Nature Medicine, Published online: 23 April 2026; doi:10.1038/s41591-026-04350-5
How to meaningfully evaluate AI in clinical medicine
Intestinal metaplasia is the only precursor to esophageal adenocarcinoma
Nature Medicine, Published online: 23 April 2026; doi:10.1038/s41591-026-04332-7
We integrated large-scale epidemiological and genomic data from patients with esophageal adenocarcinoma to compare cancers with and without Barrett’s esophagus (BE). We found shared risk factors, molecular features, evolutionary trajectories and BE lineage markers in both cancer phenotypes. Our findings support a single intestinal metaplasia-mediated pathway and have direct implications for early detection and prevention strategies.
BOLD fMRI reflects both vascular and metabolic signals
Nature Neuroscience, Published online: 23 April 2026; doi:10.1038/s41593-026-02288-y
A recent study by Epp et al. uses advanced, quantitative functional MRI measures to demonstrate that the ‘canonical’ interpretation of blood-oxygenation-level-dependent (BOLD) functional MRI (fMRI) — that increases and decreases in brain activation are accompanied by corresponding changes in blood flow and oxygen metabolism — does not strictly hold across the human brain. Although the authors provided a balanced interpretation, this has been viewed by others as undermining fMRI. We discuss whether the findings bring into question the validity of fMRI-based measures of brain function.
Early dopamine disruption in the entorhinal cortex of a knock-in model of Alzheimer’s disease
Nature Neuroscience, Published online: 23 April 2026; doi:10.1038/s41593-026-02260-w
The authors reveal entorhinal cortex dopaminergic and behavioral dysfunction in Alzheimer’s model mice, suggesting the possibility that entorhinal dopamine loss may contribute to aspects of Alzheimer’s disease.
Across 7 hearings, RFK Jr. talks a new, more moderate MAHA
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Good morning, we made it to Thursday. Thanks for reading.
STAT+: Can Erasca be biotech’s next big thing? We’ll see
This is the online version of Adam’s Biotech Scorecard, a subscriber-only newsletter. STAT+ subscribers can sign up here to get it delivered to their inbox.
I wore my Tottenham Hotspur hoodie while shopping at Market Basket last Sunday. One fellow shopper laughed at me. He must have been an Arsenal fan. But another guy commiserated.
If none of this means anything to you, I’m sorry. My favorite soccer team is circling the drain and I feel sad.
The promise of a better pan-RAS inhibitor
Erasca has been described as the poor man’s Revolution Medicines. Impoverished doesn’t exactly fit, not with Erasca’s market value nearing $7 billion on the promise of a better pan-RAS inhibitor for pancreatic cancer. But RevMed’s value now tops $30 billion, so you can see why biotech investors are motivated to find the next big thing.
Whether Erasca is worthy of that description will become clearer in May when the company reports initial results from an early stage study of its drug, called ERAS-0015.
“RevMed has been a real pioneer in this space,” Erasca co-founder and CEO Jonathan Lim told me when we spoke on Tuesday. “What a day it was last week seeing their data with 13.2 months of median overall survival. It’s great for patients with pancreatic cancer.”
Will fusion power get cheap? Don’t count on it.
Fusion power could provide a steady, zero-emissions source of electricity in the future—if companies can get plants built and running. But a new study suggests that even if that future arrives, it might not come cheap.
Technologies tend to get less expensive over time. Lithium-ion batteries are now about 90% cheaper than they were in 2013. But historically, different technologies tend to go through this curve at different rates. And the cost of fusion might not sink as quickly as the prices of batteries or solar.
It’s tricky to make any predictions about the cost of a technology that doesn’t exist yet. But when there’s billions of dollars of public and private funding on the line, it’s worth considering what assumptions we’re making about our future energy mix and its cost.
One crucial measure is a metric called experience rate—the percentage by which an energy technology’s cost declines every time capacity doubles. A higher figure means a quicker price drop and better economic gains with scaling.
Historically, the experience rate is 12% for onshore wind power, 20% for lithium-ion batteries, and 23% for solar modules. Other energy technologies haven’t gotten cheap quite as quickly—fission is at just 2%.
In the new study, published in Nature Energy, researchers aimed to improve predictions of fusion’s future price by estimating the technology’s experience rate. The team looked at three key characteristics that can correlate with experience rate: unit size, design complexity, and the need for customization. The larger and more complex a technology is, and/or the more it needs to be customized for different use cases, the lower the experience rate.
The researchers interviewed fusion experts, including public-sector researchers and those working at companies in the private sector. They had the experts evaluate fusion power plants on those characteristics and used that info to predict the experience rate. (One note here: The study focused only on magnetic confinement and laser inertial confinement, two of the leading fusion approaches, which together receive the vast majority of funding today. Other approaches could come with different cost benefits.)
Fusion plants will likely be relatively large, similar to other types of facilities (like coal and fission power plants) that rely on generating heat. They will probably need less customization than fission plants—largely because regulations and safety considerations should be simpler—but more than technologies like solar panels. And as for complexity, “there was almost unanimous agreement that fusion is incredibly complex,” says Lingxi Tang, a PhD candidate in the energy and technology policy group at ETH Zurich in Switzerland and one of the authors of the study. (Some experts said it was literally off the scale the researchers gave them.)
The final figure the researchers suggest for fusion’s experience rate is between 2% and 8%, meaning it will see a faster price reduction than nuclear power but not as dramatic an improvement as many common energy technologies being deployed today.
That means that it would take a lot of deployment—and likely quite a long time—for the price of building a fusion reactor to drop significantly, so electricity produced by fusion plants could be expensive for a while. And it’s a much slower rate than the 8% to 20% that many modeling studies assume today.
“On the whole, I think questions should be raised about current investment levels in fusion,” Tang says. (The US allocated over $1 billion to fusion in the 2024 fiscal year, and private-sector funding totaled $2.2 billion between July 2024 and July 2025.) “If you’re talking about decarbonization of the energy system, is this really the best use of public money?”
But some experts say that looking to the past to understand the future of energy prices might be misleading.“It’s a good exercise, but we have to be humble about how much we don’t know,” says Egemen Kolemen, a professor at the Princeton Plasma Physics Laboratory.
In 2000, many analysts predicted that solar power would remain expensive—but then production exploded and prices came crashing down, largely because China went all in, he says. “People weren’t exactly wrong then,” he adds. “They were just extrapolating what they saw into the future.”
How fast prices drop depends on regulations, geopolitical dynamics, and labor cost, he says: “We haven’t built the thing yet, so we don’t know.”
This article is from The Spark, MIT Technology Review’s weekly climate newsletter. To receive it in your inbox every Wednesday, sign up here.
South East GP practices face internet outages
GP practices in the South East of England are experiencing network outages, affecting internet connectivity and access to clinical systems.
STAT+: Will bargain-basement telehealth visits help pharma drive drug scripts?
The little pink pill recently got a retail boost. Addyi, a drug that treats low libido in premenopausal women, has been on the market for more than a decade after a controversial approval. But in December the Food and Drug Administration expanded its use, approving the daily drug for all women under 65.
More women than ever now could qualify for the pill — and its maker, Sprout Pharmaceuticals, made it easy for them to find out. On its Instagram account, in Facebook ads, and on its website, Sprout shared how women could get a quick consult for an Addyi prescription: With a special code, PINKPILL, they could get a telehealth visit for just $10.
Drugmakers have long used discount coupons to encourage patients to use their high-cost medications. Now, coupons can influence not just a drug’s out-of-pocket price, but the cost of consulting with a clinician who can prescribe it.
For Addyi, those consultations and discounts are managed by a telehealth company called Prescribery — one of several that work with drugmakers to help patients “talk to a doctor now” about their products. “We give them the coupon codes that they can use, and they get to market it to drive additional business,” said Prescribery’s CEO and CFO Ross Pope. “That’s sort of our arrangement, where they’re driving more business, both for them and for us.”
As links between pharmaceutical companies and telehealth providers grow, health policy experts and legislators have sounded alarms. Telehealth companies can receive hundreds of thousands of dollars in pharma fees a year. Critics have questioned whether those partnerships break federal laws prohibiting financial kickbacks to induce prescribing, highlighting their potential to promote uncoordinated care and overprescription of unnecessary, and often expensive, branded medications.
The same questions, they say, apply to coupons extended for a drug-specific telehealth visit. “These discount structures are one more piece of the same puzzle,” said Daniel Eisenkraft Klein, a postdoctoral fellow at the Program on Regulation, Therapeutics, and Law at Brigham and Women’s Hospital and Harvard Medical School. “It’s this big financial architecture that’s every step of the way designed to move patients toward the specific drug cheaply and quickly.”
Opinion: Kennedy’s new silence on vaccines is political — and it won’t last
For the moment, Health and Human Services Secretary Robert F. Kennedy Jr. seems quieter and more positive on vaccines than many, us included, ever expected he could be. Public messaging has shifted — at least superficially — toward nutrition, chronic disease, and the Make America Healthy Again agenda. Kennedy even acknowledged in a recent congressional hearing that the measles, mumps, and rubella vaccine is safe and effective “for most people.”
But this lull in anti-vaccine rhetoric and action should not be mistaken for a durable pivot in federal vaccine policy. It is a cynical, political pause: the eye of a storm shaped more by electoral timing than public health strategy.