Opinion: The ‘brain drain’ narrative about health professionals misses half of the story

About 10 years after a breast surgeon we interviewed returned to Dubai to practice, a colleague stopped her in a hospital corridor to tell her: “It’s great — since you came back I no longer see those advanced cases of breast cancer.”

She had not stopped to notice. “You get on the wheel,” she told us in an interview for our research. When you return to your home country after training abroad, you run your clinics, train your nurses, drive out to women’s groups in the hinterlands to give talks, design educational videos that explain breast self-examination without showing a breast, because that is what the censors will pass. You argue to have the word “breast” printed on your medical license; the authorities prefer “chest.” You establish a support group, then a drop-in center, likely the only cancer drop-in center in the Middle East. Somewhere in the middle of all that, you alter what late-stage breast cancer looks like in your country.

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Opinion: The cruise ship hantavirus outbreak is a warning sign to the U.S.

Three passengers are dead. Seven people are ill. The ship is anchored off Cape Verde, passengers cannot disembark, and the World Health Organization is coordinating the response.

The suspected cause is hantavirus, a rodent-borne pathogen with no cure and no approved vaccine. It is not a disease we associate with cruise ships. The MV Hondius departed Ushuaia, Argentina, on April 1, transited Antarctica and the island of St. Helena, and is now the site of what infectious disease experts are calling a genuinely unprecedented outbreak in this kind of setting. Notably, authorities in the Argentine province of Tierra del Fuego— from which the ship departed — have confirmed that no hantavirus cases have ever been recorded there. WHO notes, however, that the virus is endemic in other regions of Argentina and Chile.

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STAT+: Top lawmaker takes aim at doctor lobby, linking AMA’s billing codes to fraud fight

WASHINGTON — For decades, politicians have blamed the country’s biggest doctor lobby for some of the health care systems problems. Now it faces a new line of attack as Republicans portray their health care cuts as fraud-fighting policies. 

The law requires that doctors bill for services in Medicare and Medicaid using Current Procedural Terminology, or CPT, codes, which are owned by the American Medical Association. The codes describe what services a patient received.

A key House Republican is requesting a meeting with Centers for Medicare and Medicaid Services officials to discuss their oversight of the CPT coding system as part of his committee’s investigation into fraud, waste, and abuse. In the letter, Rep. James Comer (Ky.) suggests the “complexity” of medical coding “may be contributing to improper billing and higher costs” and “creates an environment where billing inaccuracies can flourish.”

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Structural Brain Network Alterations in Relation to Treatment and Illness Severity in Bipolar Disorder

Large-scale T1-weighted MRI studies have established grey-matter abnormalities in bipolar disorder (BD), with our group contributing to consensus findings. However, structural connectivity, particularly within emotion- and reward-related circuits, remains poorly understood. Diffusion-weighted MRI (dMRI) enables investigation of white-matter pathways, yet prior work is constrained by small samples, methodological heterogeneity, and unclear medication effects. We conducted the largest dMRI network analysis in BD, relating symptom burden and polypharmacy to tractography-derived connectivity and graph-theoretic metrics.

Gene Syntax Determines DNA Supercoiling and Modulates Gene Expression

When synthetic biologists sketch gene circuits, they usually think in terms of promoters, repressors, and transcription factors—biochemical parts that toggle genes on or off. But DNA is not a flat schematic. It’s a physical polymer that twists, coils, and buckles as genes are transcribed. A pair of new papers from MIT and collaborators shows that this physicality could suggest approaches to controlling the output of gene circuits.

In a recent Science study titled “Gene syntax defines supercoiling-mediated transcriptional feedback,” researchers demonstrate that the order and orientation of neighboring genes—what they call gene syntax—can reshape local DNA supercoiling and, in turn, amplify or suppress the expression of adjacent genes.

“Syntax will be really useful for dynamic circuits. Now we have the ability to select not only the biochemistry of circuits, but also the physical design to support dynamics,” said Katie Galloway, PhD, an assistant professor of chemical engineering at MIT.

The team engineered human cell lines and hiPSCs with synthetic two‑gene reporter circuits arranged in tandem, divergent, or convergent configurations. Their earlier modeling predicted that divergent syntax should boost the expression of both genes, while tandem syntax should suppress the downstream gene. “The thing that we were trying to solve in this paper was: When you put two genes on the same piece of DNA, how does their physical interaction become coupled?” said Galloway. The experimental results matched those predictions: divergent circuits amplified both genes, while tandem circuits showed strong upstream‑to‑downstream repression, with effects reaching up to 25‑fold.

To understand why, the researchers used Region Capture Micro‑C, a high‑resolution genome‑folding mapping technique, to visualize how transcription reshapes DNA. When a gene was activated, the DNA downstream tightened into plectonemes—twisted structures that hinder RNA polymerase binding—while upstream DNA loosened. “Supercoiling impacts transcription of adjacent genes by altering RNA polymerase binding, forming a feedback loop,” the authors of the first paper wrote.

The second paper, published in Nature Biomedical Engineering and titled “STRAIGHT-IN Dual: a platform for dual single-copy integrations of DNA payloads and gene circuits into human induced pluripotent stem cells,” introduced STRAIGHT‑IN Dual, a platform that enables simultaneous, allele‑specific, single‑copy integration of two DNA constructs into hiPSCs. This system allowed the team to “investigate how promoter choice and gene syntax influence transgene silencing and how these design features affect reporter expression and forward programming of hiPSCs into neurons, motor neurons, and endothelial cells,” according to the authors of the second paper.

Using STRAIGHT‑IN Dual, the researchers also demonstrated a practical application: a divergent circuit expressing two components of a yellow fever antibody produced higher output than other configurations.

“This is really exciting because we can coordinate gene expression in ways that just weren’t possible before,” Galloway said. “Now that we understand the syntax, I think this will pave the way for us to program dynamic behaviors.

“If you want coordinated expression, a divergent circuit is great. If you want something that’s either/or, you can imagine using a convergent or tandem circuit, so when one turns on, the other turns off, and you can alternate pulses,” Galloway added.

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