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would allow law enforcement to determine if drivers are operating a vehicle while impaired through oral fluid screenings
State Representative Brian Begole believes there's been a decrease in drivers operating under the influence of alcohol
but says Michigan needs to do more to address drivers operating under the influence of drugs
"I think if people knew how many people were out there operating under the influence of narcotics
The proposed testing would use a handheld instrument with a mouth swab to enable officers to complete real-time testing to determine whether a driver has drugs in their system
it'll tell you if the subject is under the influence of methamphetamine
cannabis or THC and benzodiazepine," Begole said
Michigan initiated pilot programs in 2016 that permitted roadside oral fluid screenings
more than 20 states have oral fluid authorization written into law
with many modeling their legislation after Michigan's approach
"The National Transportation Safety Board has recommended that Michigan adopt these practices of the oral fluid testing on the roadside to improve the safety on our streets," Begole said
The oral fluid screening would be conducted after field sobriety tests and preliminary breath testing if there is probable cause for a drug-impaired arrest
The test involves placing a sterile swab in the mouth and rubbing it under the gums and tongue
The sample is then analyzed by a handheld screening machine within five minutes
Data from the pilot programs showed the technology was easy to use
reliable and accurate for preliminary roadside testing
The National Transportation Safety Board (NTSB) recommends making this type of testing permanent, especially considering that over 10,000 crashes involving an impaired driver occurred in 2023, according to Michigan State Police
nearly 2,500 people in Michigan have died due to drug-involved crashes in the last decade
"Statistics show that driving under the influence of narcotic has increased about 22% over the last several years," Begole adds
Begole is hopeful oral fluid screenings will offer drivers more safety on the streets
"I'm optimistic that this is something that we can get through the House
and right onto the governor's desk," Begole said
The bill has been referred to the House Government Operations Committee for consideration
This story was reported by a journalist and has been converted to this platform with the assistance of AI
Our editorial team verifies all reporting on all platforms for fairness and accuracy
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but we just felt in our plums that we had to cover the greatest outtake ever filmedBy • -The two funniest television scenes of the 21st century never actually aired
Late in the first season of Eastbound & Down
there’s a showdown between washed-up major league reliever Kenny Powers (Danny McBride) and his former rival Reg Mackworthy (Craig Robinson)
But before they square off on a makeshift baseball diamond in a parking lot
Ric Flair–haired BMW dealer Ashley Schaeffer (Will Ferrell)
King of Fools: The Oral History of Danny McBride
Schaeffer’s shit stirring doesn’t last very long
he did whatever he possibly could to make McBride and Robinson laugh
The results—the outtakes—are now the stuff of legend
Watching them is like taking hits of nitrous.During the first exchange
Schaeffer says that he can feel the tension in his “plums.” During the second
when McBride and Robinson are standing nose to nose
Schaeffer tells a story about his “young son Gabriel” walking in on him and his wife having sex
The moment might be the quintessential example of the long-gone let-the-cameras-roll-and-see-what-happens era of comedy
stars like Ferrell were encouraged to just try shit
Stephanie Laing (co–executive producer): I’m fairly certain it was the first season where I was like
we’ve rolled 12,000 feet of film.” They were improvising the end of the scene
“Cut.” I’d just never seen anything like it
and you don’t want to leave.David Gordon Green (consulting producer): The fact that we had Will Ferrell behind the show
When other people were looking at us cross-eyed and confused
Will put his face on the show and really took a risk.Danny McBride (cocreator and star): There’s just something about Will that inherently is so funny.Jody Hill (cocreator): Will Ferrell at the time was such a big star
it was a thrill for everybody that he was actually going to be in the show
it was like everybody was just giddy.Steve Little (Stevie Janowski): When you’re an actor
and this will lead me somewhere.” I remember that scene at the car dealership
maybe everything led here.”Laing: I don’t even think we had that much time to shoot it
but we were definitely at the end of a long day
it was a blur because it was so good.McBride: That was all just part of a jam-packed 10-hour day
But we were just going balls to the wall and just having a blast with it.Green: And to see those three comedic champions not be able to keep a straight face
we should be so lucky in our lives to be able to witness that
“What are we watching right now?”Katy Mixon Greer (April Buchanon): Will Ferrell is hysterical
“My plums,” there’s no words to describe it.Craig Robinson (Reg Mackworthy): That line was one of his bombs
Will Ferrell (Ashley Schaeffer, in 2012): Ashley Schaeffer is one of the crazier characters I’ve done by far
There’s a point where my wife was watching with me
“That might be the most disgusting person you’ve ever played,” and it just made me laugh.McBride: And when you have to be in a scene with him and you look him in the eyes
it is pretty much impossible to remain calm.Robinson: You have to stare Danny McBride in the eye while Will Ferrell is improvising
He’s just trying to kill you.McBride: You can see the gears spinning
And then without putting any more effort into it
he can just double down on that and just keep drilling in and drilling in and drilling in until you’re unwound
The Righteous Bros: In Praise of the Danny McBride Multiverse
Did ‘Eastbound & Down’ Stick the Landing
McBride: The pure joy of being in a scene with those two guys and making something that is legitimately making people want to piss their pants and being in the middle of it and trying to not be the one who ruins it.Mixon Greer: That was a very, very epic day.
Green: It’s three people that don’t break, breaking. It’s just a kid in a candy store watching that type of joy. Like when you’re 12 years old and you fart in church and you think you’re going to get in trouble—the more that you keep giggling, the more you feel like you’re striking some sort of comedy gold. You’re going to be able to open the treasure chest with your friends and keep this thing going.
ArchiveWe’ve been around since Brady was a QB
Food and Drug Administration (FDA) accepted its New Drug Application (NDA) submission for an investigational once-daily
25 mg oral formulation of Wegovy® (semaglutide) for chronic weight management in adults living with obesity or overweight with one or more comorbid conditions and to reduce the risk of major adverse cardiovascular events (MACE) in adults with overweight or obesity and established cardiovascular disease.2 If approved
Wegovy® would become the first oral formulation of a GLP-1 indicated for chronic weight management
"We are entering a new era of obesity care where patients want individualized treatment plans that address their needs and provide choices
including oral formulations," said Anna Windle
Medical & Regulatory Affairs at Novo Nordisk Inc
"Novo Nordisk's strong legacy in obesity care and decades of scientific research and innovation have brought us to this moment
We are pleased that the FDA has accepted our submission and look forward to working with regulatory authorities on what would be the first oral GLP-1 treatment for obesity."
The FDA application is based on results from OASIS 4
controlled trial evaluating the efficacy and safety of once-daily oral semaglutide 25 mg versus placebo in 307 adults with obesity (BMI >/= 30 kg/m2) or overweight (BMI >/= 27 kg/m2) with one or more comorbidities.1,3 Patients with diabetes were excluded.1,3
OASIS 4 included a 64-week treatment period including a 12-week dose escalation
and a 7-week off-treatment follow-up period.1,3 In total
307 participants were randomized 2:1 ratio to once-daily oral semaglutide 25 mg or placebo
as an adjunct to lifestyle intervention for 64 weeks.1,3
The FDA action date to decide on the Wegovy® oral formulation NDA will be in Q4 2025.2
About Wegovy®Wegovy® (semaglutide) injection 2.4 mg is currently approved along with a reduced calorie diet and increased physical activity
for adults and children aged 12 years and older with obesity
or some adults with overweight who also have weight-related medical problems
to help them lose excess body weight and keep the weight off and to reduce the risk of major cardiovascular events such as death
or stroke in adults with known heart disease and either obesity or overweight.4
and misunderstood disease that requires long-term management.5-7 One key misunderstanding is that this is a disease of just lack of willpower
when in fact there is underlying biology that may impede people with obesity from losing weight and keeping it off.5,7 Obesity is influenced by a variety of factors
The prevalence of overweight and obesity is a public health issue that has severe cost implications to healthcare systems.10,11 In the U.S.
Liz Skrbkova (US)+1 609 917 0632[email protected]
Ambre James-Brown (Global)+45 3079 9289[email protected]
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the country's largest Pharmacy Benefit Manager (PBM) has decided that Wegovy® (semaglutide)..
The New England Journal of Medicine (NEJM) published results from part 1 of the ongoing phase 3 ESSENCE trial which investigated the effects..
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THUNDER BAY — "This is quite an honour," said Bruce Pynn
one of three University of Toronto graduates to receive Alumni of Influence awards this year
U of T's faculty of dentistry describes the recipients as having sky-high goals
being technically precise and impressively innovative
and demonstrating a deep level of care for their patients.
Pynn is chief of dentistry/oral and maxillofacial surgery at Thunder Bay Regional Health Sciences Centre while also running a private practice and teaching at the Northern Ontario School of Medicine.
An online article posted by the U of T outlines a host of accomplishments and contributions
and credits him with building "a meaningful career in a community where the needs are palpable," but adds that he remains modest about his work
"I came to Thunder Bay from Toronto 30 years ago
I'm super glad that I stayed," he says
Pynn said he was a little older as a graduate from the U of T because he focused on research in a plastic surgery lab for years before going into dentistry
"I came to Thunder Bay for a year to just make some money
the oral surgeon. We were kindred spirits
He said the most rewarding aspect of his job is "fixing up" trauma patients
"There's up to 10 fractured jaws per week
so it's among the busiest services in the province for the fewest number of oral surgeons. There are 200-plus in the province
and only three up here looking after an area the size of France."
Pynn said he's received requests to care for patients from as far away as Timmins
He called the award "very special" because he puts a lot of effort into treating his patients
and sometimes even goes to their homes to do a consultation or post-operative check
"That's following in the footsteps of Dr
because the next place for big oral surgery in Ontario is Toronto
so I take the effort to see people and spend time with people."
Pynn also supervises dental students at Confederation College
and travels to Toronto monthly to oversee U of T oral surgery students
he will take a long flight overseas to deliver a talk about his professional experiences in Thunder Bay at a meeting of the International Association of Oral and Maxillofacial Surgeons in Singapore
This story was made possible by our Community Leaders Program partner
Thank you to Waste Connections of Canada for helping to expand local news coverage in Thunder Bay. Learn more
Patients with food allergy who discontinued oral immunotherapy were those who were more likely to experience a reaction to the treatment than those who reached maintenance of allergen foods, according to research at the Pediatric Academic Societies 2025 Meeting.
They were also more likely to experience moderate and severe reactions
of the MD program at Weill Cornell Medical College in New York City
“Oral immunotherapy discontinuation was low overall but varied by allergen
with higher discontinuation rates observed for allergens with a high incidence of severe reactions compared to the mean,” they reported
Food allergy affects an estimated 8% of children and 10% of adults in the United States
but advances in oral immunotherapy have opened up treatment options for these individuals
“The fear of adverse reactions remains a barrier to treatment
yet little data exists on the role of adverse reactions in treatment discontinuation,” they wrote
“Identifying factors associated with oral immunotherapy discontinuation is critical to addressing concerns and improving the safety and efficacy of oral immunotherapy.”
The researchers conducted a retrospective cohort study with data from 1003 patients
who underwent oral immunotherapy for peanut
and/or sesame allergy at Latitude Food Allergy Care between 2018 and 2024
They assessed all treatment-related reactions in terms of frequency
They excluded patients lost to follow-up or updosing and stratified the remaining patients by those who discontinued treatment vs those who reached maintenance for all foods
Those who discontinued treatment included 8.2% receiving oral immunotherapy for milk
(Some patients were receiving oral immunotherapy for multiple allergens
so there is overlap by allergen discontinuation rates.)
results revealed that patients undergoing oral immunotherapy for milk had more than twice the odds of discontinuing treatment (OR
The average incidence of severe reactions was 13%
About 1 in 5 patients (20%) who discontinued therapy had any reaction compared with 5.2% overall and 4.0% of those who reached maintenance
“Patients who discontinued oral immunotherapy had similar frequencies of experiencing mild reactions compared to those who reached maintenance but a higher incidence of moderate and severe reactions,” the researchers reported
Those who discontinued treatment also “had a higher frequency of reactions to oral immunotherapy doses
including higher frequency of the top three reported symptoms of reaction: Mild abdominal pain
and pruritus compared to the overall mean of those who reached maintenance.”
Mild abdominal pain was reported in 5.5% of those who discontinued compared with 1.3% overall and 0.9% of those who reached maintenance
Vomiting or diarrhea occurred in 4.5% of those who discontinued treatment compared with 0.4% overall and 0.3% who reached maintenance
Pruritus occurred in 4.9% of those who discontinued compared with 2.1% overall and 1.9% of those who reached maintenance.
“The number of patients is very impressive and adds to the strengths of this retrospective study,” Jonathan Tam
medical director of the Gores Family Allergy Center at Children’s Hospital Los Angeles
He also noted that the rate of patients who discontinued oral immunotherapy overall was lower than published rates in clinical trials
but the rate of severe reactions was conversely higher
the discontinuation rate was generally low,” Tam said
the findings make sense and are a practical guide to helping patients make decisions oral immunotherapy.”
The authors did not report receiving external funding or having any disclosures
Tam was not involved with the study but is working with Latitude in a Children’s Hospital of Los Angeles clinic.
Tara Haelle is a science/health journalist based in Dallas
Send comments and news tips to news@medscape.net
Metrics details
Emerging evidence links oral-derived gut microbes to colorectal cancer (CRC) development
but CRC prognosis-related microbial alterations in oral remain underexplored
In a retrospective study of 312 CRC patients
we examined the oral microbiota using 16S rRNA gene full-length amplicon sequencing to identify prognostic microbial biomarkers for CRC
Neisseria oralis and Campylobacter gracilis increased CRC progression risk (HR = 2.63 with P = 0.007
while Treponema medium showed protective effects (HR = 0.41
A microbial risk score (MRS) incorporating these species effectively predicted CRC progression risk (C-index = 0.68
When compared to a model constructed solely from clinical factors
the predictive accuracy significantly improved with the addition of the MRS
resulting in a C-index rising to 0.77 (P = 2.33 × 10−5)
Our findings suggest that oral microbiota biomarkers may contribute to personalized CRC monitoring strategies
their implementation in clinical surveillance necessitates confirmatory studies
While the role of oral-derived microbes in CRC development is identified
the mechanisms by which alterations in the oral microbiota are associated with CRC prognosis remain largely unknown
These findings underscore the critical role of the oral microbiota in influencing cancer prognosis
and further investigation of the prognostic function of oral microbiota in CRC is warranted
we investigated the salivary microbiota of 312 CRC patients using 16S rRNA gene full-length sequencing
We identified microbial signatures associated with CRC outcomes and developed a microbial risk score (MRS) to predict CRC progression
we integrated the MRS with key clinical factors to construct a multi-factorial prognostic model with enhanced predictive performance
While these findings require validation in multi-center cohorts
our study pioneers the application of salivary microbiota profiling as a non-invasive prognostic tool in CRC
Step 1: Saliva samples were collected from 312 CRC patients scheduled for surgical tumor resection
The median follow-up time was 21.5 months for patients with disease progression and 25.4 months for survival
Salivary microbiota profiling was performed using 16S rRNA full-length sequencing
Step 2: Species-level identification was conducted with inclusion criteria of prevalence ≥10% and relative abundance ≥0.01%
A 1:1 cross-validation strategy was applied by randomly splitting the cohort into discovery (n = 156) and test (n = 156) sets
Prognosis-related microbes were identified using univariate and multivariate Cox regression analyses
and Treponema medium as significant biomarkers
Step 3: A microbial risk score (MRS) was constructed based on the identified prognostic bacterial species
Clinical prognostic factors were also evaluated
and a comprehensive model integrating microbiota biomarkers (three species) and clinical factors (three variables) was developed
The performance of the comprehensive model was validated and compared with models based solely on the clinical factors
demonstrating superior prognostic accuracy
A Kaplan–Meier curve illustrating PFS stratified by the detection status of identified oral bacterial species
P values were calculated using the log-rank test
Numbers below each graph indicate the number of patients at risk at different time points
B Volcano plot showing the hazard ratio (HR) and statistical significance of candidate prognostic bacterial species
while the y axis shows −log10-transformed false discovery rates (FDR)
Circle size indicates the frequency of significance in 1000 cross-validation tests using univariate Cox regression
and color intensity (gray to red) represents the frequency of significance in multivariate Cox regression analysis
The multivariate Cox regression model was adjusted for age
A Comparison of the predictive performance (C-index) of all combinations of microbial risk scores derived from the three identified prognostic species in the test datasets using the Cox regression model
B Kaplan–Meier curves for PFS stratified by microbial risk scores (MRS) into low (n = 38)
Numbers below the graph indicate patients at risk at different time points
The P value is calculated by the log-rank test
C Kaplan–Meier curves for overall survival stratified by the MRS
D Comparison of the predictive performance (C-index) of all combinations of clinical factors (perineural invasion
and tumor stage) in the test datasets using the Cox regression model
E Performance comparison of the clinical model
and comprehensive model (integrating both clinical and microbial factors) in the test datasets using the Cox regression model
The P value for the comparison between the clinical model and the comprehensive model was calculated using a Z score test
The bars represent the 95% confidence intervals calculated by the bootstrap method
F Performance comparison of the clinical model
and comprehensive model in the test datasets using the random survival forest (Rsf) method
The bars represent the 95% confidence intervals calculated by bootstrap method
only 4 out of 38 patients exhibited progression (10.5%)
compared to 20 out of 150 patients in the MRS-Moderate group (13.3%)
and 35 out of 124 patients in the MRS-High group (28.2%) experienced disease progression post-surgery
A Heatmap of Spearman correlation between prognostic species and differential pathways
The KEGG pathways were predicted using PICRUSt2 to infer the functional shifts in the microbiota of MRS-Low and MRS-moderate/high patients
The strength of the color depicted Spearman’s correlation coefficients (negative correlation
B The differential analysis of the oral microbial community’s functions between MRS-moderate/high and MRS-low groups
The analysis focused on KEGG pathways with an average relative abundance exceeding 1%
and the P value is corrected using the Bonferroni method
The difference in mean proportion for pathways showing significant differences in abundance was shown
The 95% confidence intervals and statistical significance (P value corrected) were indicated as well
Evidence of oral microbiota as prognostic indicators for CRC remains limited
we identified three oral bacteria associated with CRC prognosis based on follow-up data from patients
and constructed an oral MRS for predicting CRC prognosis
This approach enables the qualitative detection of the target species through a simple and straightforward PCR method
potentially providing advantages for monitoring the postoperative progression risk for CRC patients
These multilayered interactions underscore the importance of oral microbiota balance in the development of CRC
These findings elucidate the mechanistic roles of these oral pathobionts in mediating unfavorable CRC prognosis through oral-gut axis translocation
medium is associated with a reduced risk of CRC progression
medium may contribute to reducing CRC progression risk warrant further exploration in future studies
These pathogen–host interactions are involved in the carcinogenesis of CRC
we did not observe the significant associations between these microbes and CRC progression
which can partly be explained by the fact that the molecular events driving carcinogenesis and the biological processes driving disease progression (e.g.
therapeutic resistance) frequently involve distinct biological mechanisms
Our current prognostic analyses are confined to CRC patient cohorts where oral microbial profiles inherently exhibit baseline homogeneity due to their shared carcinogenesis-associated signatures
bacterial taxa already enriched in CRC populations (e.g.
F.nucleatum) may demonstrate attenuated prognostic discriminative power
this study primarily utilized a single-center design and lacks an external validation cohort
which restricts the generalizability of our predictive model
necessitating future validation through multi-center studies with independent cohorts
we conducted a series of sensitivity analyses to ensure the robustness of our results
including randomization of the sample division and different model-constructed approaches
the relatively small number of progression events (n = 59) may affect the statistical power of our findings
Future prospective investigations incorporating multi-center designs
and extended follow-up periods are required to reliably identify CRC prognostic biomarkers
while our analysis suggests potential microbial metabolic pathway involvement
the proposed associations between identified microbes
and clinical outcomes require experimental validation through in vitro and in vivo studies to elucidate the mechanisms underlying the influence of oral microbiota on CRC progression
we acknowledge several methodological constraints of this study
while implementing enhanced mechanical lysis
quantitative assessment of microbial lysis efficiency was not conducted
leaving potential Gram-positive bacterial under-lysis unverified
the inherent primer bias of 16S rRNA sequencing may skew microbial composition
which has the potential to be biased towards amplifying specific bacteria
As a high percentage of host genomic DNA is present in oral specimens
16S rRNA sequencing is widely used in oral microbiota research due to its cost-effectiveness
while metagenomic sequencing data are necessary for more precise information on taxonomic composition
inferred metabolic pathways through PICRUSt2 disregard strain-level heterogeneity
Future studies should integrate shotgun metagenomics with metabolomic profiling to establish host-microbiota interactions
our study suggests potential associations between N
medium with the risk of postoperative progression in CRC
By integrating clinical and microbial factors
we achieved improved predictive accuracy for progression risk compared to clinical factors alone
These findings collectively provide preliminary evidence for exploring oral microbiota-based biomarkers for CRC progression
the implementation of oral microbial indicators in CRC clinical surveillance required future confirmatory studies
All patients were collected the clinical information
the saliva samples were collected from patients who were instructed to refrain from eating and drinking for at least 30 min before the collection process
The participants were guided to open the collection tubes and let saliva flow into them effortlessly
which was collected using sterile 50 ml centrifuge tubes
The collected saliva was temporarily stored in an ice box and transferred to 2 ml centrifuge tubes within two hours
and subsequently stored at −80 °C for long-term preservation
DNA extracted from each salivary sample served as the template for amplifying the full-length region of the 16S rRNA gene
We amplified the full-length 16S rRNA gene using universal primers 27 F (5’-AGR GTT YGA TYM TGG CTC AG-3’) and 1492 R (5’-RGY TAC CTT GTT ACG ACT T-3’)
Saliva-derived DNA was amplified using KAPA HiFi HotStart DNA Polymerase (KAPA Biosystems) for 27 cycles
The process involved denaturation at 95 °C for 30 s
We used Agencourt AMPure XP (Beckman Coulter) for fragment selection and purification of the PCR products
We prepared the SMRTbell libraries from the purified amplicons by ligating adapters and sequenced them using the PacBio Sequel platform (Pacific Biosciences)
We obtained high-quality circular consensus sequence (CCS) reads from the raw PacBio sequencing data using SMRT Link software (v9.0.0
Pacific Biosciences) and assigned multiplexed libraries to each sample using Lima (v2.0.0) based on the barcodes
All statistical analyses and visualization procedures were performed using R software (version 4.4.0) with designated R packages
A total of 291 bacterial species were observed
of which 98 were included in the prognosis analysis
which met criteria with a frequency exceeding 10% in the total sample and a relative abundance >0.01%
Patients were divided into two groups based on the median abundance of each species
and a univariate Cox regression model was performed
Species that were statistically significant were subsequently incorporated into a multivariate Cox regression model
we applied Monte Carlo simulation cross-validation for a robust selection
by randomly partitioning the entire datasets into discovery and validation sets (1:1) and performing 1000 times randomized resampling
we performed univariate and multivariate Cox regression models to identify the species associated with prognosis (P < 0.05)
Species with significance in the discovery stage were then included in the validation set for confirmation
three bacterial species were identified as prognostic biomarkers
demonstrating substantial effect sizes (HR > 1.5 or HR < 0.8) and significance (corrected FDR < 0.1)
Three validated oral bacterial species significantly associated with CRC prognosis were included to construct an MRS
which was conversely associated with good prognosis
The presence of species indicating poor prognosis or the absence of species indicating good prognosis was scored as one point each
Each patient was assigned an MRS ranging from 0 to 3
To evaluate the performance of the combinations
50% of the samples (156 out of 312) were randomly selected 1000 times without replacement to create a pool of test datasets
and the concordance index (C-index) across the test datasets was used as an indicator of model stability
was categorized by assigning scores 0 for MRS low
to comprehensively predict the probability of PFS in CRC patients
We constructed a clinical model based on selected clinical factors
all of which were statistically significant in a univariate Log-rank test
A comprehensive model was constructed by integrating both clinical factors and MRS
We calculated the concordance index (C-index) to evaluate the performance of the models and compared the differences in predictive performance between models incorporating and excluding MRS
we utilized STAMP software to evaluate significant differential metabolic pathways between moderate/high and low MRS groups
applying the Bonferroni correction with adjusted p value < 0.05 considered significant
The correlation between oral microbes and the significantly related differential pathways was performed by Spearman’s rank correlation test
along with the corresponding patient metadata
are currently being uploaded to the China National Center for Bioinformation (CNCB)
Full access to these resources will be public prior to the publication of the study
The key computer codes for the analyses in this study are available on https://github.com/ZSH-AMF/Key_code.git
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Download references
We thank Hong-Ling Sun and Huan Ren from Sun Yat-sen University Cancer Center for their help in participant enrollment
This research was funded by the National Key Research and Development Program of China (2021YFC2500400)
the National Natural Science Foundation of China (82404339
the Guang Dong Basic and Applied Basic Research Foundation (2023A1515110442 and 2025A1515010642)
the Fundamental Research Funds for the Central Universities
the Science and Technology Planning Project of Guangzhou
and the Young Talent Support Project of Guangzhou Association for Science and Technology (QT2024-030)
These authors contributed equally: Shi-Hao Zhou
State Key Laboratory of Oncology in South China
Guangdong Provincial Clinical Research Center for Cancer
and Y.L had full access to all the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis
carried out the statistical analysis; W.H.J
obtained funding and supervised this project
All authors revised the manuscript and approved the final manuscript
The authors declare no competing interests
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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DOI: https://doi.org/10.1038/s41522-025-00702-0
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The FDA has accepted Novo Nordisk’s new drug application (NDA) for a once-daily
25 mg oral formulation of Wegovy (semaglutide) for adults living with obesity and to reduce the risk of major adverse cardiovascular events (MACE) in adults with overweight or obesity and established cardiovascular disease
Wegovy would become the first oral formulation of a GLP-1 indicated for chronic weight management
A decision is expected in the fourth quarter of 2025
a phase 3 trial evaluating once-daily oral semaglutide 25 mg compared with placebo
The trial enrolled 307 adults who were obese or who were overweight
The trial included a 64-week treatment period including a 12-week dose escalation and a 7-week off-treatment follow-up period
The trial found that once-daily oral semaglutide 25 mg reduced body weight
and improved metabolic health in adults with overweight/obesity
with comparable efficacy to semaglutide 50 mg in the OASIS 1 trial
A greater proportion of participants achieved weight loss in the semaglutide group compared with placebo
significant improvements in cardiometabolic risk factors were also observed with semaglutide vs placebo
Adverse events leading to treatment discontinuation were comparable between groups
Data from the OASIS 4 trial were presented in November 2024 at ObesityWeek2024
OASIS is a phase 3 clinical development program with once-daily oral semaglutide 25 mg and 50 mg in adults with obesity
The program currently consists of four trials
having enrolled approximately 1,300 adults with obesity or overweight with one or more comorbidities
This news comes after results of several other oral GLP-1 therapies were released. Last week, Lilly reported positive topline phase 3 results from ACHIEVE-1 for orforglipron in adults with type 2 diabetes
It also reduced weight by an average of 16.0 lbs (7.9%) at the highest dose in a key secondary endpoint
The overall safety and tolerability profile of orforglipron in ACHIEVE-1 was consistent with injectable GLP-1 therapies
Related: Liver Injury Ends Development of Pfizer’s Oral GLP-1 for Obesity
But Pfizer stopped clinical development of its once-daily oral GLP-1 candidate to treat obesity
Danuglipron was being studied for adults with obesity and without type 2 diabetes
Company executives said that the overall frequency of elevated liver enzymes across the more than 1,400 participants in the clinical development program of danuglipron was in line with approved drugs in the class
But in one of the dose optimization studies
an asymptomatic patient experienced potential drug-induced liver injury
which resolved after discontinuation of danuglipron
Novo Nordisk already markets an oral semaglutide product
Rybelsus is approved to treat type 2 diabetes
It is available in both 7 mg and 14 mg and has a list price of $997.58 per package
People with commercial insurance may pay as little as $10 for a one-
Novo Nordisk reported the results of the SOUL trial
which assessed Rybelsus 14 mg to lower cardiovascular risk in adults with type 2 diabetes
This trial found that Rybelsus reduced the risk of major adverse cardiovascular events (MACE) by 14% compared with placebo in adults with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) and/or chronic kidney disease (CKD)
These data were presented at the American College of Cardiology’s Annual Scientific Session and Expo
Novo Nordisk has submitted a supplemental application to the FDA for Rybelsus 14 mg for this indication
A regulatory decision is anticipated in 2025
FDA Approves Imaavy for Long Term Treatment of Generalized Myasthenia Gravis
Adult and pediatric generalized myasthenia gravis patients have a new
longer acting option for treatment called Imaavy
CVS Caremark to Place Wegovy as Preferred GLP-1 for Weight Loss
CVS Caremark will place Wegovy injection 2.4 mg as preferred on its commercial template formularies
Oncologists: Prior Authorizations Lead to Delays in Getting Cancer Meds
Insurance hurdles and the complexities of prior authorization create barriers to care
according to oncologists in a new survey by Sermo
Novo Nordisk Offers Wegovy Through Telehealth Providers, Including Hims & Hers
Food Retailer Giant Eagle Selects EmpiRx Health as PBM
Giant Eagle also helped EmpiRx Health create a national pharmacy care network that was purpose-built for pharmacy and grocery chains
Part D Plans Cover a Larger Share of Medicare Beneficiaries in Rural Counties
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Baits are dropped in northeastern Ohio to immunize wild raccoons for rabies
In 1996, a new strain of rabies in wild raccoons was introduced into northeastern Ohio from Pennsylvania. To protect Ohioans and their domestic animals
the Ohio Department of Health (ODH) and other state and local agencies partnered with the United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service Wildlife Services to implement a program to immunize wild raccoons for rabies using an oral rabies vaccine (ORV)
This effort created a barrier of immune animals that reduced animal cases and prevented the spread of raccoon rabies into the rest of Ohio. The vaccine-laden baits are dropped by fixed wing aircraft in rural areas and by low-flying helicopters and ground vehicles in urban and suburban neighborhoods
Although placement is targeted to raccoon habitat
it is inevitable that some baits may end up in a yard or be found by a pet or person. Dogs
are attracted to them. Please refer to the information below if you or your pet finds a bait
One type of bait will be used for the 2025 spring operation:
The ONRAB® vaccine is enclosed in a 1" x 2" blister pack filled with the vaccine and covered with a sweet-smelling dark green waxy coating
The baits contain a rabies vaccine that if consumed by a raccoon should vaccinate the animal against the rabies virus
ONRAB® does not contain rabies virus but contains a gene from the rabies virus that causes raccoons and skunks that come in contact with the vaccine to produce antibodies that protect them against rabies infection
Ohio is one of seven states using ONRAB® for baiting operations in the U.S
Ingesting the vaccine will not harm your pet
although eating a large number may temporarily cause vomiting or diarrhea. It is recommended to contact a veterinarian as a precaution if a pet has consumed the vaccine baits
but intact baits can be moved if they are found in your lawn
or other area where children and pets may find it. Damaged baits should be bagged and disposed in the trash
Contact with intact baits is not harmful. Persons who are immunocompromised or pregnant should contact a physician if the bait ruptures and vaccine gets into a mucous membrane or open wound. If a person is exposed to the vaccine (liquid) within the bait
thoroughly wash any areas of the exposed skin with soap and warm water
Working with employees from cooperating agencies
USDA Wildlife Services distributes baits in urban area and suburban areas by vehicle or helicopter
The vaccines do not contain the live rabies virus but contains a gene from the rabies virus that causes raccoons and skunks that come in contact with the vaccine to produce antibodies that protect them against rabies infection
The vaccine is contained inside a blister packet
which is made attractive to wildlife with a sweet attractant. When an animal bites into the bait
it punctures the blister pack and the vaccine bathes the oral cavity and tonsils
resulting in an oral vaccination against rabies. The animal's immune system is exposed to the part of the rabies virus that causes an immune response and production of antibodies against rabies
but the vaccine cannot cause rabies. The blueprint for making antibodies to neutralize the rabies virus is stored in the animal's immune system
allowing it to respond quickly if it is later exposed to a rabid animal
Rabies
Raccoons
National Rabies Management Program
Oral Rabies Vaccine Operation Daily Progress Map
which the company hopes will be a powerful successor to Wegovy.Reporting by Sriparna Roy in Bengaluru; Editing by Sriraj Kalluvila
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OKMULGEE, Okla – The Muscogee Creek Nation Supreme Court issued an order on April 28 resetting the oral arguments in SC-2023-20
Citizenship Board of the Muscogee Creek Nation v
The oral arguments will be held on June 20 at 10 A.M
Oral arguments in the case had originally been scheduled for July 26
The MCN SC issued a stay in the case on July 12
In the Matter of the Constitutionality of NCA 24-077
legislation on the process for appointing Special Justices
the MCN SC issued the opinion that NCA 24-077 was unconstitutional
This ruling resulted in the MCN SC order to rescind the stay and schedule oral arguments in SC-2023-10
arguments will not be available to the public:
and/or reproductions of the Virtual Meeting and Oral Argument are strictly prohibited…IT IS FURTHER ORDERED that
the Court will decline to consider any request for continuance of the virtual meeting or oral argument in this matter filed after 5:00 p.m.
Mvskoke Media will have ongoing coverage of this story
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Novo Nordisk has pulled ahead in the race to bring the first oral GLP-1 for obesity to market
The company announced Friday that the FDA has accepted its New Drug Application (NDA) submission for a once-a-day 25mg pill form of Wegovy (semaglutide) for chronic weight management
The FDA action date is in Q4 of this year according to the company, who also stated in a release that the submission is based on strong data from the Phase 3 OASIS study, some of which was shared at ADA in 2023
"We are entering a new era of obesity care where patients want individualised treatment plans that address their needs and provide choices
including oral formulations," said Anna Windle
Semaglutide is already available in pill form under the name Rybelsus, but that drug, which cleared the FDA back in 2019
While Rybelsus sales haven't come anywhere near Ozempic's highs
the drug has brought in $3.4 billion in sales for the company last year -- and the addressable market for obesity is much larger than diabetes
pills are cheaper to manufacture and generally easier for patients to administer
pharma companies see a weight loss pill as a winning prospect for standing out in an increasingly crowded market
Novo Nordisk is in a race with several other companies to bring an oral GLP-1 for obesity to market, most notably Eli Lilly whose oral candidate orforglipron has also posted strong data recently. Lilly's CEO told Fortune in January he expects the drug to notch FDA approval in 2026
Another competitor, Pfizer's danuglipron
had to halt its efforts last month after seeing signs of liver toxicity in late-stage clinical testing
Roche and AstraZeneca have candidates as well
but they're both considerably behind Lilly and Novo Nordisk
Trump's 2026 budget request envisages sweeping cuts to funding for the NIH and other federal agencies that will be a disaster
Shares in Eli Lilly have weakened after pharmacy benefit manager CVS Health said it would no longer cover its weight-loss therapy Zepbound
Understanding how to harness real-world data and digital insights is essential
The importance of biosimilars only continues to grow
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Jonah Comstock welcomed back Alice Valder Curran to the podcast to pick apart Trump's Executive Order order piece by piece
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ROCHESTER — Share interesting tales from the past with storytellers Karen Chace and Andrea Lovett at the Carving Out Your Story oral history workshop
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Asking scientists to identify a paradigm shift, especially in real time, can be tricky. After all, truly ground-shifting updates in knowledge may take decades to unfold. But you don’t necessarily have to invoke the P-word to acknowledge that one field in particular — natural language processing
The goal of natural language processing is right there on the tin: making the unruliness of human language (the “natural” part) tractable by computers (the “processing” part)
A blend of engineering and science that dates back to the 1940s
Siri a brain and social media companies another way to target us with ads
It was also ground zero for the emergence of large language models — a technology that NLP helped to invent but whose explosive growth and transformative power still managed to take many people in the field entirely by surprise
To put it another way: In 2019, Quanta reported on a then-groundbreaking NLP system called BERT without once using the phrase “large language model.” A mere five and a half years later
disruption and debate in whatever scientific community they touch
But the one they touched first — for better
worse and everything in between — was natural language processing
What did that impact feel like to the people experiencing it firsthand
Quanta interviewed 19 current and former NLP researchers to tell that story
they describe a series of moments — dawning realizations
elated encounters and at least one “existential crisis” — that changed their world
By 2017, neural networks had already changed the status quo in NLP. But that summer, in a now-seminal paper titled “Attention Is All You Need,” researchers at Google introduced an entirely new kind of neural network called the transformer that would soon dominate the field
ELLIE PAVLICK (assistant professor of computer science and linguistics
Google DeepMind): Google had organized a workshop in New York for academics to hang out with their researchers
He was making a really clear point about how aggressively this model was not designed with any insights from language
Almost trolling a bit: I’m going to just talk about all these random decisions we made
There had already been a feeling of the neural nets taking over
and so people were very skeptical and pushing back
University of Texas at Austin): It was sort of interesting
It wasn’t like the next day the world changed
I really do think it’s not conceptually the right model for how to process language
I just didn’t realize that if you trained that very conceptually wrong model on a lot of data
NAZNEEN RAJANI (founder and CEO, Collinear AI; at the time a Ph.D. student studying with Ray Mooney): I clearly remember reading “Attention Is All You Need” in our NLP reading group. Ray actually ran it, and we had this very lively discussion. The concept of attention had been around for a while
and maybe that’s why Ray’s reaction was kind of
I vividly remember members of the research team I was on asking
“Should we look into these transformers?” and everyone concluding
Stanford University): The transformers paper passed me by
I think it would be very hard for anyone to tell from the paper what effect it was going to have
Soon after it was introduced in October 2018, Google’s open-source transformer BERT (and a lesser-known model from OpenAI named GPT) began shattering the performance records set by previous neural networks on many language-processing tasks. A flurry of “BERTology” ensued
with researchers struggling to determine what made the models tick while scrambling to outdo one another on benchmarks — the standardized tests that helped measure progress in NLP
ANNA ROGERS (associate professor of computer science
IT University of Copenhagen; editor-in-chief
ACL Rolling Review): There was this explosion
and everybody was writing papers about BERT
I remember a discussion in the [research] group I was in: “OK
we will just have to work on BERT because that’s what’s trending.” As a young postdoc
I just accepted it: This is the thing that the field is doing
student at the University of Washington): So many projects were dropped on the floor when BERT was released
progress on these benchmarks went way faster than expected
and we need to benchmark everything we can.”
Some viewed this “benchmark boom” as a distraction
Others saw in it the shape of things to come
Anthropic; at the time an associate professor at New York University): When people submitted benchmark results and wanted to appear on the leaderboard
I was often the one who had to check the result to make sure it made sense and wasn’t just someone spamming our system
and I was noticing how much of it was just
JULIAN MICHAEL: It became a scaling game: Scaling up these models will increase their ability to saturate any benchmark we can throw at them
I don’t find this inherently interesting.”
“Transformers aren’t going to get much better than BERT without new breakthroughs.” But it was becoming clearer and clearer for me that scale was the main input to how far this is going to go
You’re going to be getting pretty powerful general systems
So I got very interested in this question: All right
what happens if you play that out for a few years
As transformer models approached (and surpassed) “human baselines” on various NLP benchmarks, arguments were already brewing about how to interpret their capabilities. In 2020, those arguments — especially about “meaning” and “understanding” — came to a head in a paper imagining an LLM as an octopus
Association for Computational Linguistics): I was having these just unending arguments on Twitter
There was one about using BERT to unredact the Mueller report
It seemed like there was just a never-ending supply of people who wanted to come at me and say
LLMs really do understand.” It was the same argument over and over and over again
I was talking with [computational linguist] Alexander Koller, and he said: “Let’s just write the academic paper version of this so that it’s not just ideas on Twitter
And that’ll put an end to it.” It did not put an end to it
Bender and Koller’s “octopus test” asserted that models trained only to mimic the form of language through statistical patterns could never engage with its meaning — much as a “hyperintelligent octopus” would never really understand what life was like on land
even if it fluently reproduced the patterns it observed in human messages
SAM BOWMAN: This argument — that “there’s nothing to see here,” that neural network language models are fundamentally not the kind of thing that we should be interested in
that a lot of this is hype — that was quite divisive
JULIAN MICHAEL: I got involved in that. I wrote this takedown of the paper — it was the one blog post I’ve ever written
I worked hard to make it a good-faith representation of what the authors were saying
I even got Emily to read a draft of my post and correct some of my misunderstandings
Ellie Pavlick (assistant professor of computer science and linguistics
ELLIE PAVLICK: These “understanding wars” — to me
that’s when a reckoning was really happening in the field
Meanwhile, another reckoning — driven by real-world scale, not thought experiments — was already underway. In June of 2020, OpenAI released GPT-3
a model more than 100 times as large as its previous version and much more capable
GPT-3 was the moment when everything changed
CHRISTOPHER CALLISON-BURCH (professor of computer and information science
University of Pennsylvania): I got early access to the GPT-3 beta and was actually playing with it myself
I’m trying out all the things that my recent Ph.D
the thing that had taken a student five years
Seems like I could reproduce that in a month
many of which I had touched on or actively researched throughout my career
I sometimes describe it as having this career-existential crisis
“Should women be allowed to vote?” it would say no
But the fact that you could just teach it to do a completely new task in
three or four lines of natural language was mind-boggling
CHRISTOPHER POTTS: Somebody in our group got early access to the GPT-3 API
thinking: I’m going to prompt it with some logic questions and it’s going to fail at them
I’m going to reveal that it has just memorized all the things that you’re so impressed by
I’m going to show you that this is a party trick
this is definitely much more than a party trick.”
Stanford University; 2022 MacArthur fellow): It was still broken
A lot of commonsense knowledge [coming] out of GPT-3 was quite noisy
R. THOMAS MCCOY: This GPT-3 paper was sort of like the series finale of “Game of Thrones.’’ It was the thing that everyone had just read and everyone was discussing and gossiping about
University of Pennsylvania): It almost was like we had a secret
and everyone you shared it with was blown away
All I had to do was bring someone over to my laptop
JULIAN MICHAEL: BERT was a phase transition in the field
A system that produces language — we all know the ELIZA effect
But it also did more to change the practical reality of the research that we did — it’s like
you can do anything [with this].” What are the implications of that
OpenAI did not publicly release GPT-3’s source code
disruptive capability and corporate secrecy put many researchers on edge
SAM BOWMAN: It was bit of a divisive moment because GPT-3 was not really coming from the NLP community
It was really frowned upon for a while to publish results of studies primarily about GPT-3 because it was [seen as] this private artifact where you had to pay money to access it in a way that that hadn’t usually been the case historically
ANNA ROGERS: I was considering making yet another benchmark
Let’s say GPT-3 either can or cannot continue [generating] these streams of characters
but that’s not actually even a machine learning research question
“API science,’’ that people would use to be like: “We’re doing science on a product
it’s not reproducible.” And other people were like: “Look
TAL LINZEN (associate professor of linguistics and data science
Google): For a while people in academia weren’t really sure what to do
This ambivalence was even shared by some within industry labs such as Microsoft
Microsoft Research India): The Microsoft leadership told us pretty early on that this was happening
It felt like you were on some rocket being thrown from Earth to the moon
it was going at a pace that meant you really had to look at all your navigation instruments to make sure you’re still headed in the right direction
an AI ethics researcher at Google] approached me in a Twitter DM exchange
asking if I knew of any papers about the possible downsides of making language models bigger and bigger
she saw people around her constantly pushing: “OpenAI’s is bigger
We’ve got to make ours bigger.” And it was her job to say
The paper that Bender subsequently wrote with Gebru and her colleagues — “On the Dangers of Stochastic Parrots: Can Language Models Be Too Big?” — injected moral urgency into the field’s core (and increasingly sore) arguments around form versus meaning and method versus scale
KALIKA BALI: Some of the points that Emily makes are things that we should be thinking about
That was the year that the NLP community suddenly decided to worry about how it had neglected everything except the top five languages in the world — nobody ever talked about these things earlier
But what I did not like was that the entire NLP community kind of organized themselves for and against the paper
JULIE KALLINI (second-year computer science Ph.D
Stanford University): As a young researcher
I was an undergraduate at Princeton University
I remember distinctly that different people I looked up to — my Princeton research adviser [Christiane Fellbaum] versus professors at other universities — were on different sides
KALIKA BALI: It was positive that that paper came out
but it was also stressful to see people that you really respect drawing swords at each other
the tension arises: If you want to do research that has any sort of lasting impact more than two or three years after you publish
Because it dictates so much of the way that you even look at problems
Usually you just subscribed to Substacks to see the angry linguistics side
and you’d go on Twitter to see the pro-scaling side
JEFF MITCHELL (assistant professor in computer science and AI
University of Sussex): It felt a little abnormal
As scale-driven research continued to accelerate, some felt that discourse within the field was seriously deteriorating. In an attempt to repair it, the NLP research community surveyed itself in the summer of 2022 on “30 potentially controversial positions” — including “Linguistic structure is necessary,” “Scaling solves practically any important problem” and “AI could soon lead to revolutionary societal change.”
SAM BOWMAN: The industry community that was doing a lot of this early work around scaling had never been that closely engaged with academic NLP
That led to a divergence in understanding and what people thought was happening between these two [groups]
because they weren’t talking to each other that much
LIAM DUGAN: They gave a large part of the survey out at ACL [Association for Computational Linguistics
This was the first conference I’d ever been to
and it was very exciting for me because there’s all these people that are really smart
JULIAN MICHAEL: It was already a field in crisis
LIAM DUGAN: You got to see the breakdown of the whole field — the sides coalescing
The linguistic side was not very trusting of raw LLM technology
There’s a side that’s sort of in the middle
And then there’s a completely crazy side that really believed that scaling was going to get us to general intelligence
On November 30, 2022, OpenAI launched its experimental chatbot
ChatGPT hit the NLP community like an asteroid
Allen Institute for AI; chief scientist and co-founder
a lot of the problems that a large percentage of researchers were working on — they just disappeared
CHRISTOPHER CALLISON-BURCH: I didn’t predict it
But I was prepared for it because I had gone through that experience with GPT-3 earlier
THOMAS MCCOY: It’s reasonably common for a specific research project to get scooped or be eliminated by someone else’s similar thing
But ChatGPT did that to entire types of research
A lot of higher categories of NLP just became no longer interesting — or no longer practical — for academics to do
SAM BOWMAN: It felt like the field completely reoriented
IZ BELTAGY: I sensed that dread and confusion during EMNLP [Empirical Methods in Natural Language Processing]
Everybody was still shocked: “Is this going to be the last NLP conference?” This is actually a literal phrase that someone said
During lunches and cocktails and conversations in the halls
everybody was asking the same question: “What is there that we can work on?”
NAZNEEN RAJANI: I had just given a keynote at EMNLP
who was my manager at Hugging Face and also one of the co-founders
can you get on a call with me ASAP?” He told me that they had fired people from the research team and that the rest would either be doing pre-training or post-training — which means that you are either building a foundation model or you’re taking a foundation model and making it an instruction-following model
“I recommend you pick one of these two if you want to continue at Hugging Face.”
It didn’t feel like what the Hugging Face culture stood for
everyone was basically just doing their own research
Rude awakenings also came from the bottom up — as one eminent NLP expert found out firsthand while teaching her undergraduate course in the weeks after ChatGPT’s release
CHRISTIANE FELLBAUM (lecturer with the rank of professor of linguistics and computer science
Princeton University): We had just started our semester
a student whom I didn’t know yet came up to me
showed me a paper with my name and title on it and said: “I really want to be in your class — I’ve researched your work and I have found this paper from you
sure.” I was flattered: He’s researching me
And while I was trying to refresh my memory
“What’s funny?” And he said: “This paper was written by ChatGPT
‘Write me a paper in the style of Christiane Fellbaum,’ and this is what came out.”
because I had to start class in 10 minutes
But everything looked like what I would write
ChatGPT threatened their research projects and possibly their careers
CHRISTOPHER CALLISON-BURCH: It helps to have tenure when something like this happens
But younger people were going through this crisis in a more visceral way
students literally formed support groups for each other
it’s like there’s nothing intellectual about them left
Just kind of dragging your feet or getting very cynical
RAY MOONEY: One of my own [graduate students] thought about dropping out
They thought that maybe the real action was happening in industry and not in academia
I was really unsure about where my direction would end up
I tried to make sure that I know my machine learning fundamentals well
It’s not the wisest thing to only specialize in potentially fleeting trends in large language models
NLP researchers from Seattle to South Africa faced a firehose of global attention
SAM BOWMAN: It goes from a relatively sleepy field to
I’m having lunch with people who were meeting with the Pope and the President in the same month
I counted five workdays with no media contact
ELLIE PAVLICK: Before ChatGPT, I don’t think I ever talked to a journalist. Maybe once or twice. After ChatGPT, I was on 60 Minutes
It was a huge qualitative difference in the nature of the work
CHRISTOPHER CALLISON-BURCH: I felt like my job went from being an academic with a narrow audience of graduate students and other researchers in my field to being like, “Hey, there’s an important responsibility for scientific communication here.” I got invited to testify before Congress
I was suddenly being asked for my opinion in interviews
“I’m such an expert in this!” Then it felt less exciting and more sort of overwhelming: “Where do you see this going in the future?” I don’t know
But it’s crazy: There’s thousands of papers
Everyone has their hot take on what’s going on
And most of them have no idea what they’re talking about
SAM BOWMAN: There was this flowering of great engagement: Suddenly a lot of really amazing people from a lot of fields were looking at this stuff
And it was also getting drowned out in noise: everyone talking about this stuff all the time
lots and lots of really dashed-off takes that didn’t make any sense
NAZNEEN RAJANI: That year was kind of a roller coaster
the annual EMNLP conference convened again in Singapore
LIAM DUGAN: The temperature was just so much higher
and the flood of arxiv [preprint] results was just so intense
You would walk the halls: All the way down
it was just prompting and evaluation of language models
it felt like there were more people there than good research ideas
the LLM-generated writing was on the wall — and it said different things to different people in the field
THOMAS MCCOY: Anytime you’re doing work that asks about the abilities of an AI system
you ought to be looking at systems for which we have access to the training data
But that’s not at all the prevalent approach in the field
we’ve become more “LLM-ologists” than scientists
I often say this when I give talks: “Right now
we are studying language models.” I get how myopic that seems
But you have to see this really long-game research agenda where it fits
there’s not a path forward to understanding language that doesn’t have an account of “What are LLMs doing?”
KALIKA BALI: Every time there’s been a technological disruption that mainly comes from the West
there’s always been these — if you may call it — philosophical concerns
“How do we make it work for us here and now?”
the initial idea that everyone gathered around [after ChatGPT came out] was to have generative language models do their work in English and then put a translation system in front of it to output into whatever language you wanted
But machine translation systems are literal
“John and Mary have a key lime pie to divide,” and you translate it into Hindi
I can bet you most people in India do not know what a key lime pie is
How would you translate that into something culturally specific
unless the model itself is made to understand things
I became much more interested in how to solve that
IZ BELTAGY: There is a point where you realize that in order to continue advancing the field
Like the Large Hadron Collider — you can’t advance experimental physics without something like this
which generally has more resources than most academic labs
ChatGPT made it clear that there’s a huge gap between OpenAI and everybody else
we started thinking about ways we can build these things from scratch
In 2024, Ai2’s OLMo provided a fully open-source alternative to the increasingly crowded field of industry-developed language models
some researchers who had continued to study these proprietary systems — which only grew in scale
capability and opaqueness in the post-ChatGPT AI boom — were already encountering a new kind of resistance
YEJIN CHOI: I had this paper [in late 2023] demonstrating how the latest GPT models, which were seemingly good at doing multiplication, suddenly get very bad at it when you used three- or four-digit numbers
People who don’t do empirical research at all were saying
“Did you do your experiments correctly?” That had never happened before
I was just surprised by how powerful this thing is
Ungrounded hype isn’t helpful in science. I felt it was important to study the fundamental limits and capabilities of LLMs more rigorously, and that was my primary research focus in 2024. I found myself in a weird situation where I was becoming the negative naysayer for how the models cannot do this and that. Which I think is important — but I didn’t want it to be all that I do. So I’m actually thinking a lot about different problems these days
TAL LINZEN: It’s sometimes confusing when we pretend that there’s a scientific conversation happening
but some of the people in the conversation have a stake in a company that’s potentially worth $50 billion
money and hype vaporized the already-porous boundaries between NLP and AI
Researchers contended with a new set of incentives and opportunities — not just for themselves
NAZNEEN RAJANI: It opened doors that wouldn’t have otherwise
I was one of the first people to get the data to reproduce ChatGPT in open-source — I basically wrote the recipe book for it
And that led me to get a good seed round for my startup
THOMAS MCCOY: Any faculty member who is AI-adjacent starts to be viewed as an AI person — you sort of get typecast to play that role
I’m happy to work on AI because it’s one of the most impactful things that I can be doing with my skillset
But the thing that would bring me the greatest joy is diving deeply into interesting corners of grammar and human cognition
Which is something that can be linked back to advancing AI
JULIE KALLINI: It’s all a matter of semantics
computational linguistics and AI at the same time
I do think there are different communities for each field
but there are plenty of people who bridge several areas
And I think to some extent that’s happened
Basically that’s because I don’t think we’ve actually solved the problem
The only reason to get upset is if you think: “This is it
Language is done.” And I don’t think that’s true
CHRISTOPHER POTTS: This should be an incredible moment for linguistics and NLP
Maybe it’s one of those moments of a field waking up and realizing that it now has incredible influence
You can’t pretend like you’re a quiet scientific or engineering field anymore that just does research for the sake of research — because now all the money in the world is behind you
and every big corporation is trying to exert influence on what you do
and language models are being deployed all over the place
you also have to accept that the debates are going to be heated
I would never have thought that just typing an instruction into a language model would get it to complete the sentence in a way that is consistent with what you’re asking it to do
I don’t think anyone would have thought that that would be the paradigm these days
We have this one interface that basically lets us do everything
Back from the word-embedding days [in 2013]
the whole premise was transfer learning — you learn something from a large amount of textual data in the hope that this will help you with something else
in how the public feels about this — but not in this underlying principle
JEFF MITCHELL: I feel like the corporate interests have changed the way the game is played
ELLIE PAVLICK: I think the media involvement makes a difference
Scientists in my field realized that success could look like becoming known outside of NLP
Papers on arxiv.org are often titled to be picked up by journalists or Silicon Valley enthusiasts
VUKOSI MARIVATE: I think in some ways the barrier to entry both got reduced and heightened
The reduced part is that there’s still a lot that we just don’t understand about what’s actually going on in these systems
so there’s a lot of work that’s just prodding them as much as possible
you don’t need to know the architecture of a neural network like the back of your hand
the barrier was heightened because in order to play with and prod those architectures
you have to be in a very high-resource space
BENDER: I have seen an enormous shift towards end-to-end solutions using chatbots or related synthetic text-extruding machines
is that these large language models are getting so powerful that we have to ask
“Where does the human fit in?’’ That’s a paradigm shift: a shift in technology
how these models are trained and how well they can learn
And then of course the educational consequences
Those are the things that keep me awake at night
there are all these questions that historically have been largely philosophical debates that suddenly are empirically testable
That’s definitely been one big paradigm shift
the way the field looked like 10 years ago was: people creating some data set
And that version of the field still exists
just with much larger data sets and much larger neural networks
CHRISTOPHER POTTS: Maybe this is the way it always works
but the hallmark of a paradigm shift is that questions we used to think were important now no longer get asked
It feels like that has happened over the past five years
I used to focus a lot on sentiment classification
“Give me a sentence and I’ll tell you if it was expressing a positive or negative emotion.’’ Now the entire field is focused on natural language generation — all those questions that we used to think were central have become peripheral compared to that
we’ll look back and think this was nothing compared to what happened in 2029
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you may be swapping your GLP-1 injections for easier and as-effective oral weight-loss medication
It's also likely to be cheaper and not suffer the same kind of supply-chain shortages that existing therapeutics have faced
But it's been a dramatic few weeks for the leading three drug-makers vying to usher in this new phase of weight-loss treatment
And while it's only a matter of time until Ozempic-like drugs are available as oral medication
the past few weeks have seem one small victory and a huge setback for some of the big players in the field
Amid profits updates and shareholder news, Pfizer released a statement titled "Pfizer provides update on oral GLP-1 receptor agonist danuglipron." The company quietly announced that it was ditching its once-daily oral drug due to liver toxicity concerns following analysis of Phase III trial data
"While the overall frequency of liver enzyme elevations across the over 1,400 participant safety database of danuglipron is in-line with approved agents in the class
a single asymptomatic participant in one of the dose-optimization studies experienced potential drug-induced liver injury which resolved after discontinuation of danuglipron," Pfizer said in the statement
Little more is known about the specifications of the liver injury
but the participant experienced elevated enzymes in the organ
But we're unlikely to know more until the trial data is "presented at a scientific forum or submitted for publication in a peer-reviewed journal in the future."
“While we are disappointed to discontinue the development of danuglipron
we remain committed to evaluating and advancing promising programs in an effort to bring innovative new medicines to patients," said Chris Boshoff
In December 2023
Pfizer scrapped development of a twice-daily danuglipron drug because of adverse side effects that included nearly 50% of participants experiencing vomiting
However, the ones to watch are Eli Lilly and Novo Nordisk, which now have their own GLP-1 oral drugs nearing the finish line. Just three days after the Pfizer news, Eli Lilly announced positive results from its Phase III trial of weight-loss drug candidate orforglipron
these results are just one part of the Phase III evaluation
with the drug being assessed for bot diabetes and obesity treatment
"[The trial] ACHIEVE-1 is the first of seven Phase II studies examining the safety and efficacy of orforglipron across people with diabetes and obesity
We are pleased to see that our latest incretin medicine meets our expectations for safety and tolerability
and we look forward to additional data readouts later this year," said David A
could be readily manufactured and launched at scale for use by people around the world."
orforglipron is a small molecule (non-peptide) oral drug designed to be taken anytime
the 40-week trial saw participants with type 2 diabetes lose an average of 16 pounds (7.25 kg)
The company is expected to apply for Food and Drug Administration approval this year
with the suite of Phase III results expected by the end of 2025 or early 2026
Finally, and the most likely company to get the first oral GLP-1 drug to market, Novo Nordisk has had a big win this week, with the US Food and Drug Administration (FDA) accepting its application for review
the Danish pharmaceutical giant is understandably confident the drug will pass its final hurdle
Medical & Regulatory Affairs at the company
passed its final safety and efficacy tests in its 64-week OASIS 4 Phase III trial
which involved 307 adults who were overweight or obese and did not have diabetes
The FDA's decision on oral Wegovy is expected as early as October 2025
Novo Nordisk already has an oral semaglutide drug
on the market but it's only approved for diabetes management
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Metrics details
This work prioritizes Indigenous control of genetic data and brings together oral tradition
with smoothing applied to produce derivative hillshade and terrain-relief datasets
they also acknowledge uncertainties because of gaps in their oral history
Such gaps are inevitable in a centuries-old community that by our estimate (below) lost at least 85% of their members in the first several decades after European Contact
the community had shrunk to around 300 members
making them the smallest of the extant Pueblo nations
centuries of oppression and prohibition of Picuris religion and rituals
the loss of access to traditional and sacred landscapes
and the placement of Picuris children into Native American boarding schools inhibited the intergenerational transmission of cultural knowledge and history at Picuris
these factors have often minimized Picuris’ voice in continuing discussions regarding the status and future of Chaco Canyon
The Picuris community initiated this research to bridge and mend gaps in their traditional knowledge with appropriate scientific data
and to address the extent to which they might have ancestral ties to Chaco Canyon and the regional system it anchored centuries ago
that were on long-term loan to Southern Methodist University
we have chosen to address both the Picuris Pueblo Tribal Nation and its members in the third person
even though some of its members are coauthors of this study
Picuris trace their origins to an underground realm inhabited by Pá à wíá è Páyó
The community is divided in two halves (the ‘North’ and ‘South’ people)
which have separate birthplaces in Picuris oral histories
with the earliest peoples emerging from lakes near big white mountains
One of those lakes is called Phaxwii Oxwalna
The geographical correspondence of the ‘North’ people’s emergence location is less clear
with some traditions identifying it as a spring near Pikes Peak
After migrating through the landscape for an unknown duration of time
these peoples settled at Picuris and Taos Pueblos
Archaeological estimates put the founding of these communities at roughly 900 ce
Although Pot Creek Pueblo was depopulated in roughly 1320 ce
communities that speak closely related languages
continuously occupied communities in the Americas
when directly testing whether those populations carry instead ancestry from the other lineage in the form D(pop
USR1.11,500 bp) we found all to be consistent with zero (maximum D = 0.011
Z = 1.82 for LaPlaya.600 bp and ‘CanAmerindian_1’)
suggesting our dataset does not include a suitable proxy for the excess ancestry not represented in Anzick1 found in Picuris and other populations
This probably represents either ancestry more basal than the one found in the Anzick1 genome
or an ancestry source very distantly related to the ones with genetic data available
the average shared IBD segments longer than 8 centiMorgans (cM) between Indigenous American populations and present-day individuals from Picuris Pueblo
Populations are ordered by latitude and coloured by major geographic areas
the demographical history of present-day Picuris individuals inferred using HapNe-LD with imputed diploid genotypes
Shaded areas show 95 and 90% confidence intervals
The x axis is the time (measured in generations ago since the time of sampling)
and the y axis the effective population size (Ne)
5,480 using HapNe-LD) are consistent with estimates of around 10,000 individuals being part of the Picuris sphere of influence at the time
The estimate of around 3,000 people at Picuris Pueblo is supported by oral traditions at Picuris
as well as archaeological estimates based on ceramic frequencies and architectural space occupied at the site’s maximal size
and arrival times in those regions have been of longstanding academic debate
error bars represent about 3.3 standard errors (P ≈ 0.001 in a Z test with 172,863 SNPs in 5-Mb jackknife blocks)
These results support a late arrival of Athabascan-related populations in the US Southwest
or admixture evident in Southern Athabascans could have been one-directional
Although this would explain the absence of an Athabascan ancestry signal in ancient Picuris
given the extensive interactions between those two groups
it is unlikely that such a scenario persisted over an extended period
we show that individuals from Picuris Pueblo are the closest sampled population
challenging claims of depopulation or disappearance in the area
and establishing a genetic component to suspected cultural affiliation between a present-day group and Ancestral Puebloan heritage
We emphasize that this conclusion does not challenge or call into question the connections and relationships that more than two dozen federally recognized Tribes have to Chaco Canyon
the only example of paleogenetic data supporting a federally recognized Tribe’s affiliation with Chaco Canyon ancestors
Their application can have profound restorative value for present-day communities
discussions of their cultural heritage and ensure their federally recognized rights as stakeholders of ancient sites
We hope collaborative efforts such as this one serve as catalysts for meaningful action and policy consideration
greater respect for oral histories and traditions
and that these results can be incorporated into well informed decision-making processes affecting Tribal sovereignty and community identity
Further information on research design is available in the Nature Portfolio Reporting Summary linked to this article
Analyses were done using freely available software, which have been fully referenced throughout the paper and Supplementary Information. Custom code can be found on https://github.com/abigailramsoe/lundbeck-pipeline
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scalable and user-friendly tool for maximum likelihood phylogenetic inference
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Y Chromosome sequences reveal a short Beringian standstill
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Download references
We dedicate this paper to the memory of Richard Mermejo
as well as the Tribal liaison of this project
We thank Picuris Pueblo Tribal council for their support for the project
for providing a stimulating environment of discussion and learning
The Lundbeck Foundation GeoGenetics Centre is supported by grants from the Lundbeck Foundation (grant nos
the Danish National Research Foundation (grant nos
the University of Copenhagen (KU2016 programme) and Ferring Pharmaceuticals A/S to E.W
is funded by the National Science Foundation (grant no
is funded by the Queen Margrethe’s and Vigdís Finnbogadóttir’s Interdisciplinary Research Centre on Ocean
CNPq 406864/2022-5 and FAPEMIG APQ-00220-22 from Brazil
is funded by the Quest Archaeological Research Fund and the Potts & Sibley Foundation
is funded by the European Research Council (grant no
These authors contributed equally: Thomaz Pinotti
These authors jointly supervised this work: David J
Laboratório de Biodiversidade e Evolução Molecular (LBEM)
Center for Molecular Anthropology for the Study of Ancient DNA
Department of Archaeology and Classical Studies
MARUM Center for Marine Environmental Sciences
developed and maintained bioinformatic infrastructure
did laboratory work and data generation (with support from M.F
analysed sequence data (with support from G.S
led community engagement (with support from T.P.
provided archaeological curation and context
were involved in conceptualizing the draft and final version
wrote the initial draft with significant input from D.G
All authors revised and agreed on the final submitted version
Nature thanks the anonymous reviewers for their contribution to the peer review of this work
The high branch lengths in some populations may reflect analytical artifacts: for ancient individuals
they arise from high error rates due to low coverage and DNA damage
they result from missing data caused by masking non-Indigenous American segments
Present-day literature mitogenomes are in black
present-day Picuris in blue and all other ancient mitogenomes in gold
Near-zero length branches were collapsed for convenience
Ancient Picuris are in red and present-day Picuris in blue
Relevant literature individuals appear in italic
In accordance with Picuris wish to not have its data included in any private database
we do not describe any variant private to them
Supplementary Table 1: Per library sequencing summary statistics
Supplementary Table 2: Per individual sequencing summary statistics
Supplementary Table 3: Present-day Picuris individuals sequencing summary statistics
Supplementary Table 4: Reference genomic dataset summary statistics
Supplementary Table 5: Reference hybridization capture dataset
Supplementary Table 6: Reference array dataset
Download citation
DOI: https://doi.org/10.1038/s41586-025-08791-9
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Law students are seen with Federal Circuit judges following a special sitting at North Carolina Central University School of Law
Law students were asked to set aside their casebooks to witness “justice in action” as Federal Circuit judges and attorneys recently gathered for oral arguments at three North Carolina law schools.
“This program has universal benefits,” said Chief Judge Kimberly A
who participated in a series of oral arguments in North Carolina
“It serves an important civic education function while at the same time reenforcing for judges the importance of the court’s mission not only to the litigants whom it serves but also to the next generation of aspiring lawyers.”
Over 100 eager law students from North Carolina Central University School of Law
the University of North Carolina School of Law
and Duke University School of Law gathered in campus auditoriums in February to watch as judges and attorneys deliberated cases involving patent and government contract disputes.
visit Duke University School of Law for a special sitting
Credit: Duke University School of Law.
has exclusive nationwide jurisdiction over a variety of subject areas
as well as a statutory requirement to provide citizens with reasonable opportunities to appear before the court
This creates a unique opportunity to hold oral arguments outside of D.C.
including most recently in the San Francisco Bay Area and in Boston later this fall
“The court believes that by engaging with the public through this program it can promote transparency and increase public trust and confidence in the Federal Circuit and the Judiciary,” Moore said
Federal courts of appeals across the country regularly conduct special sittings at law schools to provide law students with real-life exposure to a sitting panel of judges
A question-and-answer session often follows oral arguments as law students are able to gain valuable insights into career paths in the justice system
visit the University of San Diego (USD) School of Law for a special sitting
"Sitting at law schools gives the students a chance to see the court up close and personal,” said Judge M. Margaret McKeown, of the U.S. Court of Appeals for the Ninth Circuit, who recently participated in oral arguments at University of San Diego School of Law
“We follow the arguments with a lively question and answer session and then a lunch with the students
What better way to spend our time than with the next generation of lawyers?”
“The energy that law students bring to argument — as advocates or merely spectators — is very special,” said Judge John B
who also took part in the special sitting in San Diego
“I always look forward to law school sittings
and hope this important tradition continues.”
Learn more about the U.S. courts of appeals.
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10:30 am UTC • 33 minI mingle with my peers or no one
I am the man who can throw it faster than fuck
So that is why I am better than everyone in the world
he’s written himself a collection of profane
tacky Southern men whose delusions and ineptitude keep them from becoming the heroes they see themselves as in their own minds
The approach has allowed him and his tight-knit pack of collaborators to study—and make fun of—a very specific type of 21st-century American unexceptionalism
When Kimberly Gregory was cast opposite McBride and Walton Goggins in Vice Principals
and an early script called for the HBO show’s two white leads to burn her house down
“I want you to know that your character really should be the protagonist
She’s the good person,” Gregory recalls him saying
Gregory understood McBride’s sense of humor
She knew that he knew the truth about his guys: They deserved to be laughed at
He’s always trusted his audience to make the same realization
“I feel like there’s a knee-jerk reaction to what we do,” McBride says
they understand a little bit more of what we’re trying to do and what to expect from it.”
Tae kwon do instructor Fred Simmons in The Foot Fist Way
washed-up major leaguer Kenny Powers in Eastbound & Down
doofus drug dealer Red in Pineapple Express
authoritarian educator Neal Gamby in Vice Principals
and rich failson pastor Jesse in The Righteous Gemstones are all pathetically self-important
McBride manages to make them at least semi-sympathetic
“I don’t think anyone can play characters that make so many mistakes that you want to kick but also hug at the same time better than Danny McBride,” says filmmaker Stephanie Laing
who worked on Eastbound & Down and Vice Principals
It’s a trick that seems to come naturally to comedy’s preeminent cinephile
And with The Righteous Gemstones coming to an end on Sunday after four seasons
it’s the perfect time to learn how the hell he does it
“Danny’s a very smart man who plays not so smart characters really
and so it lulls you into this false sense of camaraderie,” Gregory says
that’s my friend down the street—or my not friend down the street.’ It masquerades in a really wonderful way because he’s that good.”Underneath the laughs
the Danny McBride oeuvre can be read as one collective cautionary tale: If you start to identify with his characters too much
On-screen, McBride always seems to be gleefully running back and forth between highbrow and lowbrow. One scene might reference a François Truffaut film. Another might feature Kenny Powers smelling his baby son’s diaper, holding him up, and asking him this: “What did you eat, diarrhea?” Being part of that wacked-out world is
he’s just a force of nature.Craig Robinson (Reg Mackworthy
Eastbound & Down): He has this playful confidence
but they seeing if you get the joke?Walton Goggins (Lee Russell
The Righteous Gemstones): He is one of the kindest people I’ve ever met
One of the most well-read people I’ve ever met
He’s one of the smartest people I’ve ever met
which ultimately has made him literally the funniest person I’ve ever met
The Righteous Gemstones): There’s something about him that stays very pure about “I need to gut-laugh about this,” and that’s where the good stuff is
Put that out front and figure out the other stuff later.David Gordon Green (consulting producer and director
Eastbound & Down; executive producer and director
Vice Principals and The Righteous Gemstones): Think about when Fargo came out
And you’re in the audience trying to awkwardly figure out if you’re supposed to be laughing at the stuff you’re laughing at
When Steve Buscemi gets shot and it’s disgusting
or when they’re putting a leg in the wood chipper
That’s a great part of what Danny knows how to do
Eastbound & Down and Vice Principals; executive producer and director
The Righteous Gemstones): Danny has this God-given ability to make you laugh when he does these fucked-up things
I don’t think everybody can do that.McBride (cocreator
and The Righteous Gemstones): Sometimes we embrace things that are off-putting on purpose
I started Lincoln in the Bardo and was just so deeply emotionally impacted
But it’s the underlying message of “Maybe this is what happens in the afterlife.”
what does he know about the economic differences between Ross
and Bloomingdale’s?”Green: He’s very dialed into what’s going on in the world and culture
And I say this not jokingly: He’s got a significant diet of reality television
he knows the lingo and behavior of what’s happening in technology
and I’m still stuck in the mid-’90s.McBride: I think that our sensibilities are very specific.Edi Patterson (Jen Abbott
The Righteous Gemstones): I like what my brain does when it’s looking at his brain
I feel like cool things happen.Little: We were filming in Puerto Rico
and Deep Roy’s mustache is starting to come off
He could have made the choice to be stressed and say
This is a disaster.” And he made the choice to just go with it
McBride: I look back on all these things that we’ve done with HBO
there is nothing better than days showing up on that set and being there with Steve Little and us just getting to fucking rip on each other
And the same with Walton on Vice Principals and the same on Gemstones with Devine and Edi
I think the pleasure that I take from it is just this idea of we’ve created this world
and then we get to show up at work and fuck with each other
Growing up in the ’80s and early ’90s in Fredericksburg
a town off Route 95 about 50 miles south of Washington
At the University of North Carolina School of the Arts
he met a group of guys with similar tastes
McBride: I can remember clearly to this day when our family finally got a VCR
I think we were about two years behind everyone else
That feeling of going to the fucking video store and suddenly being able to rent movies
What you used to only get to see in a theater
you could see in your house as many times as you wanted
And I just was obsessed.You went to the video store
and you didn’t have an understanding of what all these movies were
it would be any of the action movies and comedies
It was all just trying to rent the most fucked-up-looking movie based on the box.Stuff that I go back to even to this day that I loved when I was a kid: The Shining was my favorite horror movie of all time
I loved Ferris Bueller’s Day Off when I was a kid
Green: Me and Danny and Jody Hill were all on the same floor
Green: Of course the judgments of film school
you just want to know what everybody’s VHS collection is
And I was just really excited because we had a lot of overlap in the diversity of our collections
from absurdist comedies to popcorn and cotton candy blockbusters to weirdo international art films
And it was just cool to see someone with an eclectic taste that matched my own
And we quickly just realized that we had a similar sensibility for dark comedy and emotional comedy and awkward comedy
and that was kind of what our initial creative connection was all about
Danny McBride on the Premiere of ‘The Righteous Gemstones’ S4
and I remember thinking that that was unique
I hadn’t met anybody like that.Green: He was a big John Hughes fan—so was I—and always had an affection for shit-kicker movies
Smokey and the Bandit and Every Which Way but Loose
And those were always fun movies to bond on
It would be everything from Never Cry Wolf to Scarecrow to Bad News Bears to Sixteen Candles to Predator to Halloween
It’s pretty hard to define what our taste is because the only thing that they all have in common is they’re just good fucking movies.McBride: Growing up and living in a little town like Fredericksburg and just renting these movies
but I just imagined what it must be like to make that stuff
There are all these people working together
all these directors.Green: On my first movie
he replaced an actor that had bailed—I think it was his first acting gig outside of film school
It was really fun to see him go from kind of a writing collaborator
to an in-front-of-the-camera incredible performer.Hill: I grew up doing tae kwon do
and I owned a school when I was in high school that taught kids and adults
It just seemed really funny that Danny would be a tae kwon do instructor.McBride: I took karate as a kid
It is also silly and just feels like the perfect mashup for the kind of shit we like
Starring McBride, directed by Hill, and cowritten by their late creative partner, Ben Best, The Foot Fist Way was shot in North Carolina over 19 days in 2005 on a reported budget of around $70,000
The brutally uncomfortable comedy introduced its mustachioed lead to the world and caught the attention of two comedy kingmakers
Hill: Where we shot was actually the school that I started
and the guy that I turned the school over to still owned it and operated it
so they let us shoot and use all the kids for free.McBride: Foot Fist got into Sundance
into the midnight screening.Hill: Danny had done All the Real Girls
but he didn’t have as much of a pop after that
but it’s not like everybody in Hollywood knew who he was
we had CAA calling us and people in Hollywood wanting to meet
Scott Rudin called me on the plane ride to Sundance before we’d even gotten there.McBride: We didn’t get it sold there
Green: I’m really proud of Jody for putting it together
I’d done film festivals and had that kind of circuit
but he was getting phone calls from Ben Stiller and Will Ferrell and Adam McKay
McBride: We got hooked up with Will and Adam.Adam McKay (in 2008): I was handed it by Jimmy Miller, our manager, and I watched it in my living room, on the computer, by myself, like on a Saturday afternoon, like, “Ugh, I have to watch this.” And then right away, I was like, “Holy crap.”Will Ferrell (in 2008): I was watching it while working on Blades of Glory in Montreal
“This is one of the funniest things we’ve ever seen.”
I couldn’t eat for three days just because I was so nervous about it
I didn’t have any point of reference or know how to do it
And the thing in Hollywood is you have to pretend like you know what you’re doing
because if anyone figures out that you don’t
So there was just a sense of you just have to rise to the occasion and do it
Green: There was an awakening of a new comic voice
I kind of had one foot in the industry from where I was living in North Carolina at the time
Judd Apatow and Seth Rogen were one of those
And then that led to Pineapple Express for me because he had introduced them to the idea of me wanting to do comedy films
And this was before Eastbound—I hadn’t done anything comedic to speak of.McBride: When we came on that scene and met Seth and Evan [Goldberg] and Judd and all these guys
it really felt to me and Jody that we had met dudes that we were simpatico with
These guys were all a tight-knit group of people that had been dedicating their lives to being creative at a young age
And we were doing the same thing clear across the country
So the moment that we got to combine forces with them
it just felt like the world was opening up in an interesting way of
there’s other guys out there like us.”Robinson: We were shooting Pineapple Express
“Who is this motherfucker?” Because he was just firing
This dude is incredible.”McBride: Those sets were fun
You take it for granted because you’re in the middle of it
There’s a time where it’s just all Westerns or musicals or now superhero movies
And I just think we were really lucky that what we wanted to do happened to align with when all that stuff was what audiences wanted to see
Green: That wasn’t like a movie where we were getting studio notes
one time one of the executives brought their parents to set and turned right back around
and I would ruin takes because I’d keep laughing so hard and had to escort myself off set so that they could finish the scene
What that film looks like is what it was to make
It was just breaking shit and being almost irresponsible
and we were just praying that other people would enjoy that ride
McBride appeared in box office smash comedies Superbad
he and his buddies started to develop a project of their own: Eastbound & Down
McKay and Ferrell executive-produced the series
which premiered in early 2009 and gave us Kenny Powers
the MLB relief pitcher turned gym teacher with the filthiest mouth in the South
the HBO show was both laugh-out-loud funny and somehow moving
McBride: I’d always been enamored with British television
and I just felt like it was a little bit more interesting
I liked the comfort of things like Cheers and The Cosby Show and all these things that I grew up on
but I didn’t look at it as the same thing I was trying to do
from Alan Partridge to the original Office
and Edgar Wright and Simon Pegg’s Spaced—I loved that
“What do you want to do next?” That’s what I pitched: our version of a British television show
I remember they were surprised by it because
people would make TV shows to get movies made
I wanted to make something that’s only six episodes long
Green: There were a lot of things that people thought were strange about that show
I think it took a little bit of reassurance from people like us that we see Kenny Powers in a lot of people we grew up with.Hill: These were the people that either made our lives hell or we made fun of back in the day
It was an environment where even the prop person felt empowered to come up with an idea
Robinson: You felt like you could improvise, and then you would hit something and then it would catch on, and then you’d figure out how to tag it and call back to it. The big motorcycle fight
when Danny’s on the Jet Ski in the lake and it runs out of gas
to step off of it as though he might walk on water
And it’s one of the best moments in TV because you’re like
“Does Kenny Powers really think he can walk on water?”Green: What I like is that your connection to that show depends on your perspective of yourself and culture and mankind
That show can appeal to some really despicable characters that say
“This guy’s just like me.” Or appeal to a college professor at an Ivy League school that says
“This is what makes mankind tick.”Laing: I would take my son to T-ball
“My husband loves your show.”Goggins: The thing that I responded to in his work was what lies underneath the comedy
I laughed like everybody else in the first season of Eastbound & Down
when he pulls out of that gas station and he leaves [April] standing there
this is really a romantic comedy.” It’s just disguised.McBride: With every season of it
we were never really sure whether we were going to get to do it again
And so we really just tried to make every season stand on its own
had come to me about halfway through shooting Eastbound
having this larger-than-life summation of what it all adds up to for him in his brain
His idea of the happy ending is that his wife gets smoked and he starts a new life and he dies and his sidekick snorts his fucking ashes
With Eastbound & Down’s four-season run winding down, McBride turned to acting in Hollywood movies like This Is the End and Alien: Covenant. He also developed a second show for HBO. Vice Principals premiered in 2016, a year before he and his pals moved their production company, Rough House Pictures, from Los Angeles to Charleston
McBride: You don’t want to fall for the sophomore slump
it goes on for years and years and years—years when I was wanting to take more of the approach of filmmakers
not wanting to just get narrowed into one thing
I learned enough that when you’re writing for television
but you also have to give the promise of what comes next
And I didn’t want to approach Vice Principals that way
I wanted to think of Vice Principals as its own complete story.Laing: He started directing
even though it was still very centralized on those two characters.Goggins: I read for Eastbound & Down
walked into a room with five comedians there
“What the fuck am I doing here?” But I went in
and I knew that in my heart I’m such a fan of Danny’s
whether he wants it or not.” And it was a great read
And I think I said as much to him in the room
“I think you need me.” Something stupid like that
I got a phone call from David Gordon Green
and we don’t know that we want to go that way for this.” And so Jason wound up doing it.And then we were at a party
and I really want you to do it.” And it was Vice Principals
Like everybody else who reads a Danny McBride script
And then the very first table read we did at HBO
this guy is going to be very important in my life.”
Patterson: When I went to that audition, I had no idea that Danny and Jody were going to be there. I just thought I was going to the casting office to read with Sherry Thomas
hi.” And then I just assumed Danny would read with me because that’s who the scenes were with
Just go for it.” And so I was throwing some things in
It was such a crazy scene—I’m literally coming up from blowing him in a broom closet.Gregory: I had a good friend
she has this really eclectic kind of humor
I think I’m getting ready to audition for this dude that you’ve been talking about for a long time,” and she went bananas
And so I watched a little bit of Eastbound & Down
I don’t know if he’s my cup of tea.”So I go into this audition
and I could hear all of this laughter and all of this stuff going on
and I had no idea that Danny and Jody were in the room
this dude is maybe not my dude.” But it was the opposite
I’m going to have a good night’s sleep.”Gregory: I didn’t really struggle in the process until I had to do the scene where I had to get drunk and do what I did on the car
I can’t do this.” Jody was so almost deferential to me in the process
just do whatever.” And he would call me Ms
and all of this stuff was wonderful.I think they respected that “Hey
she’ll throw in what she can.” All of these respectability politics started coming up in my head
What are Black people going to think about me being drunk on what is ostensibly a white male show
And this is before we are having these kinds of conversations that we’ve been having in the last eight
My father’s family is from Louisiana and Port Arthur
“She’s on tonight.” I remember calling either Jody or Danny
Do we have to do it?” And I think it was Danny who was like
I was angry in that scene when I’m walking down the street knocking people’s drinks over
but I had become very childish and infantile
“You’re making me do something I don’t want to do.” But when I was at this theater leadership night and this woman came up to me and was like
“My wife just told me that you’re the actress
We love this show.” And it was a Black woman
it just really makes me happy that all of the stuff I was afraid of was not real
And my community in particular really wrapped their arms around Belinda
even though she was being battered in the show in some ways
That was the only moment where I just felt like
Goggins: No one can ruin a take quicker than me
I think Danny’s gone on record as saying that
because I find him as funny as I find Bill Murray
Literally just looking at him walk in a room
But there was this one line on Vice Principals
And I’m going to say we drove around Charleston 25 minutes trying to get this one line in a take where one of us didn’t laugh
and we were so lucky to do back-to-back seasons and kayak off of our little houses in Charleston
such a wise decision.McBride: I was always enamored with what that world must be like
and it wasn’t as cool as I thought it was going to be.Mixon Greer: I think whenever you’re filming elsewhere
it’s always a special situation.Devine: The sense of community that we have in Charleston
everyone just loves being there and loves working with each other
And it’s the same people that work on all of [Danny’s] stuff all the time
He immediately had his whole crew.Laing: What a gift to be able to live and work in a space that’s inspiring to you where you don’t feel like you have to be in Hollywood
I think they’ve set something up that’s so enviable
It just allows them to continue to tell stories the way that they want to tell them.McBride: Vice Principals was a way to say
let’s just focus on telling one story in this format and then be done with it.” And it was that thing where when I finished it
I had such a fucking good time shooting that and working with all those actors that were in it that there was this moment of panic of
maybe I should have planned this to be a longer series.” But the magic that we captured was in that moment in time
After Vice Principals, McBride and his crew started branching out beyond comedy. Their Halloween reboot, which Green directed and cowrote with McBride and their college friend Jeff Fradley, hit theaters in October 2018 and grossed almost $260 million worldwide
The movie’s two sequels each made more than $100 million
Green: I got a call one day from Jason Blum
asking if I’d be interested in talking about rebooting the Halloween franchise with John Carpenter involved
And I just got super excited and butterflies in my stomach and called up Danny and said
“You won’t believe the conversation I just had.”McBride: My first reaction was like
Everyone will hate you.” But then the more we talked about it
I think that we have an interesting way into this.”Green: He says
That would be a childhood dream.” I remember driving to the Blumhouse office with Danny
I think it was at a time in his life when he was drinking 5-Hour Energy drinks
The two of us were talking to Jason and then he says
Let’s go sit with John Carpenter.”McBride: I can remember to this day walking into John Carpenter's house
And once we saw that Jamie Lee [Curtis] was interested
it became hard not to get excited about the potential of it.Green: The snowball of creative
nostalgic passions that we were able to unleash on that franchise was incredible
And it’s one thing to be able to have these opportunities solo
But when you get to bring your college buddy and you’re side by side taking the hits and feeling the wins on this ride together
McBride: When we premiered that first one at TIFF
and I’ve been mad at things being relaunched before and hated on them
now’s my chance to be in the fucking bull’s-eye.” But man
when we watched that thing with that crowd and then the first time that Jamie goes over the balcony and Michael looks over and she’s gone and it gets into that last cat and mouse in the house
I can come back alive.” It’s one of the best feelings I’ve ever had with any audience
“All these rich-people-on-compound shows.” Since then
the dramatic comedy has become ridiculously ambitious
pulling off everything from motorcycle chases to a pro wrestling period piece to jet pack sermons to the premiere of the fourth and final season
a gory Civil War–set flashback starring Bradley Cooper as the first Gemstone preacher.McBride: Gemstones ended up being something where we defied any sort of genre rules
Goggins: When I’ve read anything that Danny has done
But they’re so three-dimensional that the work required to inhabit them isn’t a lot
really.Patterson: I just think he goes straight toward what he thinks is funny and good and is able somehow to not get bogged down in “Yeah but
this is a real type of person that has made me laugh before
so why don’t we dive in deep?”Laing: It’s almost like sitting in an airport waiting for your flight
and you see the most interesting people walk by and you just wonder what their lives are.Tony Cavalero (Keefe Chambers
The Righteous Gemstones): I remember people would be like
Is he literally a gas station attendant in your cast?”Devine: Danny called me and was like
“Would you be interested in playing my brother?” And I was like
I think I can make that work.” We met once
and he’s on my Mount Rushmore of comedy.And I said to him
“You’re a bright shooting star.” And he goes
And I went and grabbed my girlfriend at the time
“I just called Danny McBride a bright shooting star.” And she’s like
You want me to play your 70-year-old uncle
he can’t do that.” And so we had to do a camera test
he could absolutely do that.”Devine: When you show up on Danny’s set
“I’m going to fucking bring it because I want these guys to love what I do.” I mean
Laing: There’s just such a specificity in the way he embodies his characters
his mannerisms—it’s like there’s no one like him.Patterson: There’s a vibe thing that happens when he’s in the Cape and Pistol stuff
and it’s a haughtiness of trying to be the boss and trying to be cocky
but at the same time looking so dumb and twirling your cape
There’s something in that overconfidence that I think is the sweet spot for him and kills me
Gregory: I’ve seen Danny with and around his family, and that is something that speaks more than what I see someone doing on their set. A really gentle, fatherly sci-fi world would be really interesting to see Danny in. Danny has a good-soul-ness to him, and I would love to see him play something where that kind of shines through.McBride: There’s so much. Just wait and see.Green: Inside the absurdist comic voice is an intellectual with great mythological understanding.
McBride: I grew up in the ’80s, and martial arts was something that you definitely saw in the movies, and it seemed like a good skill to have—to be able to beat somebody’s ass, to be able to take a bad guy out. It hearkens back to an age when life was simpler. A good roundhouse kick could solve all your problems.
WASHINGTON − The Supreme Court's conservatives argued religious institutions can’t be treated as second-class and railed against discrimination
Concerns about opening the door to public funding for religious charter schools of all faiths "reeks of hostility," one said
More: Amy Coney Barrett recused herself from big religious charter school Supreme Court case
Its liberal justices defended the country’s longstanding separation between church and state as the court debated on April 30 whether to allow the nation’s first religious charter school
One justice stated that a win for the religious charter could jeopardize the quality of a publicly funded education nationwide
Attorneys for the Catholic Church, an Oklahoma charter school board and the Justice Department told the Supreme Court that allowing St
Isidore of Seville Catholic Virtual School was the natural next step following a series of recent decisions from the court
who defended the state supreme court's ruling rejecting the Catholic charter
pointed to landmark rulings against teaching religion in public schools
Requiring Oklahoma to allow religious schools in its charter school program
would be an “astounding reversal from this court's time-honored precedents.”
More: How Oklahoma leaders at Supreme Court hearing on religious charter school responded to arguments
The Catholic Church's appeal is just one of three religious rights cases the Supreme Court is deciding in the coming weeks that could increase the role of religion in public life
Here are key moments from the oral arguments
The court’s decision is expected to turn on whether charter schools
which are publicly funded but have private operators
the justices could rule that religious charter schools violate the Constitution’s prohibition on the government backing a religion
the government could be discriminating when it prohibits the church from participating in the state’s charter school program
The justices could find that's a violation of the U.S
Constitution’s promise that Americans can practice religion freely
Justice Sonia Sotomayor said charter schools are public because they’re funded by the taxpayers
Justice Elena Kagan called them “state-run institutions.”
“They give the charter schools a great deal of curricular flexibility,” she said
“But with respect to a whole variety of things
the state is running these schools and insisting upon certain requirements."
He said the only way the school would receive public funds would be if parents chose to send their children there
said Oklahoma is just “exercising contractual oversight.”
“The state is not running these schools,” Campbell said
suggested that Oklahoma was treating religious schools "as second class in the United States."
"That seems like rank discrimination against religion
and that's the concern that I think you need to deal with here," Kavanaugh told Garre
accusing the Oklahoma attorney general's office of being "motivated by hostility toward particular religions." He quoted the attorney general as saying many Oklahomans likely support charter schools for Christian faiths
but that support would require the state to approve similar schools from all faiths
"We have statement after statement by the attorney general that reeks of hostility toward Islam," Alito said
"If your concern is the treatment of Islam or Muslims
then the concern should be the Muslim family whose only practical option is the religious charter school that happens to teach the Catholic faith as truth," Garre said
all three liberal justices expressed skepticism toward the Catholic school's position
Isidore were forgetting a provision in the Constitution that prohibits the government from establishing an official religion/
"The essence of the establishment clause was
'We're not going to pay religious leaders to teach their religion,'" Sotomayor said
said a win for the Catholic school could mean having to provide taxpayer dollars for schools that aren't providing a strong education in areas like math and reading
“I don’t have to imagine very hard to come up with 100 hypotheticals like this because religious communities are really different in this country and are often extremely different from secular communities in terms of the education they think is important for their young people," Kagan said
Chief Justice John Roberts appears to be a pivotal vote
which would mean the Oklahoma Supreme Court's ruling against the Catholic school would stand
Roberts said early in the arguments that previous rulings from him and his colleagues did not clearly indicate the Catholic school should win
even if those decisions expanded religious protections
a lawyer for the charter school board that approved the Catholic school
what past ruling would support the level of government mixing with a religious school that the Catholic school and board were now requesting
that his argument for why charter schools are public didn't seem to square with the court's past decisions
Roberts asked how extensively the state could require charter schools to teach certain subjects
said if there were a requirement to teach evolution and a school rejected it
The state has a compelling interest that evolution be taught
Kagan suggested mainstream religions could meet the state’s requirements
But more obscure ones might have trouble if the government curriculum violated religious schools' beliefs
“There’s a line out the door” of people seeking charter funding
“We’re going to end up in a state of the world with kind of establishment religions and more different
more use-the-adjective-you-want religions that seem peculiar to many eyes
Sauer said allowing religious charter schools would only increase options for where parents could send their children
that line out the door will increase the diversity of options for parents and students that have programs that are similar to Oklahoma,” Sauer said
Could students be forced to attend religious schools?Alito
who is aligned with his conservative colleagues
questioned how religious charter schools could become the only option for students in some areas
one of the criticisms that have been lodged against them
the only public schools are charter schools
who was defending the state supreme court's position
Half the public schools are charter schools in other places
there are jurisdictions where children are assigned to charter schools by default
I don’t want to go to the Catholic charter school,’” he said
“That raises the same problem as raising your hand in the public school and saying you don’t want to participate in prayer today.”
argued that "the mere specter that that might result in the future is not a reason to categorically exclude religious groups on the front end."
Lawyers for the state and federal governments disagreed about the implications of the high court allowing religious charter schools
said states that don’t want to allow religious private schools could restructure their programs
said every charter school law in more than 40 states would become unconstitutional because they all require charter schools to be public and nonsectarian
Some states might change their laws to adapt and ramp up charter schools
but others would abandon charter schools to avoid teaching religion
confusion and disruption for potentially millions of school children and families across the country,” Garre said
The court would also be putting itself in a position to judge future cases about whether charter schools could exclude gay teachers or teach creationism rather than evolution
“There is going to be a lot of line drawing,” Garre said
Most oral health conditions are largely preventable and can be treated in their early stages
Most cases are dental caries (tooth decay)
Other oral conditions of public health importance are orofacial clefts
noma (severe gangrenous disease starting in the mouth mostly affecting children) and oro-dental trauma
Prevalence of the main oral diseases continues to increase globally with growing urbanization and changes in living conditions
This is primarily due to inadequate exposure to fluoride (in the water supply and oral hygiene products such as toothpaste)
availability and affordability of food with high sugar content and poor access to oral health care services in the community
Marketing of food and beverages high in sugar
have led to a growing consumption of products that contribute to oral health conditions and other NCDs
Dental caries results when plaque forms on the surface of a tooth and converts the free sugars (all sugars added to foods by the manufacturer
syrups and fruit juices) contained in foods and drinks into acids that destroy the tooth over time
inadequate exposure to fluoride and a lack of removal of plaque by toothbrushing can lead to caries
pain and sometimes tooth loss and infection
Periodontal disease affects the tissues that both surround and support the teeth
The disease is characterized by bleeding or swollen gums (gingivitis)
the gum can come away from the tooth and supporting bone
causing teeth to become loose and sometimes fall out
Severe periodontal diseases are estimated to affect more than 1 billion cases worldwide
The main risk factors for periodontal disease are poor oral hygiene and tobacco use
Losing teeth is generally the end point of a lifelong history of oral disease
mainly advanced dental caries and severe periodontal disease
but can also be due to trauma and other causes
The estimated global average prevalence of complete tooth loss is almost 7% among people aged 20 years or older
a much higher global prevalence of 23% has been estimated
Losing teeth can be psychologically traumatic
socially damaging and functionally limiting
other parts of the mouth and the oropharynx and combined rank as the 13th most common cancer worldwide
The global incidence of cancers of the lip and oral cavity is estimated to be 389 846 new cases and 188 438 deaths in 2022 (1)
Oral cancer is more common in men and in older people
more deadly in men compared to women and it varies strongly by socio-economic circumstances
alcohol and areca nut (betel quid) use are among the leading causes of oral cancer
human papillomavirus infections are responsible for a growing percentage of oral cancers among young people
Oro-dental trauma results from injury to the teeth
Latest estimates show that 1 billion people are affected
with a prevalence of around 20% for children up to 12 years old
Oro-dental trauma can be caused by oral factors such as lack of alignment of teeth and environmental factors (such as unsafe playgrounds
Treatment is costly and lengthy and sometimes can even lead to tooth loss
resulting in complications for facial and psychological development and quality of life
Noma is a severe gangrenous disease of the mouth and the face
It mostly affects children aged 2–6 years suffering from malnutrition
living in extreme poverty with poor oral hygiene or with weakened immune systems
Noma is mostly found in sub-Saharan Africa
although cases have also been reported in Latin America and Asia
Noma starts as a soft tissue lesion (a sore) of the gums
It then develops into an acute necrotizing gingivitis that progresses rapidly
destroying the soft tissues and further progressing to involve the hard tissues and skin of the face
According to latest estimates (from 1998) there are 140 000 new cases of noma annually
Survivors suffer from severe facial disfigurement
and require complex surgery and rehabilitation
its progression can be rapidly halted through basic hygiene
the most common of craniofacial birth defects
have a global prevalence of between 1 in 1000–1500 births
with wide variation in different studies and populations (2)
alcohol and obesity during pregnancy also play a role
there is a high mortality rate in the neonatal period
If lip and palate clefts are properly treated by surgery
Most oral diseases and conditions share modifiable risk factors such as tobacco use
alcohol consumption and an unhealthy diet high in free sugars that are common to other NCDs including cardiovascular disease
diabetes has been linked in a reciprocal way with the development and progression of periodontal disease
There is also a causal link between the high consumption of sugar and diabetes
Oral diseases disproportionately affect the poor and socially disadvantaged members of society
There is a very strong and consistent association between socioeconomic status (income
occupation and educational level) and the prevalence and severity of oral diseases
This association exists from early childhood to older age and across populations in high-
The burden of oral diseases and other noncommunicable diseases can be reduced through public health interventions by addressing common risk factors
Adequate exposure to fluoride is an essential factor in the prevention of dental caries
Twice-daily tooth brushing with fluoride-containing toothpaste (1000 to 1500 ppm) should be encouraged
Unequal distribution of oral health professionals and a lack of appropriate health facilities to meet population needs in most countries means that access to primary oral health services is often low
Out-of-pocket costs for oral health care can be major barriers to accessing care
Paying for necessary oral health care is among the leading reasons for catastrophic health expenditures
resulting in an increased risk of impoverishment and economic hardship.
The World Health Assembly approved a Resolution on oral health in 2021 at the Seventy-fourth World Health Assembly
The Resolution recommends a shift from the traditional curative approach towards a preventive approach that includes promotion of oral health within the family
comprehensive and inclusive care within the primary health-care system
The Resolution affirms that oral health should be firmly embedded within the NCD agenda and that oral health-care interventions should be included in national universal health coverage benefit packages
In response to the mandate outlined in the resolution, the Secretariat developed the Global strategy on oral health
and included the Global oral health action plan 2023‒2030 (GOHAP) in the report on NCDs
noted by the Seventy-sixth World Health Assembly in 2023 (WHA76.9). The GOHAP includes a range of actions for Member States
civil society organizations and the private sector
In 2024, as an outcome of the first ever WHO Global Oral Health Meeting that took place 26–29 November in Bangkok, Thailand, the Bangkok Declaration – No Health Without Oral Health was adopted
This Declaration advocates for elevating oral diseases as a global public health priority
The Bangkok Declaration reiterates Member States' commitment to the landmark 2021 resolution on oral health
which advances the prevention and control of oral diseases as part of the NCD
It emphasizes the need to strengthen health systems through primary health care approaches
ensuring that environmental sustainability and climate resilience are central components
France: International Agency for Research on Cancer
Available from: https://gco.iarc.who.int/today
cleft lip and cleft palate and lip: A comprehensive systematic review and meta-analysis
The World Health Assembly approved a Resolution on oral health in 2021 at the Seventy-fourth World Health Assembly
In response to the mandate outlined in the resolution, the Secretariat developed the Global strategy on oral health
In 2024, as an outcome of the first ever WHO Global Oral Health Meeting that took place 26–29 November in Bangkok, Thailand, the Bangkok Declaration – No Health Without Oral Health was adopted
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Amid the growing macro-level headwinds in the vaccine space
the FDA this month is expected to decide on Moderna’s mRNA COVID-19 shot
GSK is proposing its subcutaneous biologic Nucala to treat adult patients with chronic obstructive pulmonary disease (COPD) with an eosinophilic phenotype. The FDA’s decision is due on May 7
A pulmonary disease, COPD is characterized by inflammation in the lungs, manifesting as breathlessness, coughs and airflow obstruction. According to GSK, some 40% of patients suffer from disease exacerbations caused by type 2 inflammation, which in turn is linked to high eosinophil counts in the blood. Nucala
which is crucial to maintain the activity of eosinophils
GSK is supporting Nucala’s COPD application with data from the Phase III MATINEE trial. The pharma released a topline readout from the study in September 2024
noting that Nucala elicited a “statistically significant and clinically meaningful reduction” in yearly rates of moderate or severe disease exacerbations as opposed to placebo
Nucala is currently approved for eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome
and as an add-on maintenance treatment for asthma and chronic rhinosinusitis with nasal polyps
By May 22, the FDA will release its verdict on Arcutis Biotherapeutics’ proposed expansion for Zoryve into body and scalp psoriasis
Arcutis is backing its expansion bid with data from the Phase III ARRECTOR trial
which found that 66.4% of Zoryve-treated patients achieved clear or almost-clear skin
Results also showed that 65.3% of patients in the Zoryve arm saw significant improvements in itch
Arcutis also filed findings from a Phase IIb study as well as long-term efficacy and safety data for Zoryve in plaque psoriasis
Zoryve is a topical phosphodiesterase 4 inhibitor that works by helping to suppress inflammation in the skin
The drug won FDA approval in 2011 for the treatment of plaque psoriasis in patients aged 12 years and up
Zoryve would be a “truly meaningful innovation” for patients who suffer from inadequately controlled symptoms
Arcutis CEO Frank Watanabe said in a September 2024 release
Sanofi’s meningococcal disease vaccine MenQuadfi is currently approved for the primary immunization of children aged two years and up
it can be used in those 13 years and older who continue to be at risk of meningococcal disease
Sanofi is seeking to expand MenQuadfi’s label to also include infants and toddlers from six weeks to 23 months of age. The FDA is currently reviewing this proposal and is due to release its decision on May 23
MenQuadfi could protect this younger population from the A
W and Y serogroups of Neisseria meningitidis
In an April presentation before the CDC’s Advisory Committee for Immunization Practices
Results showed that MenQuadfi was safe to use in infants and toddlers
with most side effects being mild or moderate in severity
MenQuadfi was able to match a commercially approved vaccine in immune response and seroprotection
On May 23, Liquidia is expecting to win final approval of its inhalation powder Yutrepia for the treatment of patients with pulmonary arterial hypertension associated with interstitial lung disease (PH-ILD)
The FDA gave the drug tentative approval in August 2024
indicating that it had cleared all efficacy and safety hurdles and satisfied regulatory standards of product quality
Liquidia still needed to wait out regulatory exclusivity for a competing product
Merck is hoping to expand its oral cancer drug Welireg into advanced pheochromocytoma and paraganglioma (PPGL). The FDA’s decision deadline is May 26
PPGL refers to two types of rare tumors of the adrenal gland. Diagnosed in some 2,000 patients per year, they are typically caused by specific genetic mutations. Symptoms include high blood pressure
up to 25% of PPGL cases are already at the metastatic stage at diagnosis
Merck is supporting Welireg’s PPGL bid with data from Cohort A1 of the Phase II LITESPARK-015 study. The pharma did not provide specific data in a January news release
revealing only that the application is based on objective response rate and duration of response in PPGL patients after Welireg treatment
The FDA has granted the drug priority review in this indication
Welireg is an orally available inhibitor of the HIF-2α transcription factor
which is involved in oxygen sensing and in the body’s response to hypoxia
The drug is indicated for patients with renal cell carcinoma (RCC) and those with von Hippel-Lindau disease—a rare genetic disease involving the formation of tumors across various organs—who also require treatment for associated RCC
Welireg will become the only drug for advanced PPGL in the U.S.
By May 28, the FDA will release its verdict on Eton Pharmaceuticals’ ET-400
for the treatment of adrenal insufficiency in infants
This new target action date comes after the FDA in February announced that it needed more time to review Eton’s data package for ET-400
Eton submitted supplemental information in December last year
in response to a request from the regulator
is designed to rapidly deliver glucocorticoids to children with adrenocortical insufficiency
In a July 2024 announcement
Eton CEO Sean Brynjelsen said that the approval of ET-400 would allow the biotech to “capture a greater percentage of the oral hydrocortisone market” and
would open up a peak opportunity of “more than $50 million annually.”
The FDA’s last big milestone for the month belongs to Moderna and its investigational next-generation COVID-19 vaccine mRNA-1283. The regulator is expected to release its decision on May 31
the company released Phase III data for the experimental shot
only claiming that mRNA-1283 elicited a “higher immune response” against SARS-CoV-2 than Spikevax
Moderna emphasized at the time that mRNA-1283 could induce robust responses against Omicron and original strains of the virus—a benefit the company claimed was most evident in seniors over 65 years of age
Oral Health CoalitionPRAMSTobacco Quitline
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The Oral Health Branch is dedicated to preventing dental disease for Alabama's citizens by promoting and developing quality
cost-effective community and school-based preventive
and early treatment programs that emphasize the elimination of oral health disparities
Oral Health is an essential and integral component of health throughout life
No one can be truly healthy unless he or she is free from the burden of oral diseases and conditions
Millions of people in the United States experience dental caries and periodontal disease resulting in needless pain and suffering
The Oral Health Branch has developed the following materials to help educate Alabamians on the benefits of healthy teeth and gums
The Alabama Department of Public Health (ADPH) is excited to announce the winners of our eighth annual “Share Your Smile with Alabama” statewide photo contest: Channing Rose Coghlan from Lowndes County
who attends Fort Dale Academy in Butler County
Visit Share Your Smile with Alabama for details
Introducing Alabama's first Burden of Oral Disease document
This comprehensive oral health disease burden report serves as a critical tool in evaluating the state's dental landscape
The full report is available to download below
The Oral Health Branch accomplishes its mission through several programs. These include oral health education programs and materials, community water fluoridation, and the dental screening program
Oral health data from various sources are available that characterize the oral health of Alabama's children and adults
Finally, information is available on locating a dentist throughout the state
and other dental provider lists are also available
Call (334) 206-2924 or contact us via email to obtain further information
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Supreme Court heard oral arguments Wednesday over the nation’s first religious charter school that aims to open in Oklahoma
putting the constitutionality of a state-funded Catholic education to the test
An Oklahoma state board approved St. Isidore of Seville Catholic Virtual School to operate as a publicly funded charter school in 2023. The Oklahoma Supreme Court blocked the school from opening in a June ruling
finding the concept of a religious charter school a violation of the Constitution’s prohibition against government-established religion
a Catholic with ties to two legal groups behind St
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Five of the eight remaining justices who heard the case also are Catholic — John Roberts
and Justice Ketanji Brown Jackson is a nondenominational Protestant
A decision from the Court is expected by the end of June
Kagan and Jackson — appeared doubtful that previous rulings support the idea that a charter school could constitutionally adopt a religion
Kagan also wondered about the nationwide implications of permitting publicly funded religious schools
said disapproving a charter school solely on religious grounds “seems like rank discrimination against religion.” Opening charter school funding to faith-based institutions would “be expanding the options
not contracting the options” of school choice in public education
‘Don’t exclude us based on religion,’” Kavanaugh said
Isidore’s founding contract differs from that of other charter schools
The school pledged to comply with state regulations and non-discrimination laws only to the extent that Catholic doctrine allows
The Court made prior decisions that religious schools can’t be excluded from government grants and state-funded tuition assistance programs
a religious school wasn’t changing the terms of a government program
“It seems to me you are not seeking the same public benefit as everyone else,” Jackson said
The Archdiocese of Oklahoma City and the Diocese of Tulsa applied to open St
named after the patron saint of the internet
to offer an online Catholic education to students in all parts of the state
particularly in rural areas with no brick-and-mortar Catholic school
Isidore would be Catholic in all ways but open to students of all belief systems
Students would have to learn Catholic doctrine and obey school rules inspired by church beliefs
Supreme Court heard our case and now entrust it to their wisdom,” Oklahoma City Archbishop Paul S
we pray and hope for a decision that stands with religious liberty and the rights of Oklahoma families to make their own decisions in selecting the best educational options for their children.”
Both the school and the Oklahoma Statewide Charter School Board
Oklahoma’s attorney general has led the legal battle against the school
chief legal counsel of the national conservative legal group Alliance Defending Freedom
presented the statewide board’s oral arguments Wednesday
Both contended charter schools aren’t an arm of the government like traditional public schools
they are private entities who contract with the state to provide a public service
and therefore should be free to adopt a religion
Campbell said he found the justices “very receptive to the arguments we were making.”
“The First Amendment says when you create a program and invite everyone in but tell only religious groups that they can’t come
gave oral arguments on behalf of the Oklahoma attorney general
who said the concept of a publicly funded religious school is unconstitutional
Charter schools bear all necessary resemblance to traditional school districts to be considered public
The state can open and close a charter school
They are subject to the equal academic standards as Oklahoma public schools and most of the same regulations
though they have more flexibility over teaching methods and employee hiring
though they must contract with a traditional school district
Native American tribe or a state board that oversees them as a charter authorizer
and federal law all define charter schools as public schools and forbid them from religious affiliation
charter schools must comply with church-state separation
“When I look at Oklahoma and its charter schools program
they look like regular public schools,” she said
So why shouldn’t we take the state at its word (that they are public)?”
Oklahoma Attorney General Gentner Drummond has been the school’s leading opponent
despite it having support from fellow Republican leaders in the state
Isidore would create a “slippery slope” leading to charter schools teaching faith systems that most Oklahomans would disagree with — a position Alito said “seems to be based on hostility to certain religions.”
Kevin Stitt has been a vocal advocate of opening St
Stitt said the school “expands choice and freedom,” and the government shouldn’t stand in the way
“I think the Supreme Court is going to rule with us because it’s just common sense,” he said
Charter school advocates feared a ruling in St
Isidore’s favor could cause a widespread closure of charter programs in states that won’t abide taxpayer-funded religious education
“we won’t know what the rules are for charter schools anymore in 47 states and the federal level,” said Starlee Coleman
president and CEO of the National Alliance for Public Charter Schools
“This is going to shut down the charter school program in many states where there is simply no appetite by state lawmakers to fund religious schools,” Coleman said after oral arguments
Illinois where there are millions of children attending charter schools today.”
Oklahoma Voice is an affiliate of States Newsroom, a nation 501(c)(3) nonprofit supported by grants and donations focused on delivering state government news. The Voice maintains full editorial independence. For more stories by Oklahoma Voice go to oklahomavoice.com
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The Dental Health Program (DHP) at VDH works internally and with partners to make Virginia the healthiest state in the nation by improving equitable access to dental care and public health interventions that improve oral health outcomes
The DHP in Virginia began in 1952 with school-based clinical programs
VDH employed over 100 dentists and auxiliary staff to provide dental services and education
the Agency has re-aligned the DHP’s focus on prevention and education and has transitioned clinic-based restorative programs to community-based prevention programs
The ability of VDH dental hygienists to work under “Remote Supervision,” without the direct supervision or initial exam of a dentist
has led to the success of the community-based education
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The Department of Communication Sciences and Oral Health is made up of two main program areas: Communication Sciences, with Speech-Language Pathology and Education of the Deaf programs, and Dental Hygiene
A dental hygiene degree from Texas Woman’s opens up career opportunities to you beyond the dentist office. Our programs teach you critical thinking and evidence-based decision making with a global context you won’t find at other universities. TWU dental hygiene students train in our on-campus Dental Hygiene Clinic to receive hands-on experience with patients
MCL 8201314 N. Bell Ave.Denton, TX 76204-5737940-898-2025 (phone)940-898-2070 (fax)coms@twu.edu
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straightforward answers when I asked patients about their tobacco use
“I don’t smoke.” Then later in the appointment they would casually mention using nicotine pouches
I saw friends discreetly popping in nicotine pouches with little thought or discussion
Nicotine pouches are rapidly gaining popularity
Social media platforms are flooded with videos and posts that spread awareness of these products
Most of our time in dental hygiene training is spent learning about the effects of traditional tobacco products on the oral cavity
it’s time to expand our focus beyond cigarettes and vapes
What exactly are nicotine pouches doing to the oral cavity
Nicotine pouches are a recent addition to the nicotine product market
gaining widespread availability starting in 2019 in Europe
smokeless alternatives to traditional tobacco products
Each nicotine pouch typically contains between 1.29 mg and 6.11 mg of nicotine
although some are now being marketed with levels as high as 11 mg per pouch
These pouches are typically made from plant fibers
offering individuals an “easy-to-use” form of nicotine delivery.2 Additionally
many nicotine pouches include food-grade additives and flavorings such as mint
and various fruit flavors aimed at appealing to a wide range of consumers
Most of these pouches use artificial sweeteners instead of sugar
which may lower the risk of dental caries.3 However
the absence of sugar doesn’t eliminate oral health concerns
as keeping the pouches in the same spot in the mouth for extended periods can cause localized tissue irritation
Unlike traditional smokeless tobacco products
these alternatives eliminate the need to spit
making them more socially acceptable and attractive for those looking for a cleaner option.4 Marketed as a more convenient and “lower risk” choice with a reduced potential for misuse
these products are rapidly gaining popularity among tobacco users
and dental professionals should be mindful of this
a Swedish nicotine pouch available in nicotine strengths ranging from 3 mg to 8 mg per pouch.2 Users place the pouch between their gum and lip
and it gradually releases nicotine into their bloodstream.5 Another brand is On!
which offers nicotine strength from 1.5 mg to 8 mg.6 Lastly
All three brands offer a wide range of flavors
Though nicotine pouches are marketed as a safer alternative to smoking or chewing tobacco
they still carry significant risks for oral health.7 One study
which compared Zyn nicotine pouches to traditional Swedish and smokeless tobacco products
found that even the lower amounts of nicotine in Zyn pouches could deliver nicotine to the bloodstream as effectively as other smokeless products
Participants in the study reported mild side effects
as dry mouth can increase the risk of tooth decay
A case series investigating the effects of nicotine pouches on oral health highlighted the potential for adverse outcomes.8 The study examined five users
focusing on oral health and conducting histopathological analyses
users developed white lesions in their mouths
usually near the upper lip and frenum where the pouches were placed
Histopathological analysis revealed inflammation
a condition in abnormal growth of cells in tissue
These findings suggested that nicotine pouch use can directly impact oral tissues
A systematic review of the potential oral health risks of nicotine pouches
analyzed three studies involving 190 participants.9 The researchers discovered that frequent use of nicotine pouches was linked to several oral health issues
These problems were commonly observed among regular and long-term users
The review noted concerns that nicotine pouch use might contribute to inflammation and increase the risk of oral cancer
although the evidence was limited and the studies involved had a high risk of bias
particularly among adolescents and young adults
While current studies highlight oral mucosal changes
the full extent of systemic and long-term oral health effects remain unclear
especially regarding potential links to oral cancer and chronic tissue damage
dental hygienists are essential in identifying early signs of damage caused by new nicotine products
ask the right questions during patient assessments
and include nicotine pouches in our patient education and tobacco cessation conversations
we can empower patients to make more informed choices and potentially prevent long-term damage
Tobacco companies introduce 'tobacco-free' nicotine pouches
3. Patwardhan S, Fagerstrom K. The new nicotine pouch category: a tobacco harm reduction tool? Nicotine Tob Res. 2022;24: 623-625. doi:10.1093/ntr/ntab198
Nicotine pharmacokinetics and subjective responses after using nicotine pouches with different nicotine levels compared to combustible cigarettes and moist smokeless tobacco in adult tobacco users
https://lucy.co/products/pouchesf?variant=41980094742714&selling_plan=711688378#
Pharmacokinetic comparison of a novel non-tobacco-based nicotine pouch (Zyn) with conventional
tobacco-based Swedish snus and American moist snuff
Correction: oral mucosal changes caused by nicotine pouches: case series
What is the impact of nicotine pouches on oral health: a systematic review
https://doi.org/10.1186/s12903-024-04598-8
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The National Institute for Health and Care Excellence (NICE) has recommended linzagolix (Yselty
Theramex) for treating endometriosis in selected patients
The decision applies to women for whom previous medical or surgical treatments have not alleviated their symptoms
The drug is a gonadotropin-releasing hormone (GnRH) antagonist taken orally
allowing patients to self-administer the treatment at home
It must be used alongside hormonal add-back therapy to help reduce potential side effects
In final draft guidance
NICE said there was sufficient evidence to show that linzagolix with hormonal add-back therapy provides clinical benefits and value for money
the treatment will be made available on the NHS in England
NICE estimated that up to 1000 women a year could benefit from the treatment
Endometriosis affects around 1.5 million women in the UK
Linzagolix offers a non-injectable alternative to existing options
It is already approved for treating moderate to severe symptoms of uterine fibroids
The hormonal add-back therapy includes oestradiol 1 mg and norethisterone acetate 0.5 mg to help mitigate potential side effects
Current therapeutic options for endometriosis include surgery
and relugolix-oestradiol-norethisterone acetate (relugolix combination therapy [CT])
NICE said that clinical trial evidence showed that linzagolix with hormonal add-back therapy demonstrated statistically significant reductions in both dysmenorrhoea and non-menstrual pelvic pain compared with placebo
Indirect comparisons suggested that the combination offers similar pain relief to leuprorelin acetate and relugolix CT
Relugolix CT became the first long-term pill licensed to treat endometriosis following NICE’s approval for NHS use in March
The cost of linzagolix was judged comparable to relugolix CT and considered acceptable against standard care options such as surgery or leuprorelin
NICE found that the cost-effectiveness of linzagolix with hormonal add-back therapy to be within its acceptable range
described the drug as “a valuable addition to the options available for this often painful and disruptive condition.” She noted the convenience of once-daily dosing at home and its potential to ease pressure on NHS services
Linzagolix is supplied as 200-mg film-coated tablets
The hormonal add-back therapy costs £13.20 for a pack of 84 tablets
Annual treatment costs are estimated at £1100
The most common side effects reported in trials include hot flushes (6.3%) and headache (5.7%)
Linzagolix is subject to additional monitoring to allow quick identification of new safety information
Treatment should be supervised by a physician experienced in the diagnosis and treatment of endometriosis
Final guidance is due to be published on 25 June
The NHS in England must make the treatment available within 90 days of publication
Sheena Meredith is an established medical writer
and consultant in healthcare communications
with extensive experience writing for medical professionals and the general public
She is qualified in medicine and in law and medical ethics
Send comments and news tips to uknewsdesk@medscape.co.uk
2025 8:30 AM EDTMen’s Journal aims to feature only the best products and services. If you buy something via one of our links
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By John AlexanderJohn Alexander
Dogs that have oral squamous cell carcinomas often need surgeries that disfigure their jaws and lower their quality of life – and in 20% of dogs diagnosed
the cancer has metastasized to a point where surgery is no longer an option
including Cornell researchers across five departments and institutes
has found that an FDA-approved drug used in humans can be “remarkably effective,” researchers said
which is the most common oral epithelial malignancy in dogs
The drug substantially inhibited the growth of the tumors in mouse models and in dogs enrolled in a clinical trial
One dog’s tumor nearly disappeared in a matter of weeks
“It’s a super exciting clinical tool that we now have available,” said Santiago Peralta, associate professor of dentistry and oral surgery in the College of Veterinary Medicine (CVM) and senior author of the study
“We are already getting calls and emails from colleagues and from dog owners from all over the world.”
targets a downstream component of the RAS signaling pathway
which regulates cell growth and which is implicated in a number of human and animal cancers
Approved for the treatment of melanoma in humans
trametinib has been found to be safe for use in dogs and relatively inexpensive – a month’s worth of treatment is around $100 to $200 depending on the size of the dog
researchers created new cell lines from the tumors of dogs diagnosed in the clinic
They tested a number of therapeutic agents on the cells and then moved to mouse models
where trametinib was particularly effective
“I’ve never seen results like that in mice before,” said first author and research associate William Katt
“And I was blown away when we saw the results in the dogs – being on a project that made it to the clinic and seeing the tumor nearly vanish in a couple of weeks was delightfully surprising.”
with only four dogs enrolled; it’s now at 20
The researchers included the preliminary data because it was so encouraging
with one dog showing 80% tumor regression and another 40% regression
“What we’re seeing is that some dogs or some tumors are susceptible to this treatment whereas others are not,” Peralta said
we’re seeing several cases where the response is remarkable.”
Peralta and others are currently following up to try to understand the divergent tumor responses – research that could shed light on the RAS pathway and have implications across cancers and species
The original cell lines created for the experiment could also spur more research
Katt plans to add the cell lines to open-access depositories for other researchers’ use
there’s a huge toolbox to work with,” Katt said
“The first thing I did for this study was to look for existing cell cultures out there for these canine cancers
Peralta said he doesn’t expect trametinib to cure the oral cancers completely
but that it could be used to shrink them before surgery and result in less destructive interventions and improved quality of life
“There’s often this window of opportunity between diagnosis and surgery – treating the dog in this window makes sense because
Katt emphasized that the research was a team effort leveraging Cornell’s strengths and breadth
“This speaks very positively to what we can do almost entirely in-house,” he said
“and to just how much leverage and scientific power we have
with the collective wisdom and expertise and facilities on this campus.”
Distinguished Professor of Arts and Science in Chemistry in the College of Arts and Sciences and CVM
director of genomics in the Cornell Institute of Biotechnology; Jordan C
Warshaw of Prism Veterinary Dentistry in New York City; and Kristiina Keikinheimo of the University of Turku
The study was supported with funding from the Cornell Richard P
the National Cancer Institute and the Maritza and Reino Salonen Foundation
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By Kendall Rovinsky
Both the injectable and oral forms of semaglutide, a glucagon-like peptide-1 receptor agonist, have gained recent attention for their effectiveness against weight gain, high blood sugar, and potentially against alcohol cravings
A new clinical trial, co-led by endocrinologist and diabetes expert John Buse, MD, PhD, and interventional cardiologist Matthew Cavender, MD, MPH
at the UNC School of Medicine has shown that the oral form of semaglutide can significantly reduce cardiovascular events in people with type 2 diabetes and atherosclerotic cardiovascular disease
“Heart attacks and strokes are among the most common and devastating complications of diabetes,” said Buse
Caviness Distinguished Professor of Medicine and Director of the UNC Diabetes Care Center
“Semaglutide has been a main stay of our efforts to reduce heart attack and stroke in people with diabetes
Having an oral option to deliver this highly effective therapy is a big advance.”
Results from the rather large, international trial were published in the New England Journal of Medicine and presented at the American College of Cardiology’s Annual Scientific Session & Expo in Chicago
Type 2 diabetes is a progressive disease that affects one’s ability to control blood sugar levels
People with the condition need to closely monitor their diet and activity and may need to take medications as their blood sugar becomes more difficult to manage
Those with type 2 diabetes are at a significantly higher risk of cardiovascular disease because they may develop high blood pressure
Glucagon-like peptide-1 (GLP-1) receptor agonists
have shown much potential for lowering blood sugar
but little is known about whether the oral form of semaglutide actually decreases major cardiovascular events
The Semaglutide cardiOvascular oUtcomes triaL (SOUL) recruited 9,650 people for the study who have pre-existing cardiovascular disease
The trial was sponsored and funded by pharmaceutical company Novo Nordisk
Participants were divided into a placebo group (no medication) and a drug group to see if those taking oral semaglutide were more or less likely to experience major cardiac events
Both groups were given standard-of-care glucose-lowering and cardiovascular risk-reducing therapies according to local guidelines
Those in the medication group took a once-daily 14mg dose of oral semaglutide
Researchers found that oral semaglutide decreased the risk of major cardiovascular events by 14% compared to placebo across age and gender
Of all types of major cardiac events studied in the clinical trial
nonfatal myocardial infarction saw the greatest reductions in risk
The effect of oral semaglutide on cardiovascular outcomes was consistent with other clinical trials involving injectable semaglutide
but more trials are needed to determine if one method may be more effective than the other at reducing major cardiovascular events
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The aim of this report is to provide a comprehensive baseline assessment on the global oral health targets to track implementation progress of the Global oral health action plan 2023–2030
The report offers an overview of the current situation and serves as a reference for future reports
progress can be tracked every 3 years until 2031 and reported back to Member States through the mandate outlined by the World Health Assembly resolution on oral health (WHA74.5)
Metrics details
Oral health is a crucial determinant of overall well-being
face significant barriers to maintaining it
Personalized oral health education and behavior modification using models like the Health Action Process Approach (HAPA) and Motivational Interviewing (MI) can address these barriers
their individual limitations highlight the need for a combined approach
Integrating these models with personalized education and oral care kits provides a holistic solution to address both motivational and practical barriers
This study evaluates the effectiveness of such an intervention on oral health behaviors and outcomes in residents of informal settlement
A quasi-experimental pre and post interventional study was conducted among 45 participants aged 18–60 years from three wards in Bhubaneswar
The study was conducted between October 24
Participants were recruited through dental camps organised by our institute
Baseline oral health behavior was assessed using a validated questionnaire based on four behavioral constructs: outcome expectancy (OE)
and perceived barriers (PB) by faculty and postgraduate students of public health dentistry department
Participants also received personalized oral health education and an oral care kit
and behaviour towards oral health were recorded both at baseline (T0) and one-month post-intervention (T1) by same examiners
Statistical analyses included paired t-tests
and Cronbach’s alpha for internal consistency of the questionnaire
significant improvements were observed in all behavioral constructs
The mean outcome expectancy (OE) increased from 2.49 ± 0.20 to 4.15 ± 0.07 (p = 0.000)
self-efficacy (SE) from 1.90 ± 0.14 to 3.81 ± 0.14 (p = 0.000)
intention (I) from 1.92 ± 0.11 to 4.30 ± 0.33 (p = 0.001)
and perceived barriers (PB) from 1.85 ± 0.11 to 4.04 ± 0.03 (p = 0.002)
Clinical outcomes also showed significant improvements: the mean plaque index (PI) decreased from 1.9 ± 0.8 to 0.9 ± 0.4 (p = 0.000)
and the mean oral hygiene index-simplified (OHI-S) decreased from 2.3 ± 1.4 to 1.5 ± 0.9 (p = 0.003)
Internal consistency of the questionnaires was good across constructs
with Cronbach’s alpha values ranging from 0.715 to 0.751
This study demonstrates that a holistic behavioural intervention combining personalized education
behavior modification using HAPA and MI models
and oral care kit distribution significantly improves oral hygiene behavior and clinical outcomes among residents of informal settlement
The model addresses both motivational and access barriers
providing a scalable framework for improving oral health in underserved populations
Future research should explore the long-term sustainability of this approach and its applicability to other settings
we hypothesized that combining HAPA with MI along with provision of basic oral care tool can improvise the oral health especially among the underprivileged populations who lack access to oral health awareness programmes and oral health care
This study aims to assess the effectiveness of a combined intervention comprising personalized oral health education
behavior modification through a custom-designed questionnaire based on HAPA and MI constructs
and the distribution of a basic oral hygiene kit
we intend to improve oral hygiene practices among underprivileged populations
increase compliance with regular brushing and flossing
and reduce plaque and oral hygiene index-simplified (OHI-S) scores
we aimed to evaluate the association between behavioral constructs—such as outcome expectancy
and perceived barriers with these clinical indices
to understand the behavioral shifts that underpin improved oral health practices
this study targets the marginalized urban population living in environments with limited access to resources and basic services
such groups have been labeled as “slum dwellers”
but this term is now widely recognized as pejorative and stigmatizing
These communities are typically characterized by overcrowded and unplanned settlements
intention and access to formal healthcare services
we will use the term “residents of informal settlements” to refer to these communities living in precarious conditions
This terminology is considered more respectful and appropriate for describing populations residing in such under-resourced urban areas
Through this combinative approach this study may bridge the gap between intention and sustained behavior change in maintaining oral health in high-risk populations which previous studies have not addressed
This quasi-experimental study assessed the impact of an intervention—comprising personalized oral health education
and behavior modification through a questionnaire based on HAPA and MI constructs—on oral hygiene practices among residents of informal settlement in Bhubaneswar
The study evaluated changes in oral hygiene behaviors and clinical oral health outcomes
This study primarily involved quantitative data collection and analysis
Pre- and post-intervention data on participants’ behavior and oral health outcomes were collected to determine the intervention’s effectiveness on oral hygiene practices
We conducted oral health screening camps among the residents of informal settlements at three wards of Bhubaneswar
These individuals belong to low-income groups with no or unstable employments such as daily wage labors
Sanitation and ventilation in those settlements are poor
They have limited access to health care including oral health care
self-medication or alternative medicine rather than professional dental care
Most importantly nutritional deficiency and lack of autonomy in health relation decisions are prevalent in these settlements
following approval from the Institutional Ethics Committee (Approval No.: EC/NEW/INST/2022/3235)
45 participants were selected for the study
Post hoc power analysis using G*Power (version 3.1.9.7) revealed a study power of 98% with an effect size of 0.5
all eligible individuals were provided with a detailed explanation of the study objectives
Participants were informed that their participation was voluntary and that they could withdraw at any stage without any consequences
Written informed consent was obtained from each participant before enrollment
verbal consent was recorded in the presence of a witness
all data collected were anonymized and coded
with no personally identifiable information linked to the research findings
Data were stored securely and were accessible only to the investigators (SP and PR)
Participants eligible for inclusion in the study were adults aged 18–60 years diagnosed with gingivitis
who were willing to meet all study requirements
possessed the cognitive ability to understand and follow oral hygiene instructions
including at least one index tooth to evaluate plaque and OHI-S
Exclusion criteria included individuals who were current smokers or had quit smoking within the past year
or those with systemic diseases that could impact study outcomes
Participants were also excluded if they were on long-term antibiotic therapy
Convenience or purposive sampling was followed by collaborating with local health clinics
or NGOs to identify potential residents of informal settlements who gave their consent to participate
each scored on a five-point Likert scale (1 = strongly disagree to 5 = strongly agree)
Personalized as well as community based oral health education was provided
Each selected participant completed a custom-designed questionnaire (Supplementary Table 1) and responses were recorded in the data extraction sheet
The responses to the questionnaires were collected anonymously without linking responses to individual participants
ensuring complete anonymity in data collection and analysis
Education was delivered at both community and individual levels
Community-level workshops included motivational talks on oral hygiene’s benefits
and dietary influences on oral health The lectures were delivered by faculties and post graduate dental students of community dentistry department outside those settlements addressing small groups of 15 people in three sessions
Audiovisual aids through power point presentation were used to demonstrate the brushing and flossing techniques
one-on-one sessions were tailored to each participant’s specific needs
One on one session was also taken by the faculties and post graduate dental students of community dentistry department
Each participant received an oral hygiene kit
participants were re-evaluated to assess changes in plaque index
and behavioral constructs using the same custom-designed questionnaire from the baseline
We have depicted the methodology schematically in Fig. 1.
Schematic description of the methodology
Data analysis was conducted using SPSS for Mac (version 28
A p-value ≤ 0.05 was considered statistically significant
are presented as frequencies and percentages
The baseline oral health behavior of residents of informal settlements was assessed by summarizing Likert scale responses for each item in the constructs
Paired t-tests compared the means of behavioral constructs
and OHI-S between pre- and post-intervention groups
Cronbach’s alpha measured the internal consistency among questionnaire items
while chi-square tests examined improvements in index grades and associations between behavioral constructs and oral health behavior at T0 and T1
each behavioral construct was assessed in three categories
If the post-intervention score is more than pre-intervention score
If both scores are equal or post intervention score is less than pre-intervention score
The differences in post and pre-intervention score of PI and OHI-S were calculated
To evaluate the influence of change in behavioral constructs on differences in plaque index and OHI-S we conducted multivariate regression analysis
The internal consistency of the questionnaire items was assessed using Cronbach’s alpha
with scores indicating good reliability across all constructs: outcome expectancy (α = 0.751)
These values demonstrated a satisfactory level of internal consistency
supporting the reliability of the measures used in the study
The study comprised of 45 participants who gave consent to participate. The mean age among the study participants was 40.13 ± 11.91. The socio-demographic details are described in Table 1
Majority (n = 17) of the subjects belonged to the age group of 31–45 years of age followed by participants aged 46–60 years
Males comprised of 51.1% of the study population
The habit of tobacco consumption was seen among 66.7% of participants
Baseline responses across the behavioral constructs revealed low outcome expectancy and self-efficacy in practicing good oral hygiene
Only 4.4–13.3% of participants strongly agreed with statements about the positive effects of brushing
while 2.2–6.7% agreed with these statements
0–11.1% strongly agreed on following proper brushing and flossing techniques
most participants displayed low intentions for regular oral hygiene practices
with 42.2% disagreeing that improved oral hygiene could benefit systemic health
The intervention resulted in significant improvements across all items in the four behavioral constructs. Mean scores increased post-intervention for outcome expectancy, self-efficacy, intention, and perceived barriers, with statistical significance (p = 0.000) observed for all items. Pre- and post-intervention mean scores are detailed in Table 2
Post-intervention improvement of behavioral constructs
While the plaque index and OHI-S scores showed overall improvement
and poor) was not statistically significant (Chi square P value = 0.328 for PI and 0.642 for OHI-S) across all groups
The mean difference in PI and OHI-s were found to be 0.13 ± 0.94 and 0.36 ± 1.45 respectively
These values suggested a slight improvement in both the indices
High standard deviations suggested a large variability
Overall model significance in this test did not show any significant effect (Pillai’s Trace value = 0.201
p = 0.83) of behavioral constructs on either PI or OHI-S t
Individual predictor significance in this test showed that SE1 has a potential effect on OHI-S
PB3 (F value = 2.86) and I4 (F value = 2.49) have moderate effect size
though none were statistically significant
Rest of the behavioral constructs did not affect any of the indices
R² values showed that behavioral constructs explain some variance (28.4% for PI
This study evaluated the effectiveness of a comprehensive intervention combining personalized oral hygiene education
behavior modification using HAPA and MI constructs
and provision of a basic oral care kit among residents of informal settlements of Bhubaneswar
Our results indicate significant improvements in oral hygiene behavior which was reflected in improvement of plaque index and OHI-S
supporting the hypothesis that a multifaceted approach can effectively enhance oral health practices among the under-privileged population in low-resource settings
the study indicated that merging behavior modification strategies with direct oral health education and access to basic oral care tools yields a sustainable impact
and intention to maintain regular dental visits
showed positive shifts across the analyzed constructs
These findings support the idea that addressing motivational and practical barriers holistically can enhance long-term oral hygiene adherence
They attributed this to the low socioeconomic status of their participants
which may have hindered behavior change during the interventions
we included the distribution of basic oral hygiene kits to facilitate observable improvements in clinical outcomes
These visible changes could then motivate residents of informal settlement to adopt and sustain positive oral health behaviors
The observed Cronbach’s alpha range for OE
0.740 and 0.747 respectively which indicated that the reliability of the measurement instruments used in this study is good and there is an appreciable level of internal consistency across all constructs
and insufficient knowledge on oral hygiene
highlights the need for targeted interventions among underprivileged populations
These individuals are often at higher risk for oral health issues and less likely to adopt preventive practices
The approach used in this study could be adapted for similar at-risk groups
focusing on both individual and community-level teaching and kit distribution to maximize outreach and impact
the attrition rate in the present study is only 6.25% which further supports the generalizability of this intervention
The significant improvement in all items of SE construct indicated a boost in the participants’ confidence to perform oral hygiene practices which may lead to sustained behavior change
the significant improvement in OE construct explained the strong belief in benefits of appropriate oral hygiene practices which would motivate them to maintain the practice further
Observing the improvement in oral health behavior in the construct
reflected the effectiveness of this mixed intervention in overcoming barriers to oral hygiene practices
highlighted the impact of this intervention on motivation and plans for adapting good oral hygiene practices
The present study’s strength resides in its amalgamation of three interventions
each independently validated for their efficacy in fostering and sustaining oral health behavior
follow-up data were collected only after one month
potentially limiting the demonstration of significant improvements in clinical outcomes and behavioral changes
the sole follow-up session post-intervention allowed for limited interaction time between participants and dentists
we may suggest that future research should incorporate longitudinal assessments at 3
and 12 months to evaluate behavior retention and relapse rates
such as periodic follow-up sessions or digital reminders
could be explored to sustain oral health behavior
the absence of a control group precludes comparative assessments of outcomes
we implemented a quasi-experimental pre-post study design
where each participant served as their own control
Baseline (T0) and post-intervention (T1) assessments allowed us to evaluate changes in behavioral constructs and clinical indices
The statistical significance of these changes strongly suggests the effectiveness of the intervention
Future research incorporating a randomized controlled design with a control group would further validate the intervention’s effectiveness
Although the post hoc power analysis indicated a study power of 98% with an effect size of 0.5 and a significance level of 0.05
the sample size of 45 participants may limit the generalizability of our findings
Future research should aim to recruit a larger and diverse samples to enhance the external validity of the study
Association of these behavioral constructs with improvements in additional clinical parameters such as bleeding on probing
and gingival inflammation can be looked for in future studies which may require long follow up periods
There are several confounding factors which may have influenced the present result
and lack of access to healthcare are some of the possible factors
low educational level among the participants may have influenced their initial understanding of oral hygiene practices
affecting the degree of change observed even after the intervention
cultural norms and traditional beliefs including use of home remedies or reliance on quacks for oral health care
may have affected compliance with the recommended hygiene practices
Financial constraints and competing priorities like daily livelihood concerns could also limit participants’ ability to sustain improved oral hygiene behaviors beyond the intervention period
Future studies should incorporate qualitative assessments to better understand the role of these external factors in behavior modification and intervention effectiveness
this study demonstrates that a holistic approach
effectively improves oral hygiene behaviors and clinical health outcomes among underserved populations
Future studies could explore the long-term sustainability of this model
ideally employing larger sample sizes to further validate its applicability and scalability
which has the potential to mitigate oral health inequalities and enhance overall well-being in underprivileged populations
aligning with broader public health agendas
Available - requests for materials should be addressed to swagatikapanda@soa.ac.in
Oral Health Equals Total Health: A Brief Review
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This research is funded by STS Program of Indian Council of Medical Research
Open access funding provided by Siksha 'O' Anusandhan (Deemed To Be University)
Siksha ‘O’ Anusandhan deemed to be University
Department of Oral Pathology and Microbiology
and manuscript writing; SP – research concept
data curation and manuscript writing; RD – Data collection and manuscript editing; KR – Data collection and manuscript editing
The authors declare no conflicts of interest
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DOI: https://doi.org/10.1038/s41405-025-00329-5
Towards Universal Health Coverage for Oral Health by 2030
WHO convened the first-ever Global oral health meeting in Bangkok
as part of the preparatory process for the 4th United Nations High-level Meeting (HLM4) on NCDs in 2025. This landmark event aimed to accelerate and scale up the prevention and control of noncommunicable diseases (NCDs)
with a particular emphasis on oral diseases
to achieve universal health coverage (UHC) for all
A significant outcome of this meeting was the adoption of the Bangkok Declaration: "No Health Without Oral Health"
Global strategy and action plan on oral health 2023–2030