A federal judge on Wednesday tossed a proposed class-action lawsuit by Jefferson Health patients accusing the Philadelphia area’s largest health system of allowing Facebook’s third-party tracking technology, Meta Pixel, access to private patient information.
District Judge Cynthia M. Rufe rejected the request and dismissed the lawsuit, writing in an opinion that the plaintiffs had “ample opportunity to identify any defects or issues” over the last two years.
“They have not identified any discovery or new evidence to justify such delay, nor have they explained how counsel’s due diligence did not determine the limitations of Plaintiffs’ claims,” Rufe wrote.
The judge noted that the attorneys also missed the deadline to file for class certifications and did not respond to discovery requests.
Attorneys David Cohen and James Zouras of the Stephan Zouras firm, who filed the complaint, did not respond to a request for comment.
The original lawsuit was filed in 2022 in the Eastern District of Pennsylvaniaon behalf of RobertStewart and Nancy Murphy, who said they suspected that their health information had been compromised when they started seeing Facebook ads related to medical issues, such as diabetes, kidney stones, and smoking cessation, that they had discussed with Jefferson providers through the patient portal.
The lawsuit says Jefferson patients were tracked on the health system’s public-facing homepage, as well as within a password-protected portal where doctors and patients communicate.
Jefferson denied in legal filings that it used Meta Pixel on its patient portals. It acknowledged using third-party tracking technology on its public-facing websites, which do not contain private medical information.
Jefferson did not respond to a request for comment.
In April, Cohen and Zouras asked the court to replace Stewart and Murphy with a third patient, Cathryn Thorpe, as the named plaintiff representing the patients in the class action.
The attorneys said Stewart and Murphy would remain members of the proposed class of harmed patients.
Jefferson’s attorneys argued in court filings that the request to replace the named plaintiffs was an admission that there was “no live controversy” and the suit should be tossed out.
Rufe could not square how the patients’ case was too problematic to serve as named plaintiffs but they couldstill remain members of the class. She denied the request and dismissed the lawsuit.
The Trump administration said Tuesday it was breaking up one of the world’s preeminent earth and atmospheric research institutions, based in Colorado, over concerns about “climate alarmism” — a move that comes amid escalating attacks from the White House against the state’s Democratic lawmakers.
“The National Science Foundation will be breaking up the National Center for Atmospheric Research (NCAR) in Boulder, Colorado,” wrote Russell Vought, the director of the White House Office of Management and Budget on X. “This facility is one of the largest sources of climate alarmism in the country.”
The plan was first reported by USA Today.
The NCAR laboratory in Boulder was founded in 1960 at the base of the Rocky Mountains to conduct research and educate future scientists. Its resources include supercomputers, valuable datasets, and high-tech research planes.
The announcement drew outrage and concern from scientists and local lawmakers, who said it could imperil the country’s weather and climate forecasting, and appeared to take officials and employees by surprise.
NCAR’s dismantling would be a major loss for scientific research, said Kevin Trenberth, a distinguished scholar at NCAR and an honorary academic in physics at the University of Auckland in New Zealand.
Trenberth, who joined NCAR in 1984 and officially retired in 2020, said the research center is key to advanced climate science discoveries as well as in informing the climate models that produce the weather forecasts we see on the nightly news.
Colorado Gov. Jared Polis said in a statement that the state had not received information about the administration’s intentions to dismantle NCAR.
“If true, public safety is at risk and science is being attacked,” said Polis. “Climate change is real, but the work of NCAR goes far beyond climate science. NCAR delivers data around severe weather events like fires and floods that help our country save lives and property, and prevent devastation for families.”
The action comes as Republicans have escalated their attacks on Polis and others in the state for their handling of a case involving Tina Peters, a former county clerk in Colorado who was convicted in state court on felony charges related to efforts to overturn the 2020 presidential election. President Donald Trump announced last week that he is pardoning Peters, who is serving a nine-year sentence, but it is unclear whether Trump has that authority, because she was not convicted in federal court.
In a joint statement, Colorado’s two Democratic senators, John Hickenlooper and Michael Bennet, and Rep. Joe Neguse (D., Colo.) slammed the move and vowed to fight back against it.
In his social media post, Vought said that “any vital activities such as weather research will be moved to another entity or location” — but did not specify further.
“The Colorado governor obviously isn’t willing to work with the president,” said a White House official, who spoke on the condition of anonymity because they were not authorized to discuss the matter publicly.
The official declined to cite any specifics about how Polis is refusing to cooperate, from the administration’s perspective, but denied that the move was in response to the state’s refusal to release Peters from prison.
The facility “is not in line with the president’s agenda,” the official added, noting that it had “been on the radar” of the administration “for a while.”
The National Science Foundation, the federal science agency that funds the center, was blindsided by the announcement, according to a person familiar with NSF operations who spoke on the condition of anonymity to avoid retribution. But they said facilities managers at NSF will need to be involved in moving assets or capabilities. An NSF spokesman did not immediately respond to questions about the plan to dismantle NCAR.
Antonio Busalacchi, the president of the University Corporation for Atmospheric Research, which oversees NCAR, said it was aware of reports to break up the center but did not have “additional information about any such plan.”
“Any plans to dismantle NSF NCAR would set back our nation’s ability to predict, prepare for, and respond to severe weather and other natural disasters,” Busalacchi said.
An internal email obtained by the Washington Post, sent Tuesday night, emphasized the critical work NCAR does for “community safety and resilience.”
Busalacchi wrote that the news had come as a shock, and the institution had reached out to NSF for more information. “We understand that this situation is incredibly distressing, and we ask that you all continue doing what you have done so well all year — provide support for one another as we navigate this turbulent time,” Busalacchi wrote.
The center is “quite literally our global mother ship,” Katharine Hayhoe, a Texas Tech University professor and chief scientist for the Nature Conservancy, wrote on X. “Dismantling NCAR is like taking a sledgehammer to the keystone holding up our scientific understanding of the planet.”
NCAR plays a unique role in the scientific community by bringing together otherwise siloed specialists to collaborate on some of the biggest climate and weather questions of our time, Caspar Ammann, a former research scientist at the center, said in an email.
“Without NCAR, a lot could not happen,” he said. “A lot of research at US Universities would immediately get hampered, industry would lose access to reliable base data.”
Ammann added that around the world, weather and climate services use NCAR modeling and forecasting tools.
The Colorado-based center draws scientists and lecturers from all over the world, and through its education programs has helped produce future scientists, Trenberth said.
He said he feared not just for the discoveries and data that would be lost if the center were to close, but for the early careers that could also be affected or destroyed.
“If this sort of thing happens, things will go on for a little while,” he said. “But the next generation of people who deal with weather and science in the United States will be lost.”
Four moderate Republicans — including three who are in the hot seat for reelection in swing districts in Pennsylvania — joined Democrats to sign a discharge petition Wednesday to force a vote on a proposal to extend pandemic-era expanded Obamacare subsidies.
While the move may not save the subsidies from expiring, given that Republican-controlled Senate has indicated resistance to the plan, the votes mark the sharpest rebuke of party leadership from within the GOP since President Donald Trump started his second term.
U.S. Rep. Brian Fitzpatrick, who has represented Bucks County since 2017, and two GOP freshmen from elsewhere in the state, U.S. Reps. Rob Bresnahan and Ryan Mackenzie, joined New York moderate Mike Lawler to give Democrats the votes they needed to push a vote on a clean extension of the subsidies to the floor.
The move comes on the heels of other high-profile examples of rank-and-file Republicans bucking Trump and House Speaker Mike Johnson, including last month’s bipartisan vote to release the Jeffrey Epstein files, following a discharge petition after Johnson had slow-walked the legislation.
The “dam is breaking,” U.S. Rep. Marjorie Taylor Greene (R., Ga.) told CNN on Tuesday in reference to the string of incidents in which members of the party had defied the president and speaker ahead of next year’s midterms.
The Republicans who defected on the healthcare bill had favored a compromise that they hoped might have a chance of passing Congress, but that was rejected by Johnson (R., La.), who sided with conservatives against expanding the subsidies, on Tuesday night.
That left them supporting a vote on a bill that extends the program as is, with far fewer restrictions and concessions than the compromise bills included.
“Despite our months-long call for action, leadership on both sides of the aisle failed to work together to advance any bipartisan compromise, leaving this as the only way to protect the 28,000 people in my district from higher costs,” Bresnahan said in a statement posted on X.
“Families in NEPA cannot afford to have the rug pulled out from under them. Doing nothing was not an option, and although this is not a bill I ever intended to support, it is the only option remaining. I urge my colleagues to set politics aside, put people first, and come together around a bipartisan deal.”
Later Wednesday, House Republican leaders pushed to passage a healthcare bill that does not address the soaring monthly premiums that millions of people will soon endure. The bill passed on a mostly party-line vote of 216-211. U.S. Rep. Thomas Massie (R., Ky.) joined with Democrats in voting against the measure.
Fitzpatrick and Lawler tried to add a temporary extension of the subsidies to the bill, but were denied.
“Our only request was a floor vote on this compromise, so that the American People’s voice could be heard on this issue. That request was rejected. Then, at the request of House leadership I, along with my colleagues, filed multiple amendments, and testified at length to those amendments,” Fitzpatrick said in a statement. “House leadership then decided to reject every single one of these amendments.
“As I’ve stated many times before, the only policy that is worse than a clean three-year extension without any reforms, is a policy of complete expiration without any bridge,” Fitzpatrick said.
Bresnahan’s vote for the discharge petition came a little more than a week after he welcomed Trump to his Northeast Pennsylvania district for a rally, which was meant to address voter concerns about affordability ahead of next year’s midterms.
Bresnahan won his election last year by about 1 percentage point. He was also one of just 20 House Republicans to sign a successful discharge petition earlier this month to force a vote for collective bargaining to be restored for federal workers.
“At the end of the day that might have been going against party leadership, but it was what’s right for northeastern Pennsylvania,” he told The Inquirer of the vote at the Pennsylvania Society last weekend.
Rep. Brian Fitzpatrick (R-Pennsylvania) speaks at a hearing on Capitol Hill on Dec. 3.
Mackenzie, in an interview with The Inquirer, blamed Democrats for not signing on to one of the compromise proposals, leaving him and the other three Republicans with no alternative but to sign onto a discharge for a plan he doubts will pass.
“But if you send the Senate anything at this point, I’m of the opinion it will continue the conversation and they’ll consider what their options are,” Mackenzie said. “If they would like to do additional reforms, I welcome those.”
While Republicans who have opposed the extension argue the subsidies were meant to be temporary and affect only about 7% of Americans, Mackenzie said he has been hearing from constituents constantly.
“Healthcare and the current system is unaffordable for many people,” he said. “We recognize the current system is broken for millions of Americans, so to actually get to some kind of better position, you need both short-term and long-term solutions.”
He called the Affordable Care Act subsidy extension a needed short-term solution “to do something for people struggling right now.”
Like Bresnahan, Mackenzie won his Lehigh Valley seat by 1 percentage point last year. And the district will be a top priority for both parties in next year’s election — as shown by Vice President JD Vance’s visit there Tuesday.
U.S. Rep. Scott Perry, a staunch Trump ally, represents a swing district in Central Pennsylvania but voted against the discharge petition. Janelle Stelson, a Democrat seeking Perry’s seat, called him “extreme” for voting against the measure.
“While other Republicans are working across party lines to lower costs, Perry is yet again refusing to do anything to make life more affordable,” said Stelson, who narrowly lost to Perry last year.
Some Republicans do not want to extend the credits at all, while others want abortion restrictions included.
Democrats hoping to unseat Fitzpatrick argue he has a record of pushing back on Trump and GOP leaders only in ways that do not actually damage the party or its priorities. In this case, though, the three Pennsylvanians were critical in getting the petition through, even if the future of ACA tax credits remains uncertain.
“The only thing Brian Fitzpatrick has perfected in his 9 years in Congress is the art of completely meaningless gesture, designed to protect his political future not the people he serves,” his Democratic challenger, Bucks County Commissioner Bob Harvie, wrote on X.
Harvie had previously called on Fitzpatrick to sign the Democrats’ discharge petition.
Not all ACA tax credits are under threat. Under the ACA, people who earn less than 400% of the federal poverty level — about $60,000 — are eligible for tax credits on a sliding scale, based on their income, to help offset the monthly cost of an insurance premium.
That tax credit is part of the law, and therefore not expiring. But what will expire is an expansion passed in 2021 when Congress increased financial assistance so that those buying coverage through an Obamacare marketplace do not pay more than 8.5% of their income.
This article includes information from the Associated Press.
CAPE CANAVERAL, Fla. — Saturn’s giant moon Titan may not have a vast underground ocean after all.
Titan instead may hold deep layers of ice and slush more akin to Earth’s polar seas, with pockets of melted water where life could possibly survive and even thrive, scientists reported Wednesday.
The team led by researchers at NASA’s Jet Propulsion Laboratory challenged the decade-long assumption of a buried global ocean at Titan after taking a fresh look at observations made years ago by NASA’s Cassini spacecraft around Saturn.
They stress that no one has found any signs of life at Titan, the solar system’s second-largest moon spanning 3,200 miles and brimming with lakes of liquid methane on its frosty surface.
But with the latest findings suggesting a slushy, near-melting environment, “there is strong justification for continued optimism regarding the potential for extraterrestrial life,” said the University of Washington’s Baptiste Journaux, who took part in the study published in the journal Nature.
As to what form of life that might be, possibly strictly microscopic, “nature has repeatedly demonstrated far greater creativity than the most imaginative scientists,” he said in an email.
JPL’s Flavio Petricca, the lead author, said Titan’s ocean may have frozen in the past and is currently melting, or its hydrosphere might be evolving toward complete freezing.
Computer models suggest these layers of ice, slush, and water extend to a depth of more than 340 miles. The outer ice shell is thought to be about 100 miles deep, covering layers of slush and pools of water that could go down another 250 miles. This water could be as warm as 68 degrees Fahrenheit.
Because Titan is tidally locked, the same side of the moon faces Saturn all the time, just like our own moon and Earth. Saturn’s gravitational pull is so intense that it deforms the moon’s surface, creating bulges as high as 30 feet when the two bodies are closest.
Through improved data processing, Petricca and his team managed to measure the timing between the peak gravitational tug and the rising of Titan’s surface. If the moon held a wet ocean, the effect would be immediate, Petricca said, but a 15-hour gap was detected, indicating an interior of slushy ice with pockets of liquid water. Computer modeling of Titan’s orientation in space supported their theory.
Sapienza University of Rome’s Luciano Iess, whose previous studies using Cassini data indicated a hidden ocean at Titan, is not convinced by the latest findings.
While “certainly intriguing and will stimulate renewed discussion … at present, the available evidence looks certainly not sufficient to exclude Titan from the family of ocean worlds,” Iess said in an email.
NASA’s planned Dragonfly mission — featuring a helicopter-type craft due to launch to Titan later this decade — is expected to provide more clarity on the moon’s innards. Journaux is part of that team.
Saturn leads the solar system’s moon inventory with 274. Jupiter’s moon Ganymede is just a little larger than Titan, with a possible underground ocean. Other suspected water worlds include Saturn’s Enceladus and Jupiter’s Europa, both of which are believed to have geysers of water erupting from their frozen crusts.
Launched in 1997, Cassini reached Saturn in 2004, orbiting the ringed planet and flying past its moons until deliberately plunging through Saturn’s atmosphere in 2017.
WASHINGTON — Four centrist Republicans broke with Speaker Mike Johnson on Wednesday and signed onto a Democratic-led petition that will force a House vote on extending for three years an enhanced pandemic-era subsidy that lowers health insurance costs for millions of Americans.
The stunning move comes after House Republican leaders pushed ahead with a health care bill that does not address the soaring monthly premiums that millions of people will soon endure when the tax credits for those who buy insurance through the Affordable Care Act expire at year’s end.
Democrats led by Minority Leader Hakeem Jeffries of New York needed 218 signatures to force a floor vote on their bill, which would extend the subsides for three years.
Republican Reps. Brian Fitzpatrick, Robert Bresnahan and Ryan Mackenzie, all from Pennsylvania, and Mike Lawler of New York signed on Wednesday morning, pushing it to the magic number of 218. A vote on the subsidy bill could come as soon as January under House rules.
“Unfortunately, it is House leadership themselves that have forced this outcome.” Fitzpatrick said in a statement.
Johnson told reporters Wednesday that “I have not lost control of the House” and he noted that Republicans have a razor-thin majority that allows a small number of members to employ procedures that would not usually be successful in getting around leadership.
The revolt against GOP leadership came after days of talks centered on the health care subsidies.
Johnson had discussed allowing more politically vulnerable GOP lawmakers a chance to vote on bills that would temporarily extend the subsidies while also adding changes such as income caps for beneficiaries. But after days of discussions, the leadership sided with the more conservative wing of the party’s conference, which has assailed the subsidies as propping up a failed marketplace through the ACA, which is widely known as “Obamacare.”
House Republicans pushed ahead Wednesday a 100-plus-page health care package without the subsidies, instead focusing on long-sought GOP proposals designed to expand insurance coverage options for small businesses and the self-employed.
Fitzpatrick and Lawler tried to add a temporary extension of the subsidies to the bill, but were denied.
“Our only request was a floor vote on this compromise, so that the American People’s voice could be heard on this issue. That request was rejected. Then, at the request of House leadership I, along with my colleagues, filed multiple amendments, and testified at length to those amendments,” Fitzpatrick said. “House leadership then decided to reject every single one of these amendments.
“As I’ve stated many times before, the only policy that is worse than a clean three-year extension without any reforms, is a policy of complete expiration without any bridge,” Fitzpatrick said.
Lawler, in a social media post, similarly said that “the failure of leadership” to permit a vote had left him with “no choice” but to sign the petition. He urged Johnson to bring the plan up for an immediate floor vote.
Jeffries, for several weeks, had called on Republicans to sign his discharge petition. He particularly challenged Republicans in competitive congressional districts to join the effort if they really wanted to prevent premium increases for their constituents.
“Mike Johnson needs to bring the bill to the floor today,” Jeffries said. “Our position from the very beginning was that we are standing on the right side of the American people who want to see the Affordable Care Act tax credits extended, and we’re appreciative that we now have the bipartisan coalition to get that done.”
Path ahead is uncertain
Even if the subsidy bill were to pass the House, which is far from assured, it would face an arduous climb in the Republican-led Senate.
Republicans last week voted down a three-year extension of the subsidies and proposed an alternative that also failed. But in an encouraging sign for Democrats, four Republican senators crossed party lines to support their proposal.
Senate Majority Leader John Thune, R-S.D., argued against the Democratic extension as “an attempt to disguise the real impact of Obamacare’s spiraling health care costs.”
Pediatrician Kristin Sohl has lost count of how many times parents of children with autism have asked her for a prescription for leucovorin — the drug thrust into the spotlight after President Donald Trump touted it at a White House event this fall.
Since September, despite the rising queries, Sohl has typically told her patients no.
Early clinical trials of the drug showed hints of promise in boosting communication and cognition for some children with autism. But the studies have been small, often just a few dozen participants. Normally, approval by the Food and Drug Administration comes only after years of large-scale testing. But Trump’s pledge to fast-track the drug in September, bypassing that process, has left many doctors on the front lines divided.
“It leaves me as a practicing physician with a lot of unanswered questions,” said Sohl, a professor of pediatrics at the University of Missouri School of Medicine, who has been working in the field of autism for over 20 years.
As interest in the drug surges, Facebook groups devoted to it are swelling in membership, message boards are inundated with questions, and Google searches are climbing. Physicians, who typically rely on evidence-based guidelines and clear treatment algorithms, are finding that with leucovorin they must — lacking robust scientific data — improvise. Some are cautiously moving forward with prescribing the drug, but many are still holding off.
At Children’s National Hospital in Washington, D.C., neurodevelopmental pediatrician Sinan Turnacioglu said the hospital convened a meeting of various departments — including those specializing in autism, developmental pediatrics, genetics and psychiatry, as well as primary care doctors — to come up with a systemwide policy. Their conclusion: that they would like to see more robust research before prescribing it.
Peter Crino, chair of neurology at the University of Maryland School of Medicine and who runs a clinic for neurodivergent adults, likewise said he believes the medication is not ready for prime time.
“People are asking me a lot about it, but I do not prescribe it. Gosh I hope there will be something to the drug and it will help people in the future, but the data is simply not there yet,” he said.
Limited evidence
Each conversation Sohl has with families unfolds differently, she said, shaped by a child’s history, a parent’s worry, a flicker of hope. But the script she follows is steady: she lays out what research has shown — and what it doesn’t — about the treatment, then asks what the family hopes the drug might change.
In a field with no cure and few therapies, she uses that same framework to guide discussions about the other latest supposed breakthroughs drifting across social media — broccoli extracts, CBD oil, stem cell therapy, and more. The goal isn’t to dismiss any ideas outright but to ground them in evidence, or show the lack of it, before families decide what to do next.
For leucovorin, Sohl’s main message is that “we’re not on solid science yet.” However, there are “potential suggestions of benefit.”
Leucovorin or folinic acid has a long history of use in the context of cancer for about 50 years. It’s been shown to protect healthy cells from the toxic effects of one particular chemotherapy drug and to enhance the effectiveness of another one. Side effects were very minimal but in cancer patients have included nausea and fatigue.
For some children with autism, the immune system may produce antibodies that block the body’s ability to move folate — a vitamin essential for cell growth and DNA production — into the brain. Leucovorin, a prescription form of folate, offers a potential workaround. It crosses the blood-brain barrier by a different route, delivering the nutrient where it’s needed.
The U.S. clinical trial that got Trump’s attention is being conducted by Richard E. Frye, a pediatric neurologist who was formerly an associate professor at Arizona Children’s Hospital in Phoenix. Its design was considered the gold standard — a randomized, double-blind placebo-controlled trial — but it only had 48 children, ages 5 to 12, in it. In the trial — published in 2018 in the journal Molecular Psychiatry — the drug was well-tolerated and the parents and doctors reported improvements in communication and behavior.
Frye said in an interview that leucovorin did not work on all of his patients. But it did work for many and that children with no verbal utterances began showing meaningful word approximations, for example, and that those with phrase speech began forming full sentences.
There have been four subsequent trials in other countries, and all four of them also reported significant improvements and no serious harm. But they were also very small. A study in France with 19 patients was published in 2020, in Iran with 55 patients in 2021, in India with 40 patients in 2024, and in China with 80 patients in 2025.
The Trump administration latched onto promising research and promoted efforts to expand access to leucovorin for autism, despite the lack of large-scale clinical trials.
But since then, doctors have been proceeding cautiously. At least two influential medical societies have come out with their own interim recommendations. The American Academy of Pediatrics and the Society for Developmental & Behavioral Pediatrics both do not recommend the routine use of leucovorin for children with autism. But the AAP left an opening for doctors to prescribe it, stating that pediatric care providers “are encouraged to engage in shared decision-making with families who inquire about or request leucovorin, providing clear information about current evidence and potential risks.”
Crino said that many medical research papers — including those on leucovorin — are written in ways families can understand, and he encourages patients and their families to read the primary studies themselves. He often reviews the papers with them, he added, pointing out the limitations of the research. In the 2024 study, which was published in the European Journal of Pediatrics, for example, the authors reported that many children showed improvements in speech, but none went from nonspeaking to speaking, and the study offered no evidence about whether those changes affected daily life.
“There is a lot going on in scientific research that is getting twisted,” he said.
Turnacioglu said that some of his patients receive leucovorin from other providers. In those cases, he focuses on monitoring their progress by first establishing a baseline assessment of language and adaptive skills and then repeating the same evaluations periodically to track any changes.
In those cases, he focuses on monitoring their progress by first establishing a baseline assessment of language and adaptive skills and then repeating these evaluations periodically to track any changes.
He said the growing interest in leucovorin reflects a broader shift toward more personalized autism treatments, fueled by recent research that supports what clinicians have long observed: autism is not a uniform condition that exists along one continuous spectrum, but rather a collection of distinct conditions that have been grouped under a single label. As a result, different people may require different treatments.
“We don’t yet have enough information to use those findings to guide leucovorin treatment,” Turnacioglu said. “But it’s the kind of direction I’m excited about — figuring out which patients are going to respond to particular treatments.”
An exception
Sohl is part of a team of pediatricians who helped draft the AAP guidelines.
The patients that have approached her are all ages and across the spectrum, including adults and individuals with strong verbal skills. For months, she’d explained her reasons for holding back on leucovorin, and most families accepted them.
Then, in October, a patient sat across from her and she began to wonder if this might be an exception.
He was a teen boy she describes as minimally speaking, whom Sohl had been treating for 10 years. She was impressed by his knowledge of the research on leucovorin, his deep and realistic understanding of the potential risks and benefits, and his eagerness to document any changes both quantitatively and in narrative form. Sohl will be meeting with her patient each month to go over any changes.
“I have low expectations, his mom has low expectations, he has low expectations. But we all agreed it was worth a therapeutic trial,” Sohl said.
With the recent national attention, information about leucovorin has been spreading online far faster than through the slow, methodical channels of medical research, where studies and peer-reviewed papers can take years to emerge. She learns from the parents and patients who are often the first to encounter new ideas circulating in their communities and online.
Sohl tells families that while the drug has shown very little in the realm of side effects, this is in the context of adults with cancer, not children with autism. She said she emphasizes that she does not think this is a dangerous medicine, but there has not been enough research.
“I think it’s my duty as a doctor to say that I don’t know,” Sohl said, “and I want you to know I don’t know.”
At first, the mental health-related videos that popped up on Amy Russell’s TikTok feed made her feel seen. The tips and funny anecdotesabout living with ADHDreminded her of herself — maybe her forgetfulness wasn’t a flaw but a symptom.
After two years of learning about the condition on TikTok, she went to a doctor for an assessment. The resulting diagnosis changed her life for the better, she said, as she started taking medication and using strategies to manage daily tasks. She attributes the transformation in part to TikTok.
There’s just one problem: Now she can’t get the ADHD videos off her feed. The more she scrolls, the stranger and less trustworthy the content becomes, she said. Her efforts to see less of it — scrolling past videos and not engaging — don’t seem to help.
“You just keep finding more tunnels and it gets harder to find your way out,” Russell, 35, said.
She’s not imagining it. TikTok’s algorithm favorsmental health content over many other topics, including politics, cats, and Taylor Swift, according to a Washington Post analysis ofnearly 900 U.S. TikTok users who shared their viewing histories. The analysis found that mental health content is “stickier” than many other videos: It’s easier to spawn more of it after watching with a video, and harder to get it out of your feed afterward.
“It felt like a rabbit hole to me because you kept going down deeper and deeper,” Russell said.
TikTok uses an algorithm to select a video and gives users two main options: Watch it or skip past to something else. Along the way, the app learnswhat a user like Russell likes and dislikes, based on her watching and skipping behavior. It takes skipping past 1.3 videos, on average, to undo the effect of watching one full video about cats or politics, The Post analysis found. For mental health, it takes 2.2 skips — meaning users must work harder to get it out of their feeds.
TikTok spokesperson Mahsau Cullinane criticized The Post’s methodology as incomplete and said it doesn’t “reflect the reality of how our recommendation system works.”
This finding comes amid a broader debate on the role of algorithms and influencers in Americans’ understanding of mental health. Content about mental illness and neurological differences is extremely popular across social media apps, with about as many TikTok posts using the hashtag #mentalhealth as those that mention #sports, according to data from analytics firm Sprout Social. Mental health content on TikTok deals with not just conditions like depression or anxiety, but also living with a neurological type such as ADHD or autism.
People are turning to social media for health information as Americans face a shortage of mental health professionals, barriers to accessing and paying for care, and lingering stigma. Information from social media helps underserved and underdiagnosed populations better understand themselves, many users say. What happens next, however, is rarely examined.
Over the period that The Post examined Russell’s TikTok data, about one in 11 videos on her feed were mental-health-related. Russell, who spent more than an hour watching videos on many days, said the more she scrolled, the more often she saw videos from nonprofessionals that seemed designed to get a reaction rather than educate.
Efforts to evaluate mental health content on TikTok support Russell’s impression.Anthony Yeung, a psychiatrist and University of British Columbia researcher, ran a study examining 100 top TikTok videos about ADHD and found that some were helpful, but about half were misleading. (Videos about creators’ personal experiences weren’t classified as misleading.) Other reviews of TikTok content about ADHD and autism by mental health practitioners have found similar results.
“The algorithm says, ‘Well, you like this video about ADHD, even though it’s misleading, let’s give you another video,’” Yeung said. “And it becomes this very vicious feedback loop of misinformation.”
The phenomenon is having a profound effect on real-world mental health treatment, clinicians say. Yeung said he deals with “two visions of what ADHD is”: the one discussed on social media and the one he sees among actual patients. On TikTok, ADHD content often paints with a broad brush, portraying common quirks or struggles as not just personal experiences but diagnostic criteria for the condition.
One popular ADHD account, @lifeactuator, regularly earns views in the millions with titles like “What ADHD feels like” and “Things people with ADHD do despite knowing better.”One widely watched video with the caption “if the world was made for ADHD” depicts a Costco store with ADHD shoppers being chased around by store employees to stop them from making impulse purchases.
Eric Whittington, the Arizona-based creator behind @lifeactuator, said that because of the constraints of short-form video, he’s not able to include all the information viewers might need to understand what, if anything, his videos reflect about ADHD as an actual medical condition. Taken individually, his videos probably apply to a broad swath of the population, he said — not just people with ADHD.
“When you only have a minute to work with, it’s hard to add disclaimers on the content saying, ‘Yes, everybody experiences this from time to time, but if it happens all the time, you may have ADHD,’ ” he said.
Rana Coniglio, an Arizona-based therapist who works primarily with Gen Z clients, said they often arrive at her practice already attached to a diagnosis they found on TikTok. Sometimes, that attachment makes it harder to accurately diagnose or make a treatment plan that could improve that person’s symptoms.
“I have had people come to me and say, ‘Hey, I saw this video on TikTok and it’s actually the reason that I’m seeking therapy because it made me think I actually do need help,’ and there are benefits to that,” she said. “But I think the majority of people see a diagnosis, take it and run with it.”
High volume, low quality
For Ace Bannon, a 19-year-old in Utah, the more he watched, the darker the content became.
Bannon first got curious about autism and its characteristics after learning that many of his best friends — people he’d met on a Discord server — were autistic. He started watching TikTok videos, with content about autism taking up a growing chunk of his feed. Then, TikTok served him video after video of autistic adults discussing the trauma they endured as children, Bannon said. Before long, he wanted his old algorithm back.
“Because you’re interested, it starts recommending more of those videos and it makes you fall into these rabbit holes that you just want to get out of after a while, but you can’t.”
Sometimes this experience actually exacerbates existing mental health problems, some users say. Kailey Stephen-Lane, 30, said she had to temporarily stop using the app because spending time on TikTok was worsening the symptoms of her obsessive compulsive disorder. While her real-life therapist was helping her sit with fears and insecurities without fixating, TikTok was “bombarding” her with videos about the very symptoms that made her so anxious, she said.
“The TikToks that I’ve been getting are not helpful to my recovery,” she said. “They lead me down a lot of spirals, and me just clicking ‘not interested’ doesn’t seem to work anymore.“
TikTok provides a high-level description of some of the data its algorithm uses but few details. That makes it difficult to know why mental health videos are stickier than other topics, says Stevie Chancellor, an engineering professor at the University of Minnesota who studies AI and its risks, and whose research found that the algorithm creates a “runaway train” of mental health content.
But the app’s business incentives offer some clues, Chancellor says. Maybe users who see a lot of mental health videos spend longer on the platform or are more likely to spend money down the line, she said. Maybe the effect is completely unintentional, an example of a black-box algorithm optimizing for what it thinks users want.
“Watching [mental health] content might lead to other behaviors that are valuable on the platform,” Chancellor said.
The topic may become sticky because it’s one “that a user only wants to engage with sometimes,” said Laura Edelson, a computer science professor at Northeastern University who collaborated with The Post in a parallel TikTok research effort.
Cullinane, the TikTok spokesperson, said the company is “transparent” about how its feed works.
For TikTok users, adjusting the type of content that shows up on their feeds can be hard. It’s not always clear when engaging with a certain video would spawn something undesirable: Even watching clips about romantic relationships made a user more likely to encounter mental health content, The Post’s analysis found. TikTok has gradually added options that could help users tailor their feeds, such as clicking a “not interested” button, blocking videos with certain keywords or resetting their algorithms from scratch. A new “Manage Topics” menu lets users adjust the prevalence of 12 specific topics on their For You page — but mental health isn’t one of them.
As for Russell, she is glad for the journey toward an ADHD diagnosis because of TikTok. She just wishes her favorite type of content — lighthearted cat videos — got the same treatment from the app’s algorithm.
“I want like 10-20% cute cat videos, probably even like 30%,” she said. “But those disappear really quickly.”
Methodology
Hundreds of TikTok users in the United States sent their watch history data to The Washington Post. We downloaded the collective 14.8 million videos they’d been shown and then sorted them into topics, based on keywords in the transcripts and on-screen text. The Post calculated the stickiness of each topic by computing the difference between the number of topical mental health videos each user had been shown in the previous 50 videos and how many they saw in the next 50. We averaged this for all videos, aggregated by whether the user watched at least 90% of the video, or skipped it.
Capstan Therapeutics’ sale this year for $2.1 billion, the highest price paid for a private early-stage biotech company since 2022, was a triumph for its founders at the University of Pennsylvania.
Unfortunately for Philadelphia, the company is based in San Diego. Investors wanted an executive who lives there to be CEO.
Capstan was a miss for Philadelphia, said Jeffrey Marrazzo, who cofounded a high-profile regional biotech company, Spark Therapeutics, and is now an industry investor and consultant.
If Philadelphia had a bigger talent pool of biotech CEOs, “it would have and should have been here,” he said.
The Philadelphia region has lagged behind other biotech centers in landing companies and jobs, but industry experts are working to close the gap and better compete with Boston, the San Francisco Bay Area, and San Diego.
According to Marrazzo and others, the Philadelphia region’s relatively shallow pool of top biotech management is a key challenge.
Big investors go to managers who have proven ability to deliver big investment returns, said Fred Vogt, interim CEO of Iovance Biotherapeutics, a California company with a manufacturing facility in the Navy Yard.
“They want the company to perform. They’ll put it in Antarctica, if that was where the performance would come from,” he said.
The Lilly announcement last month also reflects Philadelphia’s national biotech stature. It’s the fourth U.S. city to get a Lilly Gateway Lab, behind Boston, the San Francisco Bay Area, and San Diego.
Those places have far outpaced Philadelphia in the creation of biotech research and development jobs, even as the sector’s growth has slowed.
From 2014 through last year, the Boston area added four biotech research and development jobs for every one job added here, according to an Inquirer analysis of federal employment data.
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Penn’s role in Philadelphia biotech
Philadelphia’s reputation as an innovation center — boosters like to call the region “Cellicon Valley” — starts with the University of Pennsylvania, which has long been a top recipient of National Institutes of Health grants to advance scientific discovery.
Research at Penn has contributed to the creation of 45 FDA-approved treatments since 2013, according to the university.
“Penn discoveries help spark new biotech companies, but we can’t build the whole ecosystem in this area alone,” said John Swartley, Penn’s chief innovation officer. “Great science is just one ingredient. We also need capital, experienced leadership, real estate and manufacturing infrastructure, and strong city and state support.”
Penn was one of two Philadelphia institutions receiving more than $100 million in NIH funding in the year that ended Sept. 30. The otherwas the Children’s Hospital of Philadelphia.
Katalin Karikó and Drew Weissman spoke at a University of Pennsylvania news conference after they were named winners of a 2023 Nobel Prize in medicine. Their work was instrumental to modifying mRNA for therapeutic uses, such as the rapid development of lifesaving vaccines during the COVID-19 pandemic.
By contrast, the Boston area was home to 10 institutions with at least $100 million in NIH grants, generating more spinoffs and jobs.
The Philadelphia region has a healthy number of biotech spinouts, but the biggest markets have more from a larger number of research institutions, said Robert Adelson, founder Osage University Partners, a venture capital firm in Bala Cynwyd.
That concentration of jobs and companies in the Boston area — where nearly 60,000 people worked in biotech R&D last year — makes it easier to attract people. By comparison, there were 13,800 such jobs in Philadelphia and Montgomery County, home to the bulk of the regional sector.
If a startup fails, which happens commonly in biotech, “there’ll be another startup or another company for me to go to” in a place like Boston, said Matt Cohen, a managing partner for life science at Osage.
Another challenge for Philadelphia: It specializes in cell and gene therapy, a relatively small segment of the biotech industry, whose allure to investors has faded in the last few years.
Such market forces shaped the trajectory of Spark, a 2013 Children’s Hospital of Philadelphia spinout that developed Luxterna, the first FDA-approved gene therapy, used to treat an inherited form of blindness. The promise of Spark’s gene therapy work for a form of hemophilia spurred its 2019 acquisition by Swiss pharmaceutical titan Roche for $4.8 billion.
The company still employs about 300 in the city, a spokesperson said, and work continues on its $575 million Gene Therapy Innovation Center at 30th and Chestnut Streets in University City.
The long arc of biotech
A handful of companies dominated the early days of U.S. biotech. Boston had Biogen and Genzyme, San Francisco had Genentech, San Diego had Hybritech, and Philadelphia had Centocor. All of them started between 1976 and 1981.
Centocor started in the University City Science Center because one of its founders, virologist Hilary Koprowski, was the longtime director of the Wistar Institute. Centocor’s first CEO, Hubert Schoemaker, moved here from the Boston area, where he had gotten his doctorate at the Massachusetts Institute of Technology.
Another drug still under development at the time of the sale, Stelara, went on to become J&J’s top-selling drug as recently as 2023 with $10.9 billion in revenue. Stelara, approved to treat several autoimmune disorders, remains a testament to Centocor’s legacy.
Despite its product success, Centocor didn’t have the same flywheel effect of creating new companies and a pipeline of CEOs as peer companies did in regions outside of Philadelphia.
The University of Pennsylvania’s Smilow Center for Translational Research, shown in 2020, is one of the school’s major laboratory buildings.
“There are a lot of alums of Centocor that are really impressive, but they seem to have wound up elsewhere,” said Bill Holodnak, CEO and founder of Occam Global, a New York life science executive recruitment firm.
Among the Centocor executives who left the region was Harvey Berger, Centocor’s head of research and development from 1986 to 1991. He started a new company in Cambridge, Mass.
At the time, the Philadelphia area didn’t have the infrastructure, range of scientists, or management talent needed for biotech startups, he said.
Since then, he thinks the regional market has matured.
“Now, there’s nothing holding the Philadelphia ecosystem back. The universities, obviously Penn, and others have figured this out,” Berger said.
Conditions have changed
Penn’s strategy for helping faculty members commercialize their inventions has evolved significantly over the last 15 years.
It previously licensed the rights to develop its research to companies outside of the area, such as Jim Wilson’s gene therapy discoveries and biochemist Katalin Karikó and immunologist Drew Weissman’s mRNA patents. Now it takes a more active role in creating companies.
Among Penn’s latest spinouts is Dispatch Bio, which came out of stealth mode earlier this year after raising $216 million from investors led by Chicago-based Arch Venture Partners and San Francisco-based Parker Institute for Cancer Immunotherapy.
Dispatch, chaired by Marrazzo, is developing a cell therapy approach that uses a virus to attach what it calls a “flare” onto the cells it wants the immune system to attack.
Marrazzo said in July that he wasn’t going to be involved in Dispatch if it wasn’t based largely in Philadelphia. As of July, 75% of its 60 employees were working in Philadelphia. Still, Dispatch’s CEO is in the San Francisco Bay Area.
The Philadelphia region is increasingly well-positioned for the current biotech era, said Audrey Greenberg, who played a key role in launching King of Prussia’s Center for Breakthrough Medicines about five years ago. The center is a contract developer and manufacturer for cell and gene therapies.
“You no longer need to move to Kendall Square to get a company funded,” she said, referring to Cambridge’s biotech epicenter. “You need good data, a credible translational plan, experienced advisers, and access to patient capital, all of which can increasingly be built here.”
Greenberg now works as a venture partner for the Mayo Clinic, with the goal of commercializing research discoveries within the health system’s network of hospitals in Minnesota, Arizona, and Florida.
She plans to bring that biotech business to the Philadelphia region.
“I’m going to be starting my companies all here in Philadelphia, because that’s where I am. And I know everybody here, and everybody I’m going to hire in these startups that are going to be based here,” she said.
Solving a technical challenge that has stymied science for 40 years, researchers have built a robot with an onboard computer, sensors, and a motor, the whole assembly less than1 millimeter in size — smaller than a grain of salt.
The feat, accomplished by a partnership of researchers at University of Pennsylvania and University of Michigan, advances medicine toward a future that might see tiny robots sent into the human body to rewire damaged nerves, deliver medicines to precise areas, and determine the health of a patient’s cells without surgery.
“It’s the first tiny robot to be able to sense, think, and act,” said Marc Miskin, assistant professor of electrical and systems engineering at University of Pennsylvania, and an author of a paper describing the work published this week in the journal Science Robotics.
The device, billed as the world’s smallest robot able to make decisions for itself, represents a major step toward a goal once rooted in science fiction. In the 1960s, the story and movie Fantastic Voyage imagined a medical team placed aboard a submarine and shrunk to the size of a microbe. The microscopic medical crew was then injected into the body of a dying man in order to destroy an inoperable blood clot.
“In the future, let’s say 100 years, anything a surgeon does today, we’d love to do with a robot,” said David Gracias, a professor in the department of chemical and biomolecular engineering at Johns Hopkins University who was not involved in the study. “We are not there yet.”
In 1989, two decades after Fantastic Voyage, Rodney A. Brooks and Anita M. Flynn, scientists at the Massachusetts Institute of Technology, wrote a paper called, “Fast, Cheap, and Out of Control: A Robot Invasion of the Solar System,” that described a robot they’d built measuring just 1¼ cubic inches, dubbed Squirt.
Sawyer Fuller, an associate professor of mechanical engineering at the University of Washington, said that when “Fast, Cheap, and Out of Control,” was published, “people thought microrobotics was coming any minute now. … Turns out it has taken a little longer than expected to put all these things together.”
Fuller, who was not involved in building the new microrobot, called it “the vanguard of a new class of device.”
Miskin said the microrobot built by the Michigan and Pennsylvania teams is about 1/100th the size of MIT’s Squirt but isn’t ready for biomedical use.
“It would not surprise me if in 10 years, we would have real uses for this type of robot,” said David Blaauw, a co-author of the paper in Science Robotics and professor of electrical engineering and computer science at University of Michigan.
For decades scientists have dreamed of buildinga microrobot less than 1 millimeter in size, a barrier that corresponds to the smallest units of our biology, Miskin said. “Every living thing is basically a giant composite of 100-micron robots, and if you think about that it’s quite profound that nature has singled out this one size as being how it wanted to organize life.”
For comparison, a human hair has a diameter of about 70 microns, while human cells are about 20 to 40 microns across.
Although scientists and engineers have been miniaturizing circuits for the last half-century, the challenge has been to shrink all of the parts needed for a computer-guided microrobot, then assemble themwithout damaging the parts or causing them to interfere with one another. The robot needs an energy source of sufficient power to operate the computer and move the robot.
Five years ago, Miskin, whose specialty has been building microrobots, met Blaauw when the two gave back-to-back talks. Blaauw’s lab then held ― and still holds ― the distinction of having built the world’s smallest computer.
“Even in the presentations we were like, ‘Oh, we need to talk to each other,’” Blaauw recalled.
The device they built uses tiny solar cells that convert light into energy. Some of that energy powers the computer, and some propels the robot as it swims through liquid. The computer runs at about one-thousandth the speed of today’s laptops and has far less memory.
In the lab, the scientists shone an LED light down into the lab dish that contained the robot in a solution. The robot is made of the same kinds of materials found in a microchip: silicon, platinum, and titanium.
To protect it from the effects of fluids, the microrobot is encased in a thick layer of what is essentially glass, Miskin said. There are a few holes in the glass that are filled in with the metal platinum, forming the electrodes that provide electrical access.
At Johns Hopkins, Gracias stressed that scientists need to ensure that the materials they use for microrobots can be safely used inside a human body.
Sensors on the robot allow it to respond to different temperatures in liquid. To move, the device uses energy from the solar panels to charge two metal electrodes on either side of it. The electrodes attract oppositely charged particles in the water, generating a flow that pulls the robot along.
As it swims, the robot communicates with the person operating it.
“We can send messages down to it telling it what we want it to do,” using a laptop, Miskin said, “and it can send messages back up to us to tell us what it saw and what it was doing.”
The robot communicates using movements inspired by the waggle dance honeybees use to communicate.
During the summer, the scientists invited a group of high school students to come in and test the new microrobots. The students were able to track the movements of the robots using a special low-cost microscope.
“They loved it,” said Miskin. “It was definitely a little bit challenging at first, just getting oriented to working with something that small. But that’s part of the appeal. Once they got the hang of it, they were all in.” Miskin said the version of the robot the students used cost only about $10.
Researchers are working now to develop the microrobot so that it can work in saltwater, on land, and in other environments.
The long-term vision, Blaauw said, is to design tiny computers that can not only talk back and forth to their operators.
“So the next holy grail really is for them to communicate with each other,” he said.
The 10-year-old boy who was severely burned in the Northeast Philadelphia plane crashwas headed home on Tuesday after spending nearly a year in the hospital, his grandmother, Alberta “Amira” Brown said.
“It’s the best thing ever that he’ll be home for the holidays,” Brown said in the morning as the boy prepared to leaveWeisman Children’s rehabilitation hospital in South Jersey. “He is truly happy to be coming home.”
Ramesses Vazquez Viana, then 9, suffered burns to 90% of his body on Jan. 31 whena Learjet medical transport crashed on Cottman Avenue near the Roosevelt Mall, killing allsix people on board.
Ramesses had been riding in a car with his father, Steven Dreuitt Jr., and Dreuitt’s fiancée, Dominique Goods Burke. Dreuitt, 37, died in the blaze. Goods Burke, 34, died in April from her injuries after spending nearly three months at Thomas Jefferson University Hospital.
A bystander saw Ramesses after he escaped from the car; the boy’s back was on fire, and his shirt was burned away.
Police took Ramesses to St. Christopher’s Hospital for Children, and he was later airlifted to Shriners Children’s hospital in Boston. He underwent more than 40 surgeries, including multiple skin grafts. He spent months in physical therapy relearning how to get out of bed, walk and climb stairs, according family interviews with CBS News.
His classmates from Smedley Elementary School in the Philadelphia’s Frankford neighborhood cheered him on from afar, writing him cards and sending videos.
Ramesses celebrated his 10th birthday in October at the Boston hospital.
A few weeks ago, Ramesses was moved closer to his Philadelphia home to Weisman Children’s in Marlton, N.J.
During a phone interview with The Inquirer, Brown said her grandson “has a long road ahead of him” and would need additional surgeries.
During a visit with him Saturday, he kicked a soccer ball around with her.
Brown confirmed a CBS report that Ramesses was being released from Weisman sometime Tuesday, but declined to provide specifics.
Brown said her grandson has chilling memoriesfrom that night: He was in the car’s backseat texting with Brown at about 6 p.m. when the plane exploded in a giant fireball, and he heard loud booms.
As flames engulfed the car, Ramesses tried to help his father, who couldn’t move his legs. The child heard his father yell to get out, and that he loved him. Ramesses told his father he loved him back. He could hear Goods Burke screaming.
Steven Dreuitt Jr. and Goods Burke shared a teenage son, Dominick Goods, who is now a junior at Imhotep Institute Charter High School. Brown said her older grandson is “really struggling” with his parents’ deaths.
The sixpassengers killedon the medical transport jet were Mexican nationals. They included the pilot and copilot, two medical personnel, an 11-year-old girl, and her mother. The girl was headed home to Mexico after undergoing treatment for a spinal condition at Shriners Children’s Philadelphia.
Investigators with the National Transportation Safety Board haven’t yet determined why the plane crashed. A preliminary report, released earlier this year, found the cockpit voice recorder “had likely not been recording audio for several years.” No distress calls were made by the pilot or copilot.
