Robert Califf
@robcaliff.bsky.social
📤 891
📥 59
📝 386
This is a good summary--quite sad that so many well motivated and highly intelligent people work in a medical care system that has gotten so dysfunctional.
open.substack.com/pub/yourloca...
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5 ways our health care system has become utterly insane
A deep dive into the U.S. health care system: rising costs, corporate takeover, and why reform keeps failing.
https://open.substack.com/pub/yourlocalepidemiologist/p/aca-health-care-insurance-us-jetelina?utm_campaign=post&utm_medium=email
about 6 hours ago
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Good summary from an expert. I hope Dr Mayne will produce a lot more substacks--she has a lot to contribute.
substack.com/home/post/p-...
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ByHeart, Botulism, and Powdered Infant Formula Safety
In the face of numerous questions about the ByHeart infant formula botulism outbreak, I wanted to share my perspective based on my prior experiences involving infant formula outbreaks and safety.
https://substack.com/home/post/p-178611383?just_subscribed=true
1 day ago
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Companion articles--there is a message here!
www.statnews.com/2025/11/11/c...
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I’m a physician who went to the anti-vaccine movement’s biggest gathering. More of my colleagues should too
A pro-vaccine physician went to the anti-vaccine movement’s biggest gathering. He warns that public health must learn what it’s up against.
https://www.statnews.com/2025/11/11/childrens-health-defense-conference-pro-vaccine-doctor/
1 day ago
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Clinical research, particularly clinical trials, are not delivering enough evidence to inform us about what to emphasize and what to reduce as we spend $5 trillion per year on medical care and fail to address well known disparities and social drivers.
substack.com/@robcaliff27...
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Why Don’t We Fix Informed Consent?
This essay, the first of a three-part series on informed consent, marks the second installment of a collection of posts devoted to specific issues in clinical research, with a focus on interventional ...
https://substack.com/@robcaliff272993/note/p-178606705?utm_source=notes-share-action&r=7bit1
1 day ago
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Another useful update from YLE. Includes a poll on future update on deep dive on menopause.
open.substack.com/pub/yourloca...
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Infant formula botulism cluster, black box warning for HRT, flu is waking up, new blood pressure guidelines, and more
This is your weekly Dose.
https://open.substack.com/pub/yourlocalepidemiologist/p/infant-formula-botulism-cluster-black?utm_campaign=post&utm_medium=email
3 days ago
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More good news for coffee enthusiasts from my specialty!
jamanetwork.com/journals/jam...
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Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation
This clinical trial compares the effect of caffeinated coffee consumption vs abstinence from coffee and caffeine on recurrent atrial fibrillation.
https://jamanetwork.com/journals/jama/fullarticle/2841253
4 days ago
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Nice description of the clinical science.
open.substack.com/pub/theunbia...
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Vaccine Immunity vs. Infection Out in the Wild
What’s the real difference between immunity from vaccines and immunity from infection?
https://open.substack.com/pub/theunbiasedscipod/p/vaccine-immunity-vs-infection-out?utm_campaign=post&utm_medium=email
4 days ago
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Thoughts on medical interventions for long-term prevention.
open.substack.com/pub/robcalif...
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Medicines for Primordial Prevention: Finding the Sweet Spot for a 21st Century Consensus
The 20th century and the first part of the 21st century have been marked by significant improvements in life expectancy (LE) and healthy life expectancy (HLE), both globally and in the United States.
https://open.substack.com/pub/robcaliff272993/p/medicines-for-primordial-prevention?r=7bit1&utm_campaign=post&utm_medium=web&showWelcomeOnShare=false
6 days ago
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YLE calling for action to promote science, public health and evidence based policy.
open.substack.com/pub/yourloca...
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A good defense demands offense
And what it looks like
https://open.substack.com/pub/yourlocalepidemiologist/p/a-good-defense-demands-offense?utm_campaign=post&utm_medium=email
6 days ago
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Brief explainer from Dr Nestle
www.foodpolitics.com/2025/11/wher...
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Where are we on SNAP funding? - Food Politics by Marion Nestle
It's hard to keep up with the fate of SNAP benefits during the shutdown. The administration says it can't fund SNAP but courts say otherwise.
https://www.foodpolitics.com/2025/11/where-are-we-on-snap-funding/?lctg=333222006
7 days ago
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reposted by
Robert Califf
JAMA
8 days ago
The JAMA Summit on Firearm Violence gathered experts from medicine, policy, engineering, and community groups to develop a plan for reducing firearm harms by 2040. Learn more in this Special Communication:
ja.ma/43hclqa
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Back to Pasteur. Raw milk is not our largest public health issue, but the purported benefits are hypothetical and not empirically proven and the risks are basic.
open.substack.com/pub/pauloffi...
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See No Evil
Why did RFK Jr. limit the reporting of certain foodborne illnesses?
https://open.substack.com/pub/pauloffit/p/see-no-evil?utm_campaign=post&utm_medium=email
9 days ago
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important perspectives
open.substack.com/pub/holdenth...
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What I learned talking to MAHA moms
Was honored to be on the "Why Should I Trust You?" podcast
https://open.substack.com/pub/holdenthorp/p/what-i-learned-talking-to-maha-moms?utm_campaign=post&utm_medium=email
10 days ago
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reposted by
Robert Califf
Eric Topol
13 days ago
We've just launched the first large, site-less (home, direct to participant) randomized trial for treatment of
#LongCovid
, testing tirzepatide (a GLP-1 drug) vs placebo. Please help spread the word
www.scripps.edu/news-and-eve...
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Scripps Research scientists launch new digital clinical trial to test repurposed drug for long COVID symptom relief
https://www.scripps.edu/news-and-events/press-room/2025/20251030-moore-vogel-locitt.html
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reposted by
Robert Califf
Steve Rattner
12 days ago
This weekend, 12% of Americans are set to lose crucial food assistance due to the govt shutdown — the majority of them are children or elderly. Cc:
@washingtonpost.com
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reposted by
Robert Califf
Steve Rattner
12 days ago
Nearly a fifth of American households with children rely on SNAP to buy groceries. cc:
@washingtonpost.com
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A cautionary warning
www.statnews.com/2025/10/30/c...
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Health care workers under 65 must be vaccinated against Covid
The vaccination status of health care workers under 65 has profound implications for millions of Americans.
https://www.statnews.com/2025/10/30/covid-vaccine-health-care-workers-under-65/
13 days ago
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Really sad to see this, knowing how many people were being helped as the foundation is destroyed.
www.statnews.com/2025/10/30/s...
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Trump cuts have decimated the federal addiction and mental health agency
The Trump administration has dismantled big chunks of the federal agency focused on mental health and addiction treatment, reducing its staff by more than half
https://www.statnews.com/2025/10/30/samhsa-grant-cuts-staff-reductions-impact-analyzed/
13 days ago
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Minimizing the nonfatal toll of Covid 19 infection would be a big mistake.
www.nature.com/articles/s44...
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COVID-19 infection associated with increased risk of new-onset vascular dementia in adults ≥50 years - npj Dementia
npj Dementia - COVID-19 infection associated with increased risk of new-onset vascular dementia in adults ≥50 years
https://www.nature.com/articles/s44400-025-00034-y
14 days ago
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A view on Covid vaccines--its decision time.
jamanetwork.com/journals/jam...
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Evidence, Opinion, and Uncertainty About COVID-19 Vaccines
This issue of JAMA Internal Medicine includes a Research Letter by Du and colleagues1 reporting findings that once again demonstrate that vaccination with a SARS-CoV-2 vaccine booster with an updated ...
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2840568
14 days ago
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Tempted to say this is too logical to carry the day.
open.substack.com/pub/theunbia...
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The Food Additive Wars
Why a Patchwork of State Bans Creates More Problems Than It Solves
https://open.substack.com/pub/theunbiasedscipod/p/the-food-additive-wars?utm_campaign=post&utm_medium=email
15 days ago
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Dr Nestle raises an unsettling question
www.foodpolitics.com/2025/10/is-r...
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Is RFK, Jr's interest in food just a smokescreen? - Food Politics by Marion Nestle
A MAHA official says interest in food issues is a cover for RFK, Jr's real agenda---getting rid of vaccines.
https://www.foodpolitics.com/2025/10/is-rfk-jrs-interest-in-food-just-a-smokescreen/?lctg=333222006
15 days ago
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"We should be building on its extraordinary life-saving pandemic success, not turning our back on it!"
open.substack.com/pub/erictopo...
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How mRNA Vaccines Can Help Fight Cancer
Turning "cold" tumors "hot"
https://open.substack.com/pub/erictopol/p/how-mrna-vaccines-can-help-fight?utm_campaign=post&utm_medium=email
21 days ago
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For those who thought RFK Jr would "clean up" industry connections, this is worth a read and reflection.
www.foodpolitics.com/2025/10/http...
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Trump food officials with ties to industry: Civil Eats has a list. - Food Politics by Marion Nestle
Many of the president’s top officials at the USDA, EPA, HHS, and FDA have connections to chemical, agribusiness, or fossil fuel interests.
https://www.foodpolitics.com/2025/10/https-www-foodpolitics-com-2025-10-27957/?lctg=333222006
21 days ago
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This is fascinating. Hard to prove, but the protean effects of "GLP1's" points out how surprised we are when we perturb the human system with an intervention.
www.thelancet.com/journals/lan...
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Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial
The cardioprotective effects of semaglutide were independent of baseline adiposity and weight loss and had only a small association with waist circumference, suggesting some mechanisms for benefit bey...
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01375-3/fulltext
21 days ago
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This seems so obvious but is said so seldom. Good to see these experts put it out there in plain English.
www.statnews.com/2025/10/21/h...
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The U.S. experiment with profit-driven health care has failed
“The market competition, managed care, and ‘corporate efficiency’ that economists prescribed as the cure for health care inflation instead accelerated it.”
https://www.statnews.com/2025/10/21/health-care-system-profit-failed/
22 days ago
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This will be a test of whether key federal agencies (USDA, HHS, etc.) can work with academic communities, especially those with strong vet, med and public health schools, and with states and counties to solve this problem.
www.nytimes.com/2025/10/22/h...
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Bird Flu Is Back
https://www.nytimes.com/2025/10/22/health/h5n1-bird-flu.html
22 days ago
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"if you don't measure it, you can ignore it"....
www.foodpolitics.com/2025/10/http...
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Trump administration tries to get rid of NHANES (it may yet succeed) - Food Politics by Marion Nestle
The Trump Administration, in its efforts to downsize government, has once again picked on a little known agency that produces data essential for food system analysis.
https://www.foodpolitics.com/2025/10/https-www-foodpolitics-com-2025-10-27958/?lctg=333222006
22 days ago
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Useful stuff from YLE. At a minimum I hope there will be popular demand for registering supplements and putting their ingredients in the label.
open.substack.com/pub/yourloca...
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Lead in protein powders, governors unite, and mammograms targeted.
In this week's Dose: what's going on with lead in protein powders, 15 governors unite for public health, and the falsehoods swirling around mammograms.
https://open.substack.com/pub/yourlocalepidemiologist/p/protein-powders-lead-governors-public-health-the-dose?utm_campaign=post&utm_medium=email
24 days ago
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Seems like a big step forward. Devil in details.
www.foodpolitics.com/2025/10/cali...
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California defines ultra-processed foods and bans them from school meals-by 2035 (!) - Food Politics by Marion Nestle
California defines ultra-processed foods and bans them from school meals---by 2035 (!)
https://www.foodpolitics.com/2025/10/california-defines-ultra-processed-foods-and-bans-them-from-school-meals-by-2035/?lctg=333222006
29 days ago
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Serious issues.
rasmussenretorts.substack.com/p/the-death-...
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The Death of Public Health
Another Friday night massacre, but this time it's not just an essential federal public health agency that will die
https://rasmussenretorts.substack.com/p/the-death-of-public-health?r=osr8f&utm_medium=ios&triedRedirect=true
about 1 month ago
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i hope one day we'll have the evidence about which supplements are beneficial, which are useless, but not detrimental, and which are dangerous.
www.nytimes.com/2025/10/07/w...
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A Plea From Doctors: Cool It on the Supplements
https://www.nytimes.com/2025/10/07/well/doctors-supplements.html
about 1 month ago
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Thoughtful response to assertions that vaccines don't save lives (or prevent suffering).
www.statnews.com/2025/10/10/m...
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RFK Jr. says vaccines don’t save lives. He’s wrong
Now RFK Jr. is claiming vaccines don’t actually save lives. Here’s the math to show what he gets wrong.
https://www.statnews.com/2025/10/10/measles-polio-vaccines-lives-saved-sanitation-nutrition-expert/
about 1 month ago
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reposted by
Robert Califf
Eric Topol
about 1 month ago
Waning immunity. A significant Covid wave in England. No new variant. Thanks Prof Pagel for highlighting and contextualizing
add a skeleton here at some point
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useful summary of the current state of things
open.substack.com/pub/yourloca...
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Updated 2025 fall vaccine guide
Your guide, frequently asked questions, webinar recording and resources
https://open.substack.com/pub/yourlocalepidemiologist/p/updated-2025-fall-vaccine-guide?utm_campaign=post&utm_medium=email
about 1 month ago
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Glad to see this happening. It won't work unless there are systems and people to be responsive, so I hope the resource and people issues will be successfully engineered.
www.foodpolitics.com/2025/10/a-ma...
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A MAHA Win? Beginning to close the GRAS loophole. - Food Politics by Marion Nestle
In what looks like a MAHA win, the FDA is starting the regulatory process to close the GRAS Loophole.
https://www.foodpolitics.com/2025/10/a-maha-win-beginning-to-close-the-gras-loophole/?lctg=333222006
about 1 month ago
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Doggone it. Wachter just wrote a lot of stuff i was planning to write.
open.substack.com/pub/robertwa...
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Will AI Rescue Primary Care?
Eventually, But Not Yet
https://open.substack.com/pub/robertwachter/p/will-ai-rescue-primary-care?utm_campaign=post&utm_medium=post%20viewer
about 1 month ago
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reposted by
Robert Califf
Deb Houry
about 1 month ago
From the 6 Surgeon Generals who served across administrations since President Bush: "Secretary Kennedy is entitled to his views. But he is not entitled to put people’s health at risk. He has rejected science, misled the public and compromised the health of Americans."
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Opinion | Six surgeons general: It’s our duty to warn the nation about RFK Jr.
We took an oath to declare dangers when we found them. We’re doing that again today.
https://www.washingtonpost.com/opinions/2025/10/07/surgeons-general-rfk-jr-robert-kennedy/
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Serious perspective.
www.washingtonpost.com/opinions/202...
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Opinion | Six surgeons general: It’s our duty to warn the nation about RFK Jr.
We took an oath to declare dangers when we found them. We’re doing that again today.
https://www.washingtonpost.com/opinions/2025/10/07/surgeons-general-rfk-jr-robert-kennedy/
about 1 month ago
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YLE update with some helpful informaion:
open.substack.com/pub/yourloca...
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The shutdown's impact on health, RSV is stirring, Covid-19 vaccines finally given green light, deadly pasta outbreak, and lots of good news!
The Dose (October 6)
https://open.substack.com/pub/yourlocalepidemiologist/p/the-shutdowns-impact-on-health-rsv?utm_campaign=post&utm_medium=email
about 1 month ago
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reposted by
Robert Califf
Eric Topol
about 1 month ago
New
@nature.com
www.nature.com/articles/d41...
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Exclusive: ex-CDC director talks about why she was fired
“I would never do that, as a scientist,” Susan Monarez says of being asked to approve changes to vaccine recommendations without knowing the details.
https://www.nature.com/articles/d41586-025-03179-1
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Good discussion of the basics of healthy lifestyle.
erictopol.substack.com/p/tom-friede...
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Tom Frieden & Eric Topol - Discuss the Formula for Better Health Book
A recording from Eric Topol's live video
https://erictopol.substack.com/p/tom-frieden-and-eric-topol-discuss?utm_source=podcast-email&publication_id=587835&post_id=174857100&utm_campaign=email-play-on-substack&utm_content=watch_now_button&r=7bit1&triedRedirect=true&utm_medium=email
about 1 month ago
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Another good discussion of issues that I believe are frequently confused.
open.substack.com/pub/yourloca...
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Routine vaccinations, sanitation, and a look back at history
Sanitation vs. vaccine impact, requirements, universal recommendations, Hep B and more
https://open.substack.com/pub/yourlocalepidemiologist/p/routine-vaccinations-sanitation-and?utm_campaign=post&utm_medium=email
about 1 month ago
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Dr Wachter gives a good summary of the evolving issues in LLM, textbooks, digital tools and decision support.
open.substack.com/pub/robertwa...
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Medicine’s AI Knowledge War Heats Up
The Battlegrounds May Surprise You
https://open.substack.com/pub/robertwachter/p/medicines-ai-knowledge-war-heats?utm_campaign=post&utm_medium=post%20viewer
about 1 month ago
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Some good, mostly not good news from YLE.
open.substack.com/pub/yourloca...
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Measles outbreak growing and common cold surging, hunger survey is stopping, abortion pill watch, why we can't split up MMR, and some great news!
The Dose (September 30)
https://open.substack.com/pub/yourlocalepidemiologist/p/measles-outbreak-growing-and-common?utm_campaign=post&utm_medium=email
about 1 month ago
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Some real wisdom here: "It’s far easier to focus on individual mothers, and the unproven promise of miracle drugs, than to create a system that supports us all."
www.nytimes.com/2025/09/27/o...
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Opinion | How Moms Got Caught in Trump’s Cross Hairs
https://www.nytimes.com/2025/09/27/opinion/trump-blame-moms.html?login=smartlock&auth=login-smartlock
about 2 months ago
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important book. Sobering in terms of pointing out that the issue is mostly the food environment, heavily subsidized by our tax money. Redirecting it will require both will to change and regulation. California has started.
www.foodpolitics.com?lctg=333222006
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Food Politics by Marion Nestle
https://www.foodpolitics.com/?lctg=333222006
about 2 months ago
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This is important--overall looks good, but my FDA friends have reminded me that there are a lot of nuances that could need adjustment. Eliminating food insecurity for children is enormous.
www.foodpolitics.com/2025/09/27888/
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California legislature passes bill banning ultra-processed foods from schools-and defining them - Food Politics by Marion Nestle
So many readers have sent me notices about California’s Senate having unanimously passed a bill banning ultra-processed foods from schools---and defining what they are---that I just have to write abou...
https://www.foodpolitics.com/2025/09/27888/
about 2 months ago
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Something we need to talk about more in my view.
substack.com/@robcaliff27...
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Interventions for Low-Probability Events
Recently, I have been struggling to understand why so few people have taken the updated COVID booster when the benefit-risk calculation seems so straightforward.
https://substack.com/@robcaliff272993/note/p-174249895?utm_source=notes-share-action&r=7bit1
about 2 months ago
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This article highlights the lack of much needed evidence about potential benefits and risks of dietary supplements.
www.statnews.com/2025/09/23/l...
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FDA’s leucovorin approval could be a boon for supplement makers
Parents may flock to a dietary supplement with the same key ingredient as leucovorin, which the FDA just approved for children with autism. But there are drawbacks.
https://www.statnews.com/2025/09/23/leucovorin-autism-treatment-folinic-acid-supplements-are-different/
about 2 months ago
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