Here’s a brief but sadly necessary history lesson.
On Oct. 7, 2023, Hamas’ marauders crossed over from Gaza into Israel, murdered more than 1,200 innocent civilians, kidnapped hundreds more, raped women and beheaded children.
Responding to the attack, and striving to rescue the hostages, the Israel Defense Forces began a limited ground operation in Gaza six days later, on Oct. 13.
The Israeli army then took another two weeks to launch its full-force assault on Hamas, which began on Oct. 27.
And yet all over America, from Midtown Manhattan to Stanford’s leafy campus, the crowd calling itself “pro-Palestine” chose Oct. 7, specifically and deliberately, as its “Day of Action.”
Leaflets shared anywhere from social media to city lampposts show a host of masked Hamas terrorists, fresh from the killing fields, flashing victory signs.
The caption calls on supporters to show up “for our martyrs.”
This decision speaks volumes.
The thugs who took to the streets on Tuesday weren’t supporting Gazans or mourning the loss of Palestinian lives.
They were celebrating the massacre of Israeli Jews, and letting Americans know that we’re next in line.
If that sounds alarmist, consider what an actual pro-Palestinian demonstration might’ve looked like.
For two years, the pro-Palestine camp had a two-word list of demands: Cease-fire now.
WhenPresident Trumplast week finally negotiated a successful cease-fire deal involving the immediate return of all hostages, Israel signed on right away.
So did virtually all Arab nations.
Hamas, unsurprisingly, was the sole holdout: The terror group continues to alter its list of concessions and demands.
Anyone who truly wants peace, anyone serious about alleviating the suffering, ought to have protested and demanded that Hamas sign the deal right away.
Instead, the loudest pro-Palestine voices, including Rep. Rashida Tlaib (D-Mich.), blasted Trump’s initiative and called on the Palestinians to reject it.
It figures.
The defensive operation Israel’s rabid detractors are outrageously calling a genocide could’ve ended a long time ago.
It could’ve ended with a simple decision to free the innocents withering away in Gaza’s terror tunnels, starved and tortured and denied access to medicine and food.
It could’ve ended with Hamas surrendering, laying down its arms and letting the rebuilding of Gaza begin.
It could’ve ended with the people of Gaza themselves demanding that the terrorists who brought on so much misery and destruction on their own people be brought to justice.
Instead, all we heard from those who purport to support Palestine is more calls to punish Israel — and all we saw is more violent protests and attempts to disrupt everyday life everywhere from New York to Barcelona.
Because the violence and the disruption are exactly the point.
Hamas and its sycophants around the world aren’t interested in peace or prosperity.
They care only about destroying the infidels, a term they apply to Israelis, Americans and anyone resisting their homicidal fantasies of world domination.
That’s the reason they’ve been targeting all-American events like the Rockefeller Center Christmas Tree lighting ceremony or the Macy’s Thanksgiving Day Parade.
It’s also the reason they chose to celebrate Oct. 7, the date commemorating the launch of their war on Western civilization.
You’d hope that, at the very least, the man likely to become New York’s new mayor would know better than to cheer on this demented bloodlust.
Zohran Mamdani failed this simple test miserably, releasing a statement thick with terms like “apartheid” and “occupation” and calling for more sanctions against the Jewish state.
We deserve better.
On the ballot, in the press, in the classrooms, in the streets, we must let the goons know that the battle they picked on this day two years ago is one they’re never going to win.
Liel Leibovitz is editor at large for Tablet and senior fellow at the Hudson Institute.
Now, new research suggests that these wildly popular medications may also be throwing off critical medical imaging scans, interfering with doctors’ ability to detect serious — even deadly — diseases.
Experts say this could lead to delayed diagnoses and treatments for some patients, while others might undergo tests and procedures they didn’t need in the first place.
Roughly 12% of US adults have tried a GLP-1 drug like Ozempic, research suggests.myskin – stock.adobe.com
Originally developed to treat Type 2 diabetes, GLP-1 meds have become a sensation due to their powerful weight-loss effects. In the US alone, usage jumped a staggering 700% between 2019 and 2023.
These drugs mimic a natural hormone called GLP-1, which helps regulate blood sugar and appetite. They also boost insulin production, slow digestion and make people feel full longer, helping them slim down in record time.
While these biological changes can improve health, they may interfere with PET-CT scans, a tool doctors use to detect cancer and inflammatory diseases.
The science behind the scare
PET-CT scans combine two powerful imaging tools to give doctors a detailed picture of what’s happening in the body.
The PET scan uses a radioactive substance called FDG that travels through the bloodstream and is absorbed by tissues. Cancer cells and other abnormal cells — like those involved in inflammation — soak up more FDG because they have a higher metabolic rate, according to UConn Health.
The PET scanner detects the radiation emitted by the FDG, creating images that highlight where the substance has collected.
Doctors use PET-CT scans to diagnose cancer and inflammatory diseases, in addition to monitoring the effects of treatment.NCPIC
The CT scan, meanwhile, provides detailed pictures of organs, bones and tissues.
When combined, PET-CT scans reveal the body’s metabolic activity and its physical anatomy, helping doctors make diagnoses and track how patients respond to treatment.
But in patients taking GLP-1s, doctors have observed unusual patterns of FDG — i.e, hot spots in the body that can mask signs of cancer or make healthy tissue look diseased.
“We noticed unusual uptake in one of our patients on a GLP-1 agonist, which prompted a wider review across our network,” Dr. Peter Strouhal, medical director at Alliance Medical Ltd in the UK and lead author of the new study, said in a statement.
“We found that these altered patterns are increasingly common, yet there is currently no national or international guidance in the UK addressing this emerging issue,” he noted.
Confusing scans, costly consequences
In the US, about 1 in 8 adults report having used a GLP-1 medication like Ozempic, Wegovy or Mounjaro, according to a 2024 survey by the Kaiser Family Foundation.
With demand showing no signs of slowing, more patients are likely to display these unusual patterns on their PET-CT scans.
There are no formal guidelines for doctors on how to interpret the results of FDG PET-CT scans in patients taking GLP-1s.ihorvsn – stock.adobe.com
That’s especially concerning because cancer rates in the US are rising — particularly among young adults — and early detection is crucial for successful treatment.
Doctors warn that misreading these FDG uptake patterns can lead to unnecessary tests, incorrect cancer staging and dangerous delays in care.
“Recognizing the characteristic uptake associated with GLP-1 agonists helps avoid unnecessary anxiety and interventions, ensuring patients receive the right care, at the right time, without detours or doubt,” Strouhal said.
For now, Strouhal and his colleagues don’t recommend patients stop taking GLP-1 medications before undergoing PET-CT scans.
Instead, they suggest imaging teams carefully document their patients’ medication histories to help doctors interpret their scans while formal guidelines are being developed.
Their research was presented Tuesday at the 38th Annual Congress of the European Association of Nuclear Medicine.
Looking ahead, the team plans to expand its data collection across more imaging centers to build stronger evidence for future national guidelines.
They also aim to collaborate internationally, so patients worldwide can benefit from consistent, reliable PET-CT interpretations.
MSD's confidence in its anti-TL1A antibody tulisokibart in inflammatory diseases has been made apparent by a decision to start trials of the drug in three more indications.
Already in phase 3 testing for ulcerative colitis and Crohn's disease and phase 2 for systemic sclerosis-associated interstitial lung disease (SSc-ILD), MSD has now started a trio of new phase 2b studies in rheumatoid arthritis, ankylosing spondylitis, and hidradenitis suppurativa.
TL1A – or tumour necrosis factor-like ligand 1A – has become something of a hot topic in immunology and inflammation R&D, with tulisokibart competing with candidates in development at Teva/Sanofi and Roche to be first to market.
MSD – known as Merck & Co in the US and Canada – acquired tulisokibart when it took over Prometheus Biosciences for $10.8 billion in 2023, and analysts have suggested peak sales of the drug could be in the region of $4 to $5 billion a year.
Roche's entry into the category with afimkibart (RG6631) stemmed from its purchase of Telavant for $7.1 billion, and since then it has advanced the drug into a phase 3 programme, also in inflammatory bowel disease (IBD), with earlier-stage studies on the go in atopic dermatitis and metabolic dysfunction-associated steatohepatitis (MASH).
Meanwhile, Sanofi licensed rights to Teva's duvakitug in a deal valued at around $1.5 billion, and the two partners have reported positive phase 2b results with the drug in ulcerative colitis and Crohn's and are recruiting for a four-study phase 3 programme.
Looking further back in development, AbbVie also recently entered the category via a deal worth up to $1.7 billion with FutureGen for an anti-TL1A antibody still in preclinical development, while Spyre Therapeutics is running early-stage trials of a pair of extended half-life TL1A antibodies (SPY002 and SPY072), and Absci recently started dosing patients in a phase 1 trial of its AI-designed candidate ABS-101.
"The expansion of our tulisokibart clinical development programme reflects Merck's ongoing commitment to addressing the burden of immune-mediated inflammatory diseases," said Dr Aileen Pangan, head of immunology, global clinical development, at Merck Research Laboratories.
"We're excited to further evaluate the potential of tulisokibart as a treatment for patients across multiple diseases in rheumatology and dermatology," she added.
The new phase 2b trials have already started recruiting patients, with a target headcount of 640, with results expected from 2027 onwards.
This year's Nobel Prize in Physiology or Medicine has been awarded to three scientists for their work on regulatory T-cells (Tregs), research that has fuelled a well-stocked pipeline of potential new therapies for cancer and autoimmune diseases.
Profs Mary Brunkow and Fred Ramsdell of the US and Prof Shimon Sakaguchi of Japan have shared the prize fund – worth SEK 11 million (nearly $1.2 million) – for their ground-breaking discoveries concerning peripheral immune tolerance, orchestrated by Tregs, that prevents the immune system from harming the body.
"Their discoveries have been decisive for our understanding of how the immune system functions and why we do not all develop serious autoimmune diseases," said Olle Kämpe, chair of the Nobel Committee.
Sakaguchi made the first key discovery in 1995, at a time when the prevailing wisdom was that immune tolerance only developed due to potentially harmful immune cells being eliminated in the thymus, through a process called central tolerance. He showed that the immune system is more complex and discovered the previously unknown Treg class of immune cells that act around the body, not just in the thymus.
Brunkow and Ramsdell made the other key finding in 2001, when they discovered why a specific mouse strain was particularly vulnerable to autoimmune diseases, linking that to a mutation in the Foxp3 gene that is also associated with a serious autoimmune disease, IPEX, in humans.
Two years later, Sakaguchi linked the discoveries by proving that Foxp3 governs the development of Tregs, and a new field of peripheral tolerance research started in earnest, with an estimated 200 clinical trials ongoing for drugs based on or interacting with the cells.
Treg cell therapies are now being explored as treatments for autoimmune diseases like rheumatoid arthritis, multiple sclerosis, and type 1 diabetes, as well as to prevent organ transplant rejection, while they are also being modified to restore and strengthen immune responses to malignant cells.
Examples that have reached clinical testing include Quell Therapeutics' QEL-001, partnered with AstraZeneca and in a phase 1/2 trial in liver transplant patients, Nektar Therapeutics' rezpegaldesleukin (NKTR-358) in phase 2 for atopic dermatitis and alopecia areata, and Orca Bio's Orca-T in late-stage testing for various blood cancers.
Last year's Nobel Prize in Physiology or Medicine was awarded to Victor Ambros and Gary Ruvkun for their discovery of microRNA, a class of RNA molecules that play a crucial role in gene regulation. In 2023, it went to Katalin Karikó and Drew Weissman for their work on technology that led to the development of mRNA-based COVID-19 vaccines.
BillionToOne, which develops prenatal and oncology diagnostics using a single molecule sequencing platform, filed on Tuesday with the SEC to raise up to $100 million in an initial public offering.
BillionToOne is focused on the field of molecular diagnostics, using its single molecule next-generation sequencing (smNGS) platform to develop prenatal and oncology products that reveal actionable insights from a simple blood draw. In 2019, the company launched its first prenatal product, UNITY, which is the first non-invasive prenatal test that uses cell-free DNA to provide fetal risk assessment for recessive conditions without requiring a paternal sample or invasive procedures. In 2023, the company launched two complementary pan-cancer liquid biopsy tests: Northstar Select, which is used to guide therapy selection, and Northstar Response, a methylation-based assay that quantifies the amount of cancer at the single molecule level without requiring a tissue biopsy.
The Menlo Park, CA-based company was founded in 2016 and booked $209 million in revenue for the 12 months ended June 30, 2025. It plans to list on the Nasdaq under the symbol BLLN. BillionToOne filed confidentially on June 20, 2025. J.P. Morgan, Piper Sandler, Jefferies, William Blair, Stifel, Wells Fargo Securities, and BTIG are the joint bookrunners on the deal. No pricing terms were disclosed.
Visits and hospitalisations linked to COVID increased by 43% for children younger than 15 years, with 156 additional visits, and by 29% for individuals aged 15 years or older, with 224 additional visits, compared with the previous week (week 36, September 8-14).
According to the Sentinelles Surveillance Network Bulletin, the incidence of COVID among patients consulting general practitioners for acute respiratory infections is estimated to be 49 cases per 100,000 inhabitants, with approximately 32,600 new cases being reported.
The incidence increased for the second consecutive week, rising among adults aged 15-64 years and 65 years or older, while remaining stable among children aged 0-14 years.
Variant XFG (‘Frankenstein’)
According to the World Health Organization (WHO), this rise is associated with the emergence of a new SARS-CoV-2 variant, XFG, also referred to as “Frankenstein,” because it is a recombinant of two other variants, LF.7 and LP.8.1.2.
XFG has been classified by the WHO as a variant under monitoring since June 25, 2025, and is growing globally. Current evidence suggests that the additional public health risk is low worldwide, and approved COVID vaccines are expected to remain effective against this variant to prevent symptomatic and severe disease.
Hospitalisations
Several Southeast Asian countries have reported simultaneous increases in new cases and hospitalisations, where XFG has been widely detected.
According to WHO, current data do not indicate that this variant causes more severe illness or increased mortality than other circulating variants.
Globally, the WHO observed a marked rise in this variant in epidemiologic week 22 vs week 21: Southeast Asia region from 17.3% to 68.7%, region of the Americas from 7.8% to 26.5%, and European region from 10.6% to 16.7%.
According to the European Centre for Disease Prevention and Control, SARS-CoV-2 continues to circulate widely in the EU, with a limited impact on hospitalisations. The incidence remains high across all age groups, although a small number of countries have observed declining trends in recent weeks.
In weeks 35-36, XFG accounted for 82% of the circulating variants in Europe.
The influenza and COVID vaccination campaigns are set to begin on October 14, 2025. In this context, the COMIRNATY® LP.8.1 vaccine, adapted to variant LP.8.1, received market authorisation from the European Commission on July 25, 2025.
Pfizer announced in a press release that “These clinical findings reinforce preclinical data that supported the recent US Food and Drug Administration (FDA) approval of the LP.8.1-adapted COVID-19 vaccine, which demonstrated improved immune responses against multiple circulating SARS-CoV-2 sublineages.”
The American Psychiatric Association (APA) has released an updated guideline for preventing and treating delirium, providing clinicians with evidence-based strategies to improve detection, management, and patient outcomes for a condition that affects tens of thousands of hospitalized adults each year.
Delirium — a sudden decline in attention, awareness, and mental function — develops rapidly, often over hours, and typically lasts 2-3 days. It can arise from numerous factors, including advanced age, prior episodes of delirium, medical conditions such as pneumonia or urinary tract infection, psychiatric conditions like cognitive impairment, medications with anticholinergic properties or opioids, metabolic disturbances, vitamin deficiencies, sensory impairments, and sleep disruption.
The condition affects roughly 1 in 4 hospitalized adults and up to three quarters of ventilated ICU patients. Often underrecognized, delirium can prolong hospital stays, increase complications, and impose significant costs and psychosocial burdens on patients and their families.
However, these estimates are likely inaccurate because delirium is frequently underdiagnosed.
“Clinicians don’t always acknowledge it, sometimes for fear it may reflect poorly on the quality of care,” said Mark A. Oldham, MD, a member of the APA Practice Guideline Writing Group and immediate past president of the American Delirium Society. He added that because delirium is classified as a complication or comorbidity, the Centers for Medicare and Medicaid Services provides no financial incentive for clinicians to diagnose it.
Mark A. Oldham, MD
Regardless of the reasons for underdiagnosis, delirium takes a significant toll on patients and their families. It can prolong hospital stays, cause psychosocial distress such as anxiety and fear, and worsen cognitive outcomes, particularly in older adults or those with preexisting cognitive impairment.
Up to 40% of delirium cases are preventable through multicomponent nonpharmacologic interventions, Oldham noted. “There’s growing awareness that such prevention strategies are effective, but unfortunately, they’re not implemented consistently across institutions, and that’s a real concern,” said Oldham, immediate past president of the American Delirium Society and associate professor of psychiatry at the University of Rochester Medical Center, Rochester, New York. He also cautioned that there is growing evidence that antipsychotics don’t reverse delirium.
The updated APA guideline includes 12 evidence-based recommendations across clinical settings and also includes three suggestions covering assessment, nonpharmacologic and pharmacologic interventions, and transitions of care, providing clinicians with a practical framework to improve patient outcomes.
The previous delirium guideline was published in 1999, with a minor revision in 2010, and was primarily aimed at psychiatrists. The updated version has a broader scope, targeting not only psychiatrists but also specialists in internal medicine, family medicine, and critical care nursing.
“The delirium field has expanded by leaps and bounds since 1999, and it includes stakeholders across a broad range of specialties, disciplines, and professions,” said Oldham.
An updated guideline was needed because so much progress has been made in recent years in clinical research, interventions, and our understanding of delirium, Catherine Crone, MD, chair of the Guideline Writing Group, told Medscape Medical News.
“The new guideline goes beyond detection and treatment and includes steps aimed at prevention,” added Crone, clinical professor in the Department of Psychiatry and Behavioral Sciences at The George Washington University School of Medicine, Washington, DC.
The new guideline goes beyond detection and treatment of delirium and includes steps aimed at prevention, added Crone.
The new guideline includes evidence-based recommendations and suggestions, with the strength of evidence rated as high (A), moderate (B), or low (C).
One key recommendation is that patients with, or at risk for, delirium undergo regular, structured assessments using validated tools. These tools measure factors such as awareness, language comprehension, and confusion, and their use varies by clinical setting.
“For example, patients in the ICU who are intubated and cannot speak will require different tests than those on the medical floor,” said Oldham.
Guidance on Antipsychotic Use
The APA also recommends that patients receive baseline neurocognitive testing and a detailed review of potential contributing factors. Clinicians are further advised to conduct thorough medication reviews, particularly for patients with cognitive impairment.
While medication reviews are routinely performed, the guideline emphasizes that they should specifically focus on drugs that can cause or worsen cognitive status. This targeted attention is a new component of the guideline, Crone noted.
The guideline recommends that antipsychotics be used only for severe agitation or psychosis in delirium — after de-escalation strategies have failed, contributing factors have been addressed, and the behavior poses a risk for harm.
“There may be a role for antipsychotics in managing some of the severe, distressing, dangerous neuropsychiatric disturbances of delirium,” said Oldham. But he added, “There’s no reason to just give antipsychotics to all comers with delirium.”
All too often, antipsychotics are used “reflexively” in people with delirium, Oldham added. “We wanted to make clear that there are no compelling data that antipsychotics either clearly prevent delirium or hasten its resolution.”
He also noted that antipsychotics carry significant risks, including increased all-cause mortality when used for dementia-related psychosis, as well as movement disorders and heart rhythm abnormalities.
The guideline recommends that benzodiazepines not be prescribed for patients with, or at risk for, delirium unless there is a specific indication. This also applies to individuals with preexisting cognitive impairment.
Benzodiazepines may cause sleepiness and confusion and can actually worsen delirium, said Oldham. He added that they can also affect balance, potentially increasing the risk for falls.
A Better Sedative
The new guidance also recommends using the intravenous sedativedexmedetomidine to prevent delirium in patients undergoing major surgery or receiving mechanical ventilation. Evidence suggests this agent works differently than other sedatives and is superior, said Oldham.
While other sedatives adversely affect sleep architecture, some data indicate that dexmedetomidine can help facilitate a more natural and physiologically restorative sleep, he added.
The guideline authors advise against using melatonin or ramelteon — a sedative commonly prescribed for insomnia — to prevent or treat delirium.
“Melatonin, which is the only hormone available over the counter, is often used like water in the hospital setting,” said Oldham. However, a review of the data found “no compelling evidence that melatonin — or ramelteon — can prevent or treat delirium.”
He added that because melatonin is considered a supplement, “you really don’t know what’s in the pill. There isn’t an FDA-approved and formally regulated formulation.”
Another key recommendation is that at-risk patients receive multicomponent nonpharmacologic interventions.
“I like to think of this as good, humanistic care,” said Oldham. “If somebody can’t see, we make sure they have their glasses, and if they can’t hear, we make sure that they have their hearing aids. We’re talking about providing ambulatory support, so making sure patients get up and walk, and about ensuring patients remain hydrated, have cognitive stimulation, and have the support they need if they’re unable to eat.”
Judicious Use of Physical Restraints
The APA recommends against using physical restraints except when a patient poses an imminent risk for harm to themselves or others. Crone noted that most patients with delirium do not become severely agitated or psychotic and generally do not attempt to leave bed or remove medical lines.
When agitation does occur, it is often linked to disorientation, delusions — such as believing staff intend to harm them — or visual and auditory hallucinations, Crone said.
“Staff may misinterpret the patient’s behavior as a primary psychotic disorder and turn to using physical restraints,” she added. “They may miss that the patient is delirious.”
Oldham noted that this can easily happen in a busy hospital environment but emphasized the importance of “using the least restrictive option that addresses any acute safety concerns that are present.”
The guideline recommends that patients being discharged or transferred to another health care setting receive “a detailed medication review, medication reconciliation, and reassessment of the indications for medications.” A medication reconciliation ensures, for example, that the pharmacy has updated prescriptions with no duplicates and correct dosages, said Oldham.
Almost all of the recommendations are based on evidence considered “low” quality. “It’s unfortunate there are no better data,” said Oldham, though he stressed, “We have definitely made strides” in recent years.
Crone noted that clinical guidelines often rely on expert consensus and indirect evidence from observational studies rather than randomized clinical trials. “While such trials would be ideal, they are difficult and can be unethical to perform,” she said.
Patients being released or transferred to another healthcare setting should get “a detailed medication review, medication reconciliation, and reassessment of the indications for medications,” according to the guideline. A medication reconciliation involves, for example, ensuring the pharmacy has updated prescriptions with no duplicates and correct doses, said Oldham.
The full guideline is available on the APA website. The APA is also developing supporting resources to help clinicians understand and implement the recommendations, including training slides, a clinician guide, a patient and family guide, webinars, and case vignettes.
