. Their political influence and the threat of Trump-approved Medicaid cuts leading to rural hospital closures — a major theme of Hinojosa’s campaign — could put pressure on Republicans to find a middle ground with the Democrats now in power.

But hospital leaders, having seen dreams of Medicaid expansion in Texas fall short before, aren’t declaring victory yet. Until some of the Texas Senate Republicans who have opposed Medicaid expansion in the past announce that they’re now open to a compromise, the GOP’s control of that chamber could be enough to continue blocking Medicaid expansion in Texas for the time being.

“Everything changed last night. But just because everything changed doesn’t mean everything changes,” John Henderson, president and CEO of the Texas Organization of Rural & Community Hospitals, told me. “We’re gonna have a different climate and different priorities in the next session. But some of these really ambitious policies still have obstacles to clear.”

Texans have been waiting for Medicaid expansion for a long time: A 2020 poll found that 69 percent of the state’s voters supported the policy. But Republican leaders, including now-ousted Republican Gov. Greg Abbott, refused to budge.

There is no guarantee that the stunning midterm results will finally break that logjam. It will require deft politicking by the new Democrats in power. But for the first time, there is real reason for hope.

Democrats’ massive wins on election night in Congress — and state races across the country — have opened the door for the party to deliver on one of its biggest campaign promises: making people’s healthcare cheaper.

When Democratic House leader Hakeem Jeffries declared victory on Tuesday night, he promised that his new majority would try to undo the massive Medicaid cuts that the GOP Congress approved in 2025. A new class of Democratic senators — including James Talarico in Texas, Abdul El-Sayed in Michigan, and Annie Andrews in South Carolina — are coming to Washington having backed a diverse suite of health policy ideas, from major overhauls like Medicare-for-all to targeted reforms like ending prior authorization for some services.

Change doesn’t come easily, however, and people should keep their expectations in check: President Donald Trump is still in the White House, and that will limit how much policy work gets done in the next two years. 

But that doesn’t mean we’re stuck, either. Everybody recognizes US healthcare is a mess, and lawmakers from both parties have expressed interest in smaller-scale changes that could actually pass in the next few years and get Trump’s signature. Given how massive the Democratic wins were, Republicans in Congress and even Trump himself may have a political incentive to cooperate with the new Democratic majorities: By a 19-point margin, voters said they trusted Democrats more than Republicans to address healthcare costs, according to a KFF analysis of exit poll data. And at the state level, Democrats will have freer rein to do what they want in the near term.

Larry Levitt, executive vice president for health policy at KFF, said he expects Democrats to push through ambitious healthcare bills — such as a repeal of the One Big Beautiful Bill Act’s healthcare provisions — that Trump will veto. “Then the game of chess between Democrats and Trump will begin to figure out what on healthcare can actually get enacted,” he said.

The other looming issue for Democrats will be the 2028 presidential campaign, in which candidates will have to figure out how much to promise if they win full control of the federal government. It could be a messy intra-party fight — or they could use this time to find a consensus that allows them to actually pass a bill in a few years. Will the progressive wing push hard for Medicare-for-all? Can Democrats unite around a public option?

These questions won’t be answered definitively before 2029 — but whether Democrats can start to make headway in bridging their differences or not will go a long way toward determining what’s possible.

There are a lot of balls in the air at once, even as Americans are desperate for relief right now. Here is how US healthcare could actually change at the federal and state level in the short term — and a look ahead at the long-term prospects for more far-reaching reforms.

What Congress could do in the short term on healthcare

Trump’s veto pen will dictate how far Democrats can go in the next two years. But there could be room for compromise. Both parties have serious criticisms of the health system, and, on some narrow problems, the two sides are actually pretty aligned on a need to do something. Those issues are the best bets for action in the next two years.

1) Reforms for Medicare payments

One top target would be limited Medicare payment reforms. Medicare is the single biggest healthcare program in the US, and even smaller-scale changes could help reduce premiums and out-of-pocket costs for millions of American seniors, while saving taxpayers money.

Here’s one opportunity for change: Under the current Medicare payment system, the price of a procedure is based in part on where the procedure is being done. So the cost of the exact same service could vary widely based simply on which building it’s performed in: A routine injection for knee pain or inflammation could cost $65 in a doctor’s office — but more than $300 if it’s done at a hospital’s outpatient clinic. 

The reason for that huge discrepancy is that Medicare allows hospitals to charge a separate “facility fee” on top of the charge for the service itself. While the exact solution would need to be worked out by lawmakers, both sides have endorsed the idea of ensuring procedures cost the same no matter where they are performed. 

That would be a win for patients, because their out-of-pocket costs are based on the total bill. And while the effect may not be enormous, lower hospital spending could also help soften premium hikes in the years to come for all Medicare enrollees.

It’s a policy change that hospitals have long opposed, because they don’t want their payments cut. But DC insiders believe the appetite could be growing to do something about that and other narrow billing issues. Former Democratic healthcare adviser Ezekiel Emanuel and Trump healthcare ally Brian Blase co-authored a Washington Post op-ed endorsing a fix during the week leading up to the midterms.

“Hospitals will always have their friends and allies,” Kim Monk, who tracks healthcare policy for the investment research firm Capital Alpha, said. “They’re the largest employers in a lot of districts. Nobody wants their hospital to close. But I think there’s also a healthy amount of skepticism around, well, wait a minute…what are these billing practices? I think it’s at least something that Congress is willing to take a look at.”

And given how roundly voters rejected AI in the midterms, Democrats could also feel empowered to push for more transparency or even restrictions on how Medicare Advantage plans use AI in ways that lead to patients being denied coverage for medical services.

2) Fixing the No Surprises Act

Of course, fixing healthcare is easier said than done — and sometimes well-intentioned policies don’t work. That’s why the next Congress could also look at remedying an earlier bill that aimed to address hospital billing but has gone awry in practice. The No Surprises Act passed in late 2020 (and was signed by Trump) to try to make sure that Americans didn’t get a massive bill if they were treated by an out-of-network provider when taken to a hospital for an emergency.

But the arbitration process that the legislation had set up to figure out how much the hospital should be paid by the person’s insurer in that scenario has been a mess, with a huge backlog waiting to be cleared. “The No Surprises Act obviously is not working as intended. Maybe they can fix it,” Monk told me. “That’s another one we’re watching.”

Insurers have blamed the law and its alleged favoritism toward providers in the arbitration process for contributing to recent premium hikes, and Democrats argue that creating a simpler system would help rein in rate increases for everyone.

3) Making medications cheaper

Drug costs are a particular point of frustration for most Americans — and it’s another area where both Democrats and Republicans have been circling some of the same policy solutions.

For instance, many Americans with diabetes still struggle to afford insulin, and there is one proposed solution in Congress that already has bipartisan support: a $35 cap for private health insurance plans, matching the cap that already exists in Medicare. Members from both parties have also co-sponsored bills making technical changes to prevent drug companies from using patent law to extend their monopolies and stave off generic competition, which could help bring cheaper versions of breakthrough drugs to the market sooner. One such bill passed the Senate unanimously over the summer, but was never taken up by the GOP-led House.

Democrats could test Trump’s willingness to cut a healthcare deal by pushing legislation based on an idea he himself has endorsed: tying US drug prices to international averages. Democrats could also look to expand Medicare drug negotiations and make more medications eligible for cheaper prices. It’s in theory an issue where they could pick off some Republicans and even win over Trump, who has endorsed negotiations in the past.

4) Reversing the GOP’s Medicaid cuts

One other unlikely change is still worth mentioning: Democrats are going to try to reverse the One Big Beautiful Bill Act’s Medicaid cuts and restore lapsed funding for the ACA marketplaces. They have said that’s their top priority. 

Trump probably isn’t going to sign a law repealing a big part of his own signature bill. But the new Democratic majorities are certainly going to press: DC insiders told me they expect Democrats to put together a healthcare-focused budget reconciliation package that can pass the Senate with only 50 votes and make overturning the Medicaid cuts its centerpiece. 

This approach will allow them to make the case that they are trying to undo the damage that they accused Trump and the Republicans of inflicting throughout the 2026 campaign. It will force Republicans to take tough votes on an issue that has already cost them dearly at the ballot box. And it sets the stage to make a more serious run at overturning the OBBBA if Democrats win full control of the government in 2029.

“That’s an opportunity for them to drive a wedge right into the Republicans,” Monk said. “Make Trump veto it. It becomes a 2028 issue.”

What states could do on healthcare after the 2026 elections

States have less sway than the federal government in shaping healthcare policy: They can’t touch Medicare, for example, nor the large employer plans that cover tens of millions of people. But they can still take some steps to make healthcare more affordable. In states where Democrats will assume full control of the government, they will have more leeway to pursue whatever agenda they wish and get creative with how they leverage state budgets and expand coverage or control medical costs. The question is whether the new administrations decide to make a major healthcare push a priority.

5) Medicaid expansion

Democratic victories in Georgia and Texas could finally open the door to expanding Medicaid through the ACA in those states. Under the law, states can receive generous federal funding in exchange for expanding Medicaid eligibility to all people making 133 percent of the federal poverty level or less (that’s about $21,000 for an individual or $44,000 for a family of three). But after the Supreme Court decided in 2012 that the expansion had to be optional for states, 10 states have resolutely refused to accept it — with Texas in particular being the biggest holdout.

Democrat Keisha Lance Bottoms, elected Georgia’s next governor, said she would make expanding Medicaid a priority, and Democrats look likely to win control of the state House there. In Texas, Democrat Gov.-elect Gina Hinojosa also ran on covering more people through the state’s program; Democrats are likewise leading the race for the state House majority. It looks like a real possibility for the first time since the law passed in 2010. However, their success is not assured: It appears both newly elected Democrats will have to negotiate with a Republican state Senate if they are going to make expansion happen.

If those states did expand Medicaid, it could be one of the biggest impacts of the 2026 election: An estimated 1.1 million people would be covered in Texas, and another 144,000 people would get coverage in Georgia.

6) Public health insurance options

The most sweeping policy change proposed across multiple states is the creation of a new public insurance option. Public options were put forward by Democratic gubernatorial candidates in Wisconsin, Maine and New Mexico, and all three candidates prevailed on Tuesday night. In Wisconsin, Democrats actually secured full control of the state legislature for the first time in over a decade.

Colorado and Washington have had public options up and running for a few years now, setting a template that these other states could draw from. That could allow their public options plans to quickly take shape and deliver more coverage options for people in those states in the next few years.

7) Prescription drug prices

Prescription drug prices are another area where states have some limited authority to make changes in the short term. Democrats ran on prescription drug initiatives in the governors’ races in Michigan, Nevada, Maine, and Georgia, and all of those candidates won their races, including Bottoms’s historic triumph in Georgia. Some of their specific proposals included capping Medicaid prices for drugs at Medicare-negotiated rates and establishing state boards to review drug costs.

8) Canceling medical debt

Canceling medical debt was put forward by Democrats in Ohio, Nevada, and Michigan, paired with technical provisions around how healthcare debt is reported for credit scores. Once again, on a very good night for Democrats nationwide, all three candidates — Amy Acton, Aaron Ford, and Jocelyn Benson, respectively — won their elections and will have a chance to try to enact the policy in office.

9) Protecting abortion rights

One healthcare issue where states hold more power than the federal government is abortion access. In Missouri, Nevada, and Virginia, voters backed direct ballot initiatives to protect the right to have an abortion. And the Democratic victories in Wisconsin, North Carolina, Iowa, and Georgia could allow politicians in those states to either restore abortion access (by, for example, reversing an existing six-week ban in Georgia) or at least preserve it (by blocking any new restrictions, as in North Carolina after Dems seized control of the state House there).

10) Serve as an incubator for other unique healthcare policies

States are laboratories for policy innovation. The Massachusetts health reform experiment of the early 2000s turned into the Affordable Care Act for the entire country. The public options currently being test-driven at the state level could be the template for a national program. For any Democratic governors who have national ambitions, making a push in the next two years could pay off in two ways: delivering results for constituents and elevating their political profile.

Several Democrats proposed bespoke healthcare policies that they can now try to pass. In New Mexico, Democratic Gov.-elect Deb Haaland has pledged to place a limit on private equity’s ownership of healthcare providers and prohibit interference with clinical decision-making. Minnesota Democrats could aim to approve new state assistance for people who purchase insurance on the ACA marketplaces, in order to try to soften their premium increases.

It will be worth watching whether these efforts and others can gain traction and ultimately achieve results. Private equity’s encroachment into healthcare has raised serious concerns about the quest for profits negatively affecting patient care — can states identify effective strategies for pushing back and preventing those adverse outcomes? Can they use state funding to lower healthcare costs for the people they represent? We shall see.

Democrats need to figure out their long-term healthcare agenda

Even with some short-term relief, America’s healthcare crisis isn’t going away. People are fed up: Millions of people are losing their insurance, and millions more are seeing their premiums spike while struggling to afford medical bills. There is going to be pressure for Democrats to think big in the next two years, especially as the presidential race heats up and lawmakers look ahead to 2029.

“That aspirational agenda has no chance of passing the next two years, but it will lay down important markers if Democrats win the presidency and congressional majorities in 2028,” Jonathan Oberlander, professor of social medicine at the University of North Carolina and the former editor of the Journal of Health Politics, Policy, and Law, told me.

The pressure could increase if, as expected, Democrats cannot restore funding for Medicaid or the ACA while Trump is president. According to the Commonwealth Fund, the US uninsured rate spiked from 9 percent in 2024 to 11 percent in 2026. Those losses could grow in the next year as costs continue to rise for millions of people. That’s the kind of crisis that demands a policy response.

Congress and the presidential primary will be the forums for figuring out the party’s long-term plans. Candidates will put forward proposals. House and Senate committees will surely hold hearings to explore a variety of ideas; as Monk described it to me, Democrats are currently in an “all ideas are welcome” phase. 

A lot of attention will focus on Medicare-for-all or public option proposals. But Democrats have other big ideas they can start working on now, too. They could develop plans to improve Medicare benefits for current enrollees: Sen. Bernie Sanders (I-VT) has signaled he wants to make this a priority by adding vision, dental, and hearing benefits, for example. They could also work on a long-term care plan; Sen. Ron Wyden (D-OR) has been soliciting ideas. This is leftover business from the ACA — a long-term care insurance plan that passed as part of the original bill was dropped before ever taking effect — and the issue is becoming more urgent as the baby boomer generation gets older.

The real push for those policies might have to wait for 2029. But Democrats can start trying to build a consensus now.

And as they begin to identify policies to move on in 2029, they could even start figuring out what is passable via budget reconciliation ahead of the 2028 election. The Senate’s procedural rules create important guardrails for what can pass with less than 60 votes and navigating that byzantine process can be a headache; getting a head start over the next two years would help grease the wheels for quick action if Democrats control the entire government in 2029.

So even though the short-term prospects for change may be limited, this week’s elections and the policy work to come could still prove pivotal in the effort to fix American healthcare.