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London Children Offered Polio Vaccine Booster as More Virus Is Found in Sewage

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London Children Offered Polio Vaccine Booster as More Virus Is Found in Sewage

LONDON — Each little one in London age 1 to 9 needs to be provided a booster dose of polio vaccine, the British well being authorities stated on Wednesday, after traces of the virus turned up in sewage samples throughout 1 / 4 of the town’s boroughs, although no particular person circumstances of the illness have been reported.

Well being authorities declared a nationwide incident in June — a designation that’s used to underscore the potential seriousness of the problem — after sewage samples advised the virus was spreading in London. Now, officers stated, samples indicated that it had unfold past a detailed community of some people.

Usually, routine surveillance of sewage in Britain picks up the virus a couple of times a yr, the U.Ok. Well being Safety Company stated in an announcement, however between February and July, 116 samples of sort 2 poliovirus have been detected in samples from eight London boroughs within the north and east of the town.

“No circumstances of polio have been reported and for almost all of the inhabitants, who’re absolutely vaccinated, the chance is low,” Dr. Vanessa Saliba, a marketing consultant epidemiologist on the well being company, stated within the assertion.

“However we all know the areas in London the place the poliovirus is being transmitted have a number of the lowest vaccination charges. Because of this the virus is spreading in these communities and places these residents not absolutely vaccinated at larger danger.”

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Polio, which may trigger paralysis, was as soon as a profoundly feared childhood illness however has virtually been eradicated by vaccination. Britain’s final identified case was in 1984, and a case found in Rockland County, N.Y., final month was the primary in the US in almost a decade. Wild poliovirus has been eradicated from each nation on this planet besides Afghanistan and Pakistan.

The traces present in London’s sewage, just like the case in New York State, concerned poliovirus derived from the oral polio vaccine, which makes use of a weakened dwell type of the virus that immunized folks excrete for a short while.

In uncommon circumstances, in communities with low vaccination protection, the virus can unfold. In very uncommon circumstances — usually the place vaccination safety is low sufficient that it circulates for a minimum of a yr, in response to the World Well being Group — it might progressively mutate again right into a type that may paralyze.

A lot of the London sewage samples contained a type of virus nonetheless very near the innocent model within the vaccine, the U.Ok. Well being Safety Company stated, however just a few carried sufficient mutations to trigger extreme illness.

The oral polio vaccination is not routinely given in Britain, which, like the US, now favors a vaccine that makes use of inactivated — in impact, lifeless — virus.

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The U.Ok. Well being Safety Company stated childhood vaccination uptake in London was decrease than the remainder of the nation. Current figures in London counsel a broader immunization protection of 86.6 %, in response to the International Polio Eradication Initiative, which ought to usually be adequate to forestall widespread transmission of the virus.

“Whereas the vast majority of Londoners are protected against polio, the N.H.S. will shortly be contacting mother and father of eligible youngsters aged one to 9 years outdated to supply them a top-up dose to make sure they’ve most safety from the virus,” stated Jane Clegg, the chief nurse for Britain’s Nationwide Well being Service in London, including that medics have been already reaching out to oldsters and carers of youngsters whose vaccinations weren’t updated.

The U.Ok. Well being Safety Company stated on Wednesday that it was working carefully with the World Well being Group, in addition to well being companies in New York and Israel, to research the hyperlinks between the poliovirus outbreak in London and up to date episodes in Israel and the US.

Many nations globally, together with the US and Israel, already present an extra polio vaccine booster as a part of their childhood vaccination schedule. Britain routinely gives a preschool booster vaccine, which incorporates polio, to youngsters on the age of three years and 4 months outdated.

The British well being company additionally stated on Wednesday that it had already elevated sewage surveillance throughout London, and that 10 to fifteen websites throughout the nation can be examined to establish whether or not poliovirus had unfold exterior of London.

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Apoorva Mandavilli contributed reporting from New York.

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Fertility clinic director vows to rebuild after Palm Springs bombing. 'Life is preserved'

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Fertility clinic director vows to rebuild after Palm Springs bombing. 'Life is preserved'

Less than a week after a targeted bomb explosion nearly destroyed his fertility clinic, Dr. Maher Abdallah stood below the blazing desert sun in front of a liquor store, its windows blown out by the powerful blast. Behind him was what remained of American Reproductive Centers.

The clinic — the Coachella Valley’s only full-service fertility center and IVF lab, according to its website — had been relegated to a crime scene. All four buildings will need to be demolished and replaced, a process that could take up to two years, he said. Still, he dismissed the destruction as “material loss.”

In what Abdallah described as a series of miracles, nobody was in the clinic last Saturday morning and its in vitro fertilization lab remained intact despite the mighty force of the explosion. The attack knocked out the electricity that powered the facility’s incubators and damaged the backup generator, but emergency responders rushed in to address the outage and ensure that the thousands of frozen eggs, sperm and embryos stored in cryogenic tanks went unharmed.

He later learned that of the 14 embryos that were dividing in incubators at the time of the attack — all belonging to one same-sex couple — eight had become “perfect blastocysts,” or balls of cells that form early in pregnancy.

Saturday’s bomb blast in Palm Springs caused large portions of the American Reproductive Centers facility to collapse.

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(Allen J. Schaben / Los Angeles Times)

“My return on the investment is babies,” said Abdallah, whose clinic claims to have helped more than 2,000 couples grow their families, many of them in the region’s LGBTQ+ community. “Life is preserved, and that’s really all I care about.”

The bomb that detonated at the fertility clinic in this resort city last Saturday injured four people and killed the suspected bomber, 25-year-old Guy Edward Bartkus, who lived about an hour away in Twentynine Palms. The FBI has labeled the incident as domestic terrorism.

FBI case investigators, as well as law enforcement sources, characterize Bartkus as having “antinatalist” ideations, a conclusion drawn from social media posts and other online materials authorities have linked to him. In those public posts, he argued that procreation without the consent of the unborn is unethical and unjustifiable in a world struggling with environmental harm, violence and overpopulation. In addition, the posts indicate he was mourning the recent death of a friend.

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A website that authorities link to Bartkus laid out the case for “a war against pro-lifers” and said a fertility clinic would be targeted. “Basically, I’m a pro-mortalist,” the author wrote, referring to a fringe philosophical position that it is best for sentient beings to die as soon as possible to prevent future suffering.

At a news conference Thursday, Abdallah told the throng of local officials and reporters gathered that he forgave the suspect and had instructed his staff not to talk about him.

When asked about the bomber’s ideology, Abdallah said simply that he was “for life” and didn’t care to weigh in further. The only reference to the suspect came from Abdallah’s business partner, who said the doctor had requested he reach out to Bartkus’ family and offer to pay for his funeral services.

 The remains of the car used in Saturday's bomb attack sit in a twisted pile of wire and metal.

The remains of the car used in Saturday’s bomb attack sit in a twisted pile outside the American Reproductive Centers in Palm Springs.

(Allen J. Schaben / Los Angeles Times)

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Instead, Abdallah said he has turned his focus to the future. Just days after the bombing, the clinic was offering basic ultrasounds at another medical office. Next week, American Reproductive Centers will temporarily relocate to a surgical center across the street.

Abdallah vowed to rebuild the clinic on the same site in uptown Palm Springs, across from the local hospital. The facility was well-secured, he said, with cameras on every corner and facing the chained cryogenic equipment. But in the future, he said, he also wants guards to patrol the premises.

“We will rebuild, we will grow, and we will continue to help families grow also,” said Abdallah’s cousin and business partner, Amer Abdallah. “We believe in miracles. We witness them every single day. And no act of hatred can stop us from bringing those miracles into this world.”

Palm Springs mayor Ron deHarte speaks during an outdoor news conference.

Palm Springs Mayor Ron deHarte said the city is working to bring “every possible resource” to the residents and small businesses affected by the bomb attack at American Reproductive Centers.

(Allen J. Schaben / Los Angeles Times)

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Palm Springs Mayor Ron deHarte said the city is working with state, regional and county offices to bring “every possible resource” to the residents and small businesses impacted by the blast, which was reportedly felt more than two miles away and damaged windows and walls in nearby buildings.

He said the City Council would be looking into creating programs to support damaged businesses, including reducing fees for building permits and expediting the processes for obtaining new permits, business licenses and inspections.

“This act,” he said, “will never deter us. Love always triumphs in Palm Springs.”

This article is part of The Times’ equity reporting initiative, funded by the James Irvine Foundation, exploring the challenges facing low-income workers and the efforts being made to address California’s economic divide.

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Trump Has Cut Science Funding to Its Lowest Level in Decades

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Trump Has Cut Science Funding to Its Lowest Level in Decades

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National Science Foundation grant funding through May 21

10-year average

$2 billion

The National Science Foundation, which funds much of the fundamental scientific research at American universities, is awarding new grants at the slowest pace in at least 35 years.

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The funding decreases touch virtually every area of science — extending far beyond the diversity programs and other “woke” targets that the Trump administration says it wants to cut.

Grants funded by the National Science Foundation through May 21 ↓ 51%

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Math, physics and chemistry

$432m

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The chart shows the intended funding amount for new grants awarded by the N.S.F. during the 2025 calendar year through May 21, compared with the average funding for the same period from 2015 to 2024. In 2025 dollars.

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Source: N.S.F.

That means less support for early-stage research that underpins future technological advancements — and American competitiveness — in areas like computer science and engineering; physics and chemistry; climate science and weather forecasting; and materials and manufacturing innovations.

It also means less money for undergraduate and graduate students, postdoctoral researchers and early-career professors — potentially disrupting the nation’s future scientific work force.

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Economists have warned that cutting federal funding for scientific research could, in the long run, damage the U.S. economy by an amount equivalent to a major recession.

“These cuts are the height of self-inflicted harm,” said Robert Atkinson, the president of the Information Technology and Innovation Foundation, a nonpartisan science and technology policy research institute. The foundation has argued that China probably already conducts more research and development than the United States.

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“If they succeed in these cuts, the result will be slower economic growth, less innovation and new tech startups, and even more diminished competitiveness vis-à-vis China,” he added.

The lag in this year’s funding, more than $1 billion below the 10-year average, is for new research grants, but the Trump administration has gone further. It has also terminated more than 1,600 active grants for existing research projects, together worth roughly $1.5 billion (of which at least 40 percent has already been spent).

And it wants to eliminate nearly $5 billion of the agency’s $9 billion budget for next year, cutting spending on “climate; clean energy; woke social, behavioral and economic sciences,” and diversity, equity and inclusion programs.

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Among the in-progress grants that have been terminated, those focused on education in science, technology, engineering and mathematics, or STEM, accounted for the vast majority of the canceled funding. Many of these grants focused on broadening participation in science and engineering among underrepresented student groups.

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Canceled funding from in-progress grants

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STEM education -$656 mil.
Math, physics, chem. -$61 mil.
Geosciences -$53 mil.
Computer science -$47 mil.
Social sciences -$46 mil.
Technology -$38 mil.
Engineering -$36 mil.
Biology -$28 mil.

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The chart shows the total cut in intended award funding for terminated grants grouped by N.S.F. directorate after excluding money that has already been spent.

Source: USA Spending and Grant Watch

But in contrast with the canceled grants, the slowdown in issuing new grants is broader, representing an across-the-board hit to American science.

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Decline in new grant funding in 2025

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Math, physics, chem. -$289 mil.
STEM education -$223 mil.
Biology -$156 mil.
Engineering -$127 mil.
Geosciences -$101 mil.
Computer science -$85 mil.
Technology -$18 mil.
Social sciences -$16 mil.

The N.S.F. said in a statement that while it will focus on the Trump administration’s priorities — like artificial intelligence, quantum information science, biotechnology and nuclear energy — it remains “committed to awarding grants and funding all areas of science and engineering.”

Yet the data shows the agency’s funding of new grants at its lowest level since at least 1990, around when the N.S.F. expanded into its modern structure. The funding has slowed even further since April 30, when agency employees were told to stop awarding funds entirely, according to an email reviewed by The New York Times.

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Cumulative grant funding by the National Science Foundation, 1990-2025

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Shows the cumulative total intended award for all grants funded by the N.S.F. from Jan. 1 to May 21 of each year in 2025 dollars. Spikes reflect large multi-year grants.

Representative Zoe Lofgren of California, the top Democrat on the House science committee, said the Trump administration was denying funding that had already been approved by Congress.

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“What they’re doing is not only illegal, but it’s also very damaging to the science enterprise and, ultimately, to the economy of the United States,” she said.

The N.S.F. has said it is canceling awards that are not in line with its priorities, including those focused on D.E.I., environmental justice, misinformation and disinformation. The cancellations have been cheered by Senator Ted Cruz, Republican of Texas, who in February published a list identifying more than a third of the grants that have been terminated.

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“My Commerce Committee investigation exposed how the Biden administration corrupted the N.S.F. grantmaking process with a divisive fixation on identity politics,” Mr. Cruz said in a statement. “This kind of politicization erodes public trust in science. The N.S.F. must spend taxpayer dollars responsibly and prioritize objectivity and scientific rigor.”

House Democrats on the science committee have said the cancellations themselves are “based on hard-right political ideology and not scientific or research expertise,” and have noted flaws in Mr. Cruz’s report, like associating the term “biodiversity” with D.E.I.

N.S.F. officials interviewed for this article said many grants that have already gone through the agency’s rigorous review process and were recommended for funding have been in limbo for months. After the April 30 email freezing new awards, which was first reported by Nature, another email on May 13 allowed for some new funding but kept a freeze in place for higher education institutions.

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A spokesman for the N.S.F. said it was still “making awards to higher education institutions.”

Either way, the N.S.F.’s directorate for STEM education has had one of the steepest shortfalls in new grants. Its award funding has declined by around 80 percent this year.

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Funding through May 21 for …

STEM education ↓ 80%

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Undergrad. education

$135m

Equity for excellence in STEM

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$46m

Research on learning

$77m

The N.S.F. says that it directly supported over 350,000 researchers, teachers and students last year alone. It supports over 20,000 graduate students, more than any other federal agency except the National Institutes of Health, which funds medical research and has also awarded far fewer grants this year.

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Within its education branch, the N.S.F. has moved to eliminate the division of equity for excellence in STEM, which promotes D.E.I. and supports students who are underrepresented in science and engineering. The closure has been put on hold by a court order.

The N.S.F.’s division of graduate education, which funds graduate student research, typically approves $21 million in grants by this point of the year, but has awarded none so far. It announced 1,000 graduate research fellowships this year, down from over 2,000 in prior years, as reported last month by Nature.

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Ms. Lofgren said these education programs are required by law and were adopted with bipartisan support.

“You can’t have science without scientists,” she said.

Here’s how the shortfall in grant awards this year has affected other areas of science:

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Math, physics and chemistry ↓ 67%

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N.S.F. grant funding for core scientific disciplines like math, physics, chemistry and material sciences has dropped by two-thirds this year.

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The N.S.F. funds “basic” research in these areas: fundamental or unexpected discoveries that may be decades away from practical applications. That includes research on ultrafast lasers in the 1990s that eventually resulted in bladeless LASIK eye surgery, or radar technology in the 1960s that revolutionized weather prediction three decades later.

Curiosity-driven research lays the foundation for private sector investments and leads to breakthroughs that can be commercialized, said Deborah Wince-Smith, the president of the Council on Competitiveness, a nonpartisan organization composed of chief executives, university presidents and heads of national laboratories.

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The N.S.F. has also funded major astronomical observatories that have made groundbreaking discoveries such as capturing the first images of black holes or detecting gravitational waves.

In 2023, the N.S.F. funded half of all federally supported basic research in math and statistics in American colleges. So far this year, math and statistics grant funding is lagging behind previous years by 72 percent.

Funding for physics grants this year has fallen by 85 percent, and funding for materials research grants has dropped by 63 percent.

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Engineering ↓ 57%

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N.S.F. grant funding for core engineering disciplines has dropped by 57 percent this year. These divisions fund areas like robotics, manufacturing innovations and semiconductor research.

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Funding for grants related to chemical, bioengineering, environmental and transport systems has fallen by 71 percent this year, while funding for grants related to civil and mechanical engineering and manufacturing innovation has fallen by 48 percent.

Biology ↓ 52%

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Biological infrastructure

$99m

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Most federal funding for biology research comes from the National Institutes of Health, but the N.S.F. also supports the field. Its grant funding for biology is at half of its previous 10-year average. There were fewer funds awarded for research in biotechnology and environmental biology, and less money for the tools, facilities and people that support biological research.

Computer science ↓ 31%

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Information & intelligent systems

$68m

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Advanced cyberinfrastructure

$39m

Computing foundations

$74m

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Computer science divisions that have supported research in topics like artificial intelligence, data science, computer security and emerging computing technologies have awarded fewer funds this year.

But the office of advanced cyberinfrastructure has awarded twice the funding that is typical by this time of year, including a $26 million grant for generative A.I. tools and a $20 million grant to “advance American leadership in artificial intelligence.”

In 2023, the N.S.F. provided 72 percent of federal funds for foundational computer science research at colleges and universities.

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The agency provided early funding that led to recent developments in artificial intelligence. For example, the researchers who received the 2024 Nobel Prize in Physics for their work in artificial neural networks — technologies that underlie tools like ChatGPT — received N.S.F. funding in the 1980s, long before their work had widespread applications.

The funds also support the careers of graduate students, a large share of whom eventually work in the technology industry, said Greg Hager, the former head of the N.S.F.’s Computer and Information Science and Engineering Directorate, who resigned from the agency this month.

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“It’s going to impact progress today, but it’s going to have profound impacts for years to come,” he said of the reductions in funding for computer science.

Geosciences ↓ 33%

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In 2023, the N.S.F. supported over half of all federally funded basic geosciences research in American universities.

This year, the agency has fired workers at the Office of Polar Programs, which coordinates research in the Arctic and the Antarctic. The polar office has awarded 88 percent less money in grants this year.

But the ocean sciences division has awarded more funding than typical this year, including a $39 million grant to establish an office that will manage a deep-sea drilling program and an $18 million grant to Columbia University to support a research vessel.

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Social and behavioral sciences ↓ 20%

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Social science & economics

$31m

Behavioral & cognitive sciences

$32m

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There has been a 96 percent decrease in grant funding for multidisciplinary research, which spans biology, physics and engineering. Previously funded projects have included using cells as sensors to monitor pollutants and diseases in wastewater, creating biodegradable robots, and engineering fungi to recover valuable metals from e-waste.

The behavioral and cognitive sciences division has awarded 30 percent more grant funding this year compared with the past decade’s average — despite the Trump administration’s targeting of “woke social, behavioral and economic sciences.” That included funding research on tracking changes in romantic relationships, how hand gestures can enhance learning and a database that lists the average rents in a neighborhood.

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Technology, innovation and partnerships ↓ 17%

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Translational impacts

$86m

The CHIPS and Science Act, a bipartisan law enacted during the Biden administration in 2022, created the N.S.F.’s Directorate of Technology, Innovation and Partnerships. Last year it funded projects for agricultural technology in North Dakota, climate resilience in Wyoming and semiconductor assembly in Central Florida.

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This branch’s grant funding has decreased by 17 percent, a moderate reduction compared with the decreases in other areas.

Here are all the changes so far:

Changes in N.S.F. grant funding

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Directorate 2015-2024 avg. funding 2025 funding Change
Education $280 mil. $56 mil. -80%
Graduate education $21 mil. $0 -100%
Equity for excellence in STEM $46 mil. $1 mil. -97%
Research on learning in formal and informal settings $77 mil. $16 mil. -79%
Undergraduate education $135 mil. $39 mil. -71%
Math, physics and chemistry $432 mil. $143 mil. -67%
Strategic initiatives $6k $0 -100%
Physics $72 mil. $11 mil. -85%
Mathematical sciences $113 mil. $32 mil. -72%
Materials research $118 mil. $43 mil. -63%
Chemistry $103 mil. $44 mil. -57%
Astronomical sciences $26 mil. $12 mil. -53%
Engineering $221 mil. $94 mil. -57%
Emerging frontiers in research and innovation $2 mil. $42k -98%
Chemical, bioengineering, environmental and transport systems $75 mil. $22 mil. -71%
Engineering education and centers $27 mil. $12 mil. -56%
Civil, mechanical, and manufacturing innovation $80 mil. $42 mil. -48%
Electrical, communications and cyber systems $36 mil. $19 mil. -48%
Biology $303 mil. $147 mil. -52%
Biological infrastructure $99 mil. $32 mil. -68%
Integrative organismal systems $88 mil. $34 mil. -61%
Environmental biology $75 mil. $39 mil. -49%
Molecular and cellular biosciences $40 mil. $37 mil. -9%
Emerging frontiers $801k $5 mil. +521%
Geosciences $305 mil. $204 mil. -33%
Office of polar programs $51 mil. $6 mil. -88%
Earth sciences $78 mil. $16 mil. -80%
Research, innovation, synergies and education (RISE) $11 mil. $6 mil. -47%
Atmospheric and geospace sciences $63 mil. $40 mil. -36%
Ocean sciences $103 mil. $136 mil. +33%
Computer science $277 mil. $192 mil. -31%
Information & intelligent systems $68 mil. $27 mil. -60%
Computer and network systems $96 mil. $42 mil. -57%
Computing and communication foundations $74 mil. $43 mil. -41%
Office of advanced cyberinfrastructure $39 mil. $80 mil. +102%
Social sciences $78 mil. $62 mil. -20%
National Center for Science and Engineering Statistics $2 mil. $0 -100%
Multidisciplinary activities $11 mil. $401k -96%
Social and economic sciences $31 mil. $20 mil. -37%
Behavioral and cognitive sciences $32 mil. $42 mil. +30%
Technology $110 mil. $92 mil. -17%
Technology frontiers $9k $0 -100%
Translational impacts $86 mil. $44 mil. -48%
Innovation and technology ecosystems $24 mil. $47 mil. +95%
Other $65 mil. $47 mil. -29%
Total $2.1 bil. $1 bil. -50%

Shows the cumulative total intended award for new grants funded by the N.S.F. from Jan. 1 to May 21 of each year.

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‘Total confusion’

The National Science Foundation has usually awarded half of its funds for the fiscal year by early July. In theory, this year’s funding levels could still catch up to former levels if the agency accelerates its pace of making awards over the summer.

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But officials described an agency that has been thrown into chaos as it tries to navigate a new political landscape under President Trump. The agency is in the midst of a major restructuring to eliminate its 37 divisions. It has also conducted layoffs and placed pressure on its workers to resign or retire. (The restructuring and termination of employees has been paused by a court order until Friday.)

Many N.S.F. divisions do not know how much they can spend this fiscal year, which ends Sept. 30, and this uncertainty may also be contributing to this year’s funding lag.

“There’s total confusion,” said one employee who has worked at the N.S.F. for more than a decade and is involved in determining which grants are recommended for funding. The employee, who did not want to be named out of fear of retaliation for speaking to the news media, said that the N.S.F.’s rigorous review process had been disassembled, and that political mandates had taken precedence over scientific merits when assessing grant proposals.

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“There’s confusion on how much money we can spend,” the employee said. “And then there’s confusion because the processes are basically paralyzed.”

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About the data

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Using the N.S.F.’s awards database, we tabulated the intended award amounts for all projects funded between Jan. 1 and May 21 of each year. The award date is determined by the initial amendment date, which typically precedes the start date of the project. Intended awards reflect the amount that the N.S.F. intends to fund over the entire life of a project, which may extend multiple years beyond the year the project was awarded. All award amounts are inflation-adjusted to March 2025 dollars by using the Personal Consumption Expenditures price index.

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You need more than Ozempic to fight food addiction. Here's how

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You need more than Ozempic to fight food addiction. Here's how

Are cookies and chips the new cigarettes? And soda, breakfast cereals and ice cream the new opioids?

In his new book, “Diet, Drugs, and Dopamine: The New Science of Achieving a Healthy Weight” (Flatiron Books), former FDA Commissioner David A. Kessler argues that ultraprocessed foods — meaning “irresistible, highly processed, highly palatable, energy-dense, high-glycemic foods,” as he describes them — have been purposefully engineered by Big Food to be addictive. He calls them “ultraformulated” instead of “ultraprocessed” so as to highlight the deliberate intent on the part of food manufacturers. As a result, 41.9% of adults in the U.S. struggle with obesity, he says. And by 2030, he projects about half of us will.

It’s a “health catastrophe,” Kessler says, “that has reached its apex on every level.”

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Shelf Help is a wellness column where we interview researchers, thinkers and writers about their latest books — all with the aim of learning how to live a more complete life.

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Toxic or visceral fat — meaning fat around our internal organs — has led to a rise in diseases and conditions such as Type 2 diabetes, arthritis, blood clots, hypertension, cardiovascular disease, dementia, stroke and certain cancers.

GLP-1 weight loss drugs, such as Wegovy and Zepbound, have helped millions of people shed weight and curb food cravings. But they create additional health problems, Kessler says, and there’s not enough scientific data accrued yet to speak to their efficacy or safety, long-term.

It’s a topic Kessler is intimately familiar with. He’s battled food addiction since childhood, growing up in New York, and his addiction ballooned in college and medical school when sub sandwiches and chicken wings were his rewards for studying hard. He’s since struggled with managing the side effects of GLP-1 drugs. To reverse the obesity crisis, says Kessler, we need to better understand addiction itself: how ultraprocessed foods take hold of our rational brain. We must also create a new paradigm for addiction, Kessler says, as the current one views addicts through the lens of weakness.

In his book, Kessler urges us to recognize that obesity is a chronic condition that needs to be treated as such.

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The Times spoke with Kessler about healthy weight loss strategies for the long-term, guidelines for using GLP-1s safely, the body positivity movement and improving lifespan.

This interview has been condensed and edited for clarity.

Dr. David A. Kessler.

Dr. David A. Kessler.

(Joy Asico Smith)

In the book, you talk about “the elephant in the room” when it comes to struggles around weight loss today. What is it?

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We’ve failed to recognize how difficult it is to escape the pull of food addiction and overcome our brain’s built-in reward response to these ultraformulated foods that flood our food supply. I’m not talking about cocaine or amphetamines that excessively hijack the dopamine circuits. But the addictive circuits are part of all of us. We are all wired to focus on the most salient stimuli in our environment. And for many of us, that stimuli are these ultraformulated foods. Food is very, very powerful in changing how we feel. It’s not a question of willpower. Our bodies have experienced an insidious decline over the past half a century. And that’s been caused by this never-ending consumption of foods that can trigger the addictive circuits.

How can we “quiet the noise,” as you say, around food addiction?

It’s the interaction between the stimuli in our environment and our brains. Change our environment, and we can remarkably change what’s going on in our brains. [Environment] is everything outside our bodies that we interact with, from the moment we wake up to the moment we go to sleep. What you put on your TV, what fast food restaurants you pass by on the way to work, we are constantly being cued. So you try to eliminate the cues. Or change your environment. Many of us don’t have the opportunity to leave our environment. And the food industry isn’t prone to change their behavior any time soon. But we now have pharmaceutical aids to help tamp that down. The effect of these GLP-1 [weight loss] drugs on food noise, that’s the big discovery.

GLP-1 drugs can lead to serious medical conditions that concern you. What are they, and what should doctors and drug companies be doing differently?

The fact is that the only way you’re going to lose weight — whether it’s drugs or diet or surgery — is to have an energy deficit. [GLP-1s] are very effective at getting you to consume less. But some people are eating less than 1,000 calories a day. There are people eating 600, 800 calories. You have to be under medical care or you run the risk of malnutrition. Food stays in your gut longer and that delay in gastric entering [called gastroparesis] can cause its own set of symptoms as well as metabolic consequences such as hypoglycemia, low blood sugar and other metabolic states. They all result from malnutrition.

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Many doctors who are prescribing this are not well-trained in obesity medicine or in nutrition. And it’s very important, if possible, that a team of healthcare professionals, including a dietitian, be available. There’s no doubt that [drug companies] need to do a better job of studying the real world data. How to use these drugs, how to safely get off these drugs, is a key issue. There needs to be better labeling surrounding gastroparesis and the risks associated with these drugs.

Flatiron Books

(Flatiron Books / Joy Asico Smith)

Most people aren’t going to be on GLP-1s for life because they’re expensive and have adverse effects, you say. Yet going off the drugs, most people gain back the weight. So what’s the solution, long-term?

The question is about intermittent use — can I use these drugs to get my weight off? Then can I use them, intermittently, over a lifetime? But we don’t have data yet to know [if] that’s safe. But you can use these drugs to condition yourself to learn how to eat differently. I eat very differently now — I don’t want to put large amounts of food in my stomach. I’ve conditioned myself not to do that. How long that will last, we’ll see. So you need a range of tools. That can range from nutrition therapy to behavioral therapy to physical activity — and they’re going to vary for the individual. There’s no one tool that’s gonna work for the duration. The pharmacological tools are only one tool, it’s the entire tool box that has to be available. But the most important thing is to recognize that this is a chronic condition that needs continuous care, even after you’ve lost the weight.

Achieving a healthy body weight starts with understanding addiction, you say, not necessarily the old advice to “eat less and move more.” Why is this so important?

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The ultimate answer is ‘eat less and move more.’ But we can’t do that because of the physiological and addictive circuits — they stand in the way. We have to understand that addiction is not just about the weak and the downtrodden. It’s part of all of us, those circuits. We can’t overestimate the amount of stigma and shame and distress that many feel because they’ve been unable to control their weight. They feel it’s their fault, they don’t like themselves for it and society has created all these biases attached to it. The simple recognition [that] our brains are not fully under our control when it comes to these energy dense foods is a very important step.

There’s a delicate balance between the body positivity movement, which encourages people to accept their bodies as they are, and the health crisis that is obesity, which you say is a root cause of many diseases. How do you suggest we navigate that?

That movement did a lot of good — it took the shame out of it, it took the stigma out. But it was at a time when we didn’t have effective tools to reduce visceral fat. You can love your body, but also do things for your health. Those things are not diametrically opposite. And I’m not comfortable with the amount of morbidity and mortality associated with visceral fat and saying we shouldn’t do something about that.

A man sits contemplatively in a tipped over bowl of cereal and milk

(Maggie Chiang / For The Times)

As former commissioner of the FDA, what keeps you up at night these days?

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The recognition that visceral fat is causal in an array of cardiometabolic diseases that increase real disability in one’s senior years. I think we’re not prepared to handle that. We’ve only woken up to the fact of how toxic this visceral fat is.

TAKEAWAYS

From “Diet, Drugs, and Dopamine”

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[Also], Trump’s greatest achievement, in the first term, was Operation Warp Speed. And I was part of it beginning January 2021. The reason we were able to do what we did, and get those vaccines safely developed and produced and distributed, was because there existed institutions within our federal government: the [National Institutes of Health], the [U.S. Food and Drug Administration], the [Center for the Biomedical Advanced Research and Development Authority], the [Centers for Disease Control and Prevention]. Those institutions had enormous expertise and resources. And yes, we had to put it together; yes, we had to do things differently. But we were able to build on that infrastructure. Now they’re destroying that infrastructure. I don’t get it.

To end on a positive note: What amount of weight loss actually decreases future risk of disease?

What’s remarkable is that relatively small amounts can have significant effects. If you want to reverse certain conditions, that would require more weight loss. But almost any weight loss is going to add clinical benefits and be useful in reducing cardiometabolic risk.

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