The Guardian 2025-04-22 00:18:56


‘Full-blown meltdown’ at Pentagon after Hegseth’s second Signal chat revealed

Existence of group chat including Hegseth, his wife and others prompt calls for defense secretary to step down

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A former top Pentagon spokesperson has slammed Pete Hegseth’s leadership of the department of defense, as pressure mounts on the US’s top military official following reports of a second Signal chatroom used to discuss sensitive military operations.

John Ullyot, who resigned last week after initially serving as Pentagon spokesperson, said in a opinion essay published by Politico on Sunday that the Pentagon has been overwhelmed by staff drama and turnover in the initial months of the second Trump administration.

Ullyot called the situation a “full-blown meltdown” that could cost Hegseth, a 44-year-old former Fox News host and national guard officer, his job as defense secretary.

“It’s been a month of total chaos at the Pentagon. From leaks of sensitive operational plans to mass firings, the dysfunction is now a major distraction for the president – who deserves better from his senior leadership,” Ullyot wrote.

The warning came as the New York Times reported that Hegseth shared details of a US attack on Yemeni Houthi rebels last month in a second Signal chat that he created himself and included his wife, his brother and about a dozen other people.

The Guardian has independently confirmed the existence of Hegseth’s own private group chat.

According to unnamed sources familiar with the chat who spoke to the Times, Hegseth sent the private group of his personal associates some of the same information, including the flight schedules for the F/A-18 Hornets that would strike Houthi rebel targets in Yemen, that he also shared with another Signal group of top officials that was created by Mike Waltz, the national security adviser.

The existence of the Signal group chat created by Waltz, in which detailed attack plans were divulged by Hegseth to other Trump administration officials on the private messaging app, were made public by the Atlantic magazine’s Jeffrey Goldberg, who had been accidentally added to the group.

The existence of a second Signal chat, coupled with Ullyot’s devastating portrait of the Pentagon under Hegseth, is likely to increase pressure on the White House to take action.

But the White House on Monday expressed support for the secretary of defense.

“The president absolutely has confidence in Secretary Hegseth,” Karoline Leavitt, the press secretary, told reporters. “I spoke to him about it this morning, and he stands strongly behind him.”

Hegseth told reporters that he had spoken with the president and “we are going to continue fighting.”

The Pentagon’s chief spokesperson, Sean Parnell, issued a statement in a post on X on Sunday night following the New York Times report.

“Another day, another old story – back from the dead,” Parnell said. “The Trump-hating media continues to be obsessed with destroying anyone committed to President Trump’s agenda. This time, the New York Times – and all other Fake News that repeat their garbage – are enthusiastically taking the grievances of disgruntled former employees as the sole sources for their article.

“There was no classified information in any Signal chat, no matter how many ways they try to write the story. What is true is that the Office of the Secretary of Defense is continuing to become stronger and more efficient in executing President Trump’s agenda. We’ve already achieved so much for the American warfighter, and will never back down.”

Tammy Duckworth, a Democratic senator from Illinois and combat veteran, said in a statement that the second Signal chat put the lives of US men and women in uniform at greater risk:

“How many times does Pete Hegseth need to leak classified intelligence before Donald Trump and Republicans understand that he isn’t only a f*cking liar, he is a threat to our national security?

“Every day he stays in his job is another day our troops’ lives are endangered by his singular stupidity,” Duckworth said. “He must resign in disgrace.”

Jack Reed, a Democratic senator from Rhode Island, a senior member of the Senate armed services committee, said the report, if true, “is another troubling example of Secretary Hegseth’s reckless disregard for the laws and protocols that every other military service member is required to follow”.

Reed called on Hegseth to “immediately explain why he reportedly texted classified information that could endanger American service members’ lives on a commercial app that included his wife, brother, and personal lawyer”.

Reed said he had “warned that Mr Hegseth lacks the experience, competence, and character to run the Department of Defense. In light of the ongoing chaos, dysfunction, and mass firings under Mr Hegseth’s leadership, it seems that those objections were well-founded.”

Ullyot warned that under Hegseth “the Pentagon focus is no longer on warfighting, but on endless drama” and said “the president deserves better than the current mishegoss at the Pentagon.”

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Donald Trump “stands strongly behind” defense secretary Pete Hegseth, the White House has said, after a Sunday report alleging that he shared sensitive information about planned strikes in Yemen in a private Signal group chat that included his wife and brother.

The White House’s press secretary Karoline Leavitt told reporters on Monday:

The president absolutely has confidence in secretary Hegseth. I spoke to him about it this morning, and he stands strongly behind him.

Leavitt, speaking to Fox News this morning, said Hegseth is doing a “phenomenal job”, adding:

This is what happens when the entire Pentagon is working against you and working against the monumental change that you are trying to implement.

US federal employees ‘improperly’ shared sensitive documents – report

Folder accessible to all General Services Administration staff also contained White House blueprints

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US government employees “improperly” shared sensitive documents, including White House blueprints, with thousands of federal workers, the Washington Post first reported on Sunday.

Staff with the General Services Administration (GSA), an independent agency that oversees the construction and preservation of government buildings, shared a Google Drive folder contacting confidential files to all GSA staff members, totaling more than 11,200 people.

The folder was mistakenly uploaded to a Google workplace with the incorrect settings, making it accessible to all workers, a source told the Axios website after the Post’s story broke.

The inadvertent leak began in 2021 under the Biden administration and was later discovered by GSA’s IT team as apart of a routine audit last week, the Post reported. Banking information for a vendor who helped with a Trump administration press conference was also included in the shared folder, the Post reported.

At least three documents have been shared in the folder during the second Trump term, including one shared just last week. The agency’s IT team is still investigating the inadvertent leak, the Post added. A cybersecurity report was also filed on the incident. The GSA did not respond to the Guardian’s request for comment.

It is unclear if any of the documents shared were classified, but experts have warned that sharing some documents, including White House floor plans, poses obvious security risks.

“Even if they were not formally classified … they would be closely held for obvious security reasons,” said Steven Aftergood, a former director for the Federation of American Scientists’ Project on Government Secrecy, to the Post.

If any documents contained information such as private passageways or security procedures, such information could be considered classified under executive order 13526, Aftergood added to the Post. The order, issued in 2009, created a system for classifying, declassifying and protecting national security information.

The incident is the latest security mishap plaguing the Trump administration. Last month, several senior Trump officials, including Vice-President JD Vance and the defense secretary, Pete Hegseth, discussed secret military plans in a Signal messaging chat involving US attacks against the Houthi group in Yemen.

The breach was first reported by Jeffrey Goldberg, editor-in-chief of the Atlantic, who was mistakenly added to the group chat. Top Democrats, including the Senate minority leader, Chuck Schumer, condemned the leak as a calamitous security blunder.

Hegseth came under fire again this week after news broke that the defense secretary shared strike plans with family members, including his wife and brother, in a separate Signal group chat, the New York Times reported.

The Guardian has independently confirmed the existence of Hegseth’s own private group chat.

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Pete Hegseth shared Yemen attack details in second Signal chat – report

US defense secretary texted strike information to his family in group chat he created, sources tell the New York Times

Before the US launched military strikes on Yemen in March, Pete Hegseth, the defense secretary, sent detailed information about the planned attacks to a private Signal group chat that he created himself, which included his wife, his brother and about a dozen other people, the New York Times reported on Sunday.

The Guardian has independently confirmed the existence of Hegseth’s own private group chat.

According to unnamed sources familiar with the chat who spoke to the Times, Hegseth sent the private group of his personal associates some of the same information, including the flight schedules for the F/A-18 Hornets that would strike Houthi rebel targets in Yemen, that he also shared with another Signal group of top officials that was created by Mike Waltz, the national security adviser.

The existence of the Signal group chat created by Waltz, in which detailed attack plans were divulged by Hegseth to other Trump administration officials on the private messaging app, was made public last month by Jeffrey Goldberg of the Atlantic, who had been accidentally added to the group by Waltz.

The fact that Hegseth also shared the plans in a second Signal group chat, according to “people familiar with the matter” who spoke to the Times, is likely to add to growing criticism of the former Fox weekend anchor’s ability to manage the Pentagon, a huge organization which operates in matters of life and death around the globe.

According to the Times, the private chat also included two senior advisers to Hegseth – Dan Caldwell and Darin Selnick – who were fired last week after being accused of leaking unauthorized information.

Hegseth has previously been criticized for including his wife, Jennifer, a former Fox News producer, in sensitive meetings with foreign leaders, including a discussion of the war in Ukraine with Britain’s most senior defense officials at the Pentagon last month, during which she was pictured sitting directly behind her husband. Phil Hegseth, the secretary’s younger brother, is a podcast producer who was recently hired as a Department of Homeland Security liaison to the Pentagon. It is unclear why either would need to know the details of strike plans in advance.

According to the Times, Hegseth used his private phone, rather than a government device, to access the Signal chat with his family and friends.

CNN reported later on Sunday that three sources familiar with Hegseth’s private Signal group confirmed to the broadcaster that he had used it to share Yemen attack plans before the strikes were launched.

The same information was also confirmed to the Associated Press by a source familiar with the group chat who said that it included 13 people.

Shortly after the news of the second Signal chat broke, Politico published an opinion article by Hegseth’s former press secretary, John Ullyot, which began: “It’s been a month of total chaos at the Pentagon. From leaks of sensitive operational plans to mass firings, the dysfunction is now a major distraction for the president – who deserves better from his senior leadership.”

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House Democrats land in El Salvador to push for return of Kilmar Ábrego García

Four representatives join effort to challenge the Trump administration’s refusal to facilitate the immigrant’s release

  • Who is Kilmar Ábrego García, the man wrongly deported to El Salvador?

A delegation of four House Democrats has arrived in El Salvador to push for the release of Kilmar Ábrego García, part of a mission to challenge the Trump administration’s refusal to comply with a supreme court order to facilitate the return of the immigrant to the United States.

Representatives Yassamin Ansari of Arizona, Maxine Dexter of Oregon, Maxwell Frost of Florida and Robert Garcia of California touched down in Central America on Sunday, following a visit by the Maryland senator Chris Van Hollen last week. The lawmakers are seeking to meet with Ábrego García, who had lived in the US for more than a decade before being swept up in a 15 March operation.

“Even with all of the illegal actions we’ve seen over the last couple of months, I think this is the one that terrifies me the most when it comes to the future of our democracy,” Ansari told the Associated Press in an interview.

According to a congressional aide familiar with the arrangements, the delegation will meet with officials at the US embassy on Tuesday morning to advocate for Ábrego García’s release and ask about other individuals transferred from the US who are currently detained in El Salvador. The lawmakers will also receive classified briefings during their visit.

The case has become a flashpoint in the ongoing tensions between the Trump administration and the supreme court, which ruled that the government had a duty to help return Ábrego García. Justice department lawyers have argued that they lack the power to secure his release from foreign custody.

Garcia, the representative from California, said that Ábrego García deserved due process.

“They’re trying to demonize him, and we’re not here to defend him. He deserves due process, and everyone deserves due process,” Garcia told the AP. “What he did or may have done, that has to be decided by a judge.”

Ábrego García, who had protected legal status that should have prevented his deportation, was sent to El Salvador on a plane carrying alleged immigrant gang members. He is currently held in the country’s Terrorism Confinement Center (Cecot), a facility that has drawn praise from Republican lawmakers but criticism from human rights advocates.

The Trump administration admitted in court filings that “an administrative error” led to Ábrego García’s deportation to El Salvador – despite a 2019 immigration judge’s order protecting him – but the same officials say they will not return him to his American wife and disabled child in Maryland.

The White House press secretary, Karoline Leavitt, has defended the deportation, claiming Ábrego García was involved in human trafficking and terrorism, and said that if he were to return to the US, “he would immediately be deported again”.

But the controversy has even drawn criticism from some Republicans, with Senator John Kennedy of Louisiana acknowledging on NBC’s Meet the Press that “the administration won’t admit it. But this was a screw-up.”

As minority party members in both chambers of Congress, Democrats have limited leverage over the administration but are still determined on maintaining public pressure. Ansari indicated that more Democratic lawmakers plan to visit El Salvador in the coming weeks, saying: “This is about the future of our democracy and the future of due process as American citizens.”

Ábrego GarcÍa’s wife, Jennifer Vasquez Sura, said in a statement on Monday that the lawmakers’ visit “sends a powerful message”.

“We’re deeply grateful to the members of Congress and advocates for justice now on the ground in El Salvador, building on the leadership of Senator Van Hollen,” she said in the statement, according to NBC News.

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El Salvador’s president proposes swapping US-deported Venezuelans with Maduro’s ‘political prisoners’

Venezuela’s chief prosecutor hits back at ‘cynical’ offer by ‘neofascist’ Salvadoran leader and demands rights for Venezuelan prisoners

El Salvador’s president, Nayib Bukele, has proposed sending 252 Venezuelans deported from the US and imprisoned in his country to Venezuela, in exchange for “political prisoners” held by Venezuela.

On Sunday, Bukele asked that the Venezuelan president, Nicolas Maduro, hand over 252 “of the political prisoners you are holding” under his proposed deal.

The Salvadoran leader did not say whether the prisoners would be incarcerated again upon an exchange.

Venezuela’s chief prosecutor, Tarek William Saab, said Bukele’s proposal was cynical and accused El Salvador of unlawfully detaining 252 Venezuelans. Saab demanded to know what crimes the detainees were accused of, whether they had appeared before a judge, had access to legal counsel, or were allowed to contact family members. In a statement, Saab’s office called Bukele a “neofascist” and added: “The treatment received by Venezuelans in the United States and El Salvador constitutes a serious violation of international human rights law and constitutes a crime against humanity.”

Among those Bukele proposed for release from Venezuela were journalist Roland Carreno, human rights lawyer Rocio San Miguel, and Corina Parisca de Machado, mother of the Venezuelan opposition leader Maria Corina Machado.

He also mentioned nearly 50 detainees of other nationalities, including US, German and French citizens, as part of the proposed exchange.

Adam Boehler, US special envoy for hostage response, posted online in praise of the move and said 10 Americans were among those proposed for the exchange.

Bukele said his foreign ministry would formally present the proposal to the Venezuelan government through diplomatic channels.

In March, the Trump administration deported at least 200 Venezuelans from the US to El Salvador, accusing them of being members of the Tren de Aragua criminal gang. The US is paying El Salvador $6m to detain them in its high-security terrorism confinement centre, known as Cecot.

The Venezuelan government has said it has no political prisoners and that imprisoned people have been convicted of crimes. However, non-governmental organisations claim more than 800 people are detained for political reasons.

The Venezuelan government has denied that the Venezuelans deported by the US have gang affiliations. Lawyers and family members of the detainees have also asserted that the migrants have no ties to criminal groups.

On Saturday, the US supreme court temporarily blocked the Trump administration from deporting another group of Venezuelan migrants accused of gang ties under a rarely used wartime law. The court issued a stay after the American Civil Liberties Union asked it to intervene on an emergency basis.

The Trump administration pressed the supreme court to reject the ACLU’s request. White House officials said the president remained committed to his immigration crackdown, but gave no indication the administration would defy the court’s decision.

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US supreme court hears challenge to Obamacare free preventive healthcare

At issue is constitutionality of taskforce that decides which services insurers must cover without cost to patients

The US supreme court was hearing arguments today in a case that could threaten Americans’ access to free preventive healthcare services under the Affordable Care Act, commonly known as Obamacare.

At issue is the constitutionality of the US preventive services taskforce, which plays a critical role in determining which preventive services health insurers must cover without cost to patients. The 16-member panel of medical experts, appointed by the health secretary without Senate confirmation, has designated dozens of life-saving screenings and treatments as essential preventive care.

If the justices uphold the lower court’s ruling, health associations said in a filing, life-saving tests and treatments that have been cost-free would become subject to co-pays and deductibles, deterring many Americans from obtaining them.

The case represents the latest in a long series of legal challenges to Barack Obama’s signature healthcare legislation to reach the nation’s highest court since its passage in 2010. A big critic of the program during his first term, Trump and his administration have now taken over the case after the Biden administration initially filed the appeal.

In Monday’s oral arguments, Jonathan Mitchell, the conservative lawyer representing the plaintiffs who previously represented Trump in ballot access litigation, insisted that taskforce members are “principal officers” because “their preventive care coverage mandates are neither directed nor supervised by the Secretary of Health and Human Services.”

Mitchell’s argument hinges on interpreting statutory language requiring the task force to be “independent” and “protected from political pressure”, which he argues is incompatible with secretary oversight: “We don’t see any way that statutory language can be squared with the regime envisioned by the government,” he told the justices.

Several justices appeared skeptical of Mitchell’s reading of the statute, with Justice Elena Kagan questioning whether Congress would create a board without specifying who appoints its members: “I mean, it would be an odd statute. I doubt you could find another where Congress has set up a board and … just not said who should appoint.”

The taskforce is made up of medical experts who serve four-year terms on a volunteer basis. It reviews medical evidence and public feedback and issues recommendations about which preventive services would be most effective for detecting illnesses earlier or addressing ailments before a patient’s condition worsens.

The taskforce has identified dozens of preventive services as having a high or moderate net benefit to patients including screenings to detect diabetes and various types of cancer, statin medications to lower the risk of heart disease and stroke, and interventions to help patients quit smoking or unhealthy alcohol use.

The New Orleans-based fifth US circuit court of appeals ruled in 2024 that the taskforce’s structure violates the constitution, as the plaintiffs claimed. The government’s appeal of the fifth circuit’s decision initially was filed by Biden’s administration before being taken up by Trump.

Trump’s administration argued in a supreme court brief that the taskforce’s preventive care recommendations cannot become legally binding on insurers without the HHS secretary’s permission.

“The secretary can remove them at will, and the threat of removal is the ultimate tool for control over final decisions on recommendations,” justice department lawyers wrote.

For this and other reasons, justice department lawyers argued, the taskforce’s members should be seen as so-called “inferior officers”, meaning they can be lawfully appointed by an executive branch department head – like the HHS secretary – and do not require Senate confirmation under the constitution.

In a supreme court filing, the plaintiffs argued that the Affordable Care Act has transformed the longstanding taskforce from an advisory body into one that now issues “decrees” to insurers, adding that the HHS secretary has no authority to stop taskforce recommendations from becoming binding law.

The taskforce’s lack of supervision, they argued, makes its members “principal officers” who must be presidentially appointed and Senate confirmed under the constitution.

Before the case was narrowed to the appointments issue, the lawsuit included a religious objection to being required to cover pre-exposure prophylaxis for HIV. They claimed that such drugs “facilitate and encourage homosexual behavior, prostitution, sexual promiscuity and intravenous drug use”.

The fifth circuit’s ruling also rejected the government’s request to remove certain offending words from the Obamacare provision at issue – a process called severing – in order to make that part of the law conform to the constitution. That issue is also part of the appeal before the supreme court.

The supreme court’s decision is expected by the end of June.

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Trump administration axes key STI lab amid dramatic rise in US syphilis cases

Chaotic cuts to CDC hit expert leadership and programs that surveil, test and research sexually transmitted diseases

The Trump administration’s cuts to a sexually transmitted infection lab at the Centers for Disease Control and Prevention (CDC) comes as some states, such as Wisconsin, announce enormous increases in syphilis.

Syphilis mitigation is just the latest example of work in sexually transmitted infections (STIs) that will be affected by the lab’s closure, as the Trump administration discards expert leadership and programs that surveil, test and research STIs amid chaotic government cuts.

“This is the Cultural Revolution 2.0,” said Gregg Gonsalves, an associate professor of epidemiology at Yale University’s school of public health, about the mid-20th-century political upheaval in China. Gonsalves is an expert in modeling the impact of public policy on infectious disease.

“The 30,000-ft view is this is not necessarily about HIV and STIs – although it is because they have a particular animus against it – they are looking to gut the ability of federal institutions to do their jobs,” he said.

Authorities in Wisconsin announced that syphilis cases had risen 1,450% in the state since 2019, the public health director said in a statement on Thursday. The trend mirrors a nationwide increase that officials at the CDC described only two years ago as a “heartbreaking” epidemic.

Congenital syphilis is also on the rise. The secondary infection occurs when a fetus is infected with syphilis in the womb. The condition is both highly preventable and devastating. Experts consider even one case a sign of failing health infrastructure, because it is easily treated with a single-dose antibiotic.

“We have a raging congenital syphilis epidemic in this country,” said David C Harvey, executive director of the National Coalition of STD Directors. “CDC’s STI lab provides an important backup to confirm results and to tackle difficult diagnosis. We know this is going to negatively impact on our ability to prevent babies being born with syphilis and to prevent stillborns from syphilis.”

Sexually transmitted infections (STIs) are among the most common diseases in the world – and the most marginalized. Years of flagging public health funding already meant that the US had some of the highest STI rates in the developed world in four diseases tracked by public health authorities: chlamydia, gonorrhea, HIV and syphilis.

The most recent data shows gonorrhea slightly decreased and chlamydia remained stable, according to a report from the CDC from 2023. New HIV infections decreased 12% between 2018 and 2022, because of new government supports, some put into place during Trump’s first term. Trump pledged to eliminate HIV in the US in his 2019 State of the Union address.

“In the short term, we’re going to see a rebound in a lot of this because public health departments are already suffering under the clawback, and people are having to let go of staff and programs that support [pre-exposure prophylaxis for HIV],” said Gonsalves. “All this other stuff is collapsing.”

Experts have pointed specifically to the highly specialized lab at the CDC, formally called the STD Laboratory Reference and Research Branch, as one of the most shocking cuts.

The lab worked on syphilis and multidrug-resistant gonorrhea, sometimes called “super gonorrhea”. It had the “highest degree of viral hepatitis expertise of any public health laboratory in the world”, according to a letter from the Association of Public Health Laboratories, and the nation’s only capacity to use a PCR test for syphilis, which primarily still relies on mid-20th-century serology testing. The work was not replicated anywhere else in federal or state government, or in private universities or labs.

All 28 employees were laid off by the Trump administration on 1 April, alongside a total of roughly 10,000 colleagues in cuts imposed by the health secretary, Robert F Kennedy Jr.

Together with cuts by the billionaire Elon Musk’s unofficial “department of government efficiency”, the federal Department of Health and Human Services (HHS) has lost nearly a quarter of its 82,000-person workforce.

“This is very concerning to our ability to maintain a functioning public health system and a world-class system that protects the American people,” said Harvey. “We don’t know what’s going to happen, and we’re very worried about this.”

Updating syphilis testing was an especially important project for the lab. Although syphilis is easy to treat, it can be difficult to diagnose, even spawning its own medical aphorism: “He who knows syphilis knows medicine.”

Symptoms of the highly invasive bacterium can be mild or go unnoticed for years, causing feared outcomes such as dementia-like symptoms or blindness. Congenital syphilis is a special horror: up to 40% of infants who contract the disease in utero will be stillborn or die. Those that survive can suffer lifelong disabilities including seizures, cataracts and deafness.

In comments made to the Guardian just before Trump was elected, Dr Jeanne Marrazzo, the director of the National Institutes of Allergy and Infectious Diseases, said she was looking forward to developing new diagnostics for syphilis and researching vaccines for gonorrhea.

“We’ve made commitments to things we can’t back down on – and STIs are a great example,” Marrazzo said. “One of the most frustrating aspects of syphilis in the field is making a diagnosis of active syphilis and then monitoring the response to therapy … So we desperately need new diagnostics.” As part of Kennedy’s cuts, Marrazzo was placed on administrative leave.

Similarly placed on leave was Jonathan Mermin, former director of the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP). In 2023, Mermin described congenital syphilis as “an unacceptable American crisis”.

In addition to work on syphilis tests, the CDC lab was charged with investigating cases of antimicrobial-resistant gonorrhea. Gonorrhea can only be reliably treated with one antibiotic: ceftriaxone. While resistant strains of the infection are rare, they are rising globally – a fact that is only known because the CDC lab was one of three globally that worked alongside the World Health Organization (WHO) to monitor the disease. Trump pledged to withdraw from the WHO as one of his first acts as president. It is not clear what will happen to the 50,000 samples of gonorrhea isolates the lab held in freezers.

“They’re irreplaceable,” a former CDC employee, who asked not to be named for fear of reprisal, told Stat News. “Are they just going to autoclave the whole thing and destroy it?”

Cuts imposed by Doge and Kennedy have also eviscerated expertise and funding for STI research and testing beyond the CDC. The administration’s clawback of more than $11bn ended grants to study STI testing and prevention among transgender women in Florida; efforts to improve the health of mothers and babies in the Mississippi Delta region (an area especially hard-hit by congenital syphilis); and a grant to study the best way to tackle the HIV-syphilis “syndemic” in Chicago. HIV awareness campaigns and studies into prophylactic treatment for chlamydia – among many other programs.

“The biggest concern about containing syphilis is the erosion of our ability to ensure people who have the disease or who have come into contact with the disease are taken care of medically,” said Brandon Kufalk, supervisor of the STI unit at the Wisconsin department of health services, about cuts to health infrastructure.

“We want to maintain our capacity to ensure proper medical care is given, that the correct medications are available to medical facilities, to perform contact tracing on individuals, and communicate what is happening with syphilis in our state effectively,” he said.

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Wild chimpanzees filmed by scientists bonding over alcoholic fruit

Footage of apes consuming fermented breadfruit leads researchers to ask if it may shed light on origins of human feasting

Humans have gathered to feast and enjoy a tipple together for thousands of years, but research suggests chimpanzees may also bond over a boozy treat.

Wild chimpanzees in west Africa have been observed sharing fruit containing alcohol – not in quantities to get roaring drunk but, possibly, enough for a fuzzy beer buzz feeling.

The researchers, led by scientists from the University of Exeter in the UK, caught chimpanzees on film sharing fermented African breadfruit in Guinea-Bissau’s Cantanhez national park.

“For humans, we know that drinking alcohol leads to a release of dopamine and endorphins, and resulting feelings of happiness and relaxation,” said Anna Bowland, from the Centre for Ecology and Conservation at Exeter’s Penryn campus in Cornwall.

“We also know that sharing alcohol, including through traditions such as feasting, helps to form and strengthen social bonds.

“Now we know that wild chimpanzees are eating and sharing ethanolic fruits, the question is: could they be getting similar benefits?”

Using motion-activated cameras, the researchers filmed chimpanzees sharing the large, dense and fibrous fermented fruit on 10 occasions. The fruit shared was tested for alcohol content. The highest level found was the equivalent of 0.61% alcohol by volume (ABV).

“Chimps don’t share food all the time, so this behaviour with fermented fruit might be important,” said Kimberley Hockings, also from the University of Exeter.

Though the alcohol level is relatively low, the chimpanzees ate a lot of fruit every day so might ingest a fair quantity of alcohol, she said. “They can feed on kilograms of the stuff every day. It’s probably analogous to us sipping on a light beer.”

Hockings and her colleagues published a paper in 2015 describing how chimpanzees in west Africa stole and consumed palm sap alcohol created by humans. Some of them appeared to become troublesome, causing mischief such as not letting others build their night nests.

The researchers behind the latest study, however, said chimpanzees were unlikely to get “drunk” on the breadfruit because it would not improve their survival chances.

The sharing seemed to take place between all ages and sexes. Two adult females, nicknamed Chip and Até, were seen ignoring a larger hunk of breadfruit in favour of a smaller but fermented piece.

Two adult males, Mandjambé and Gary, were observed approaching ripe breadfruit with aggressive stances. Mandjambé claimed a piece and began to feed, while another adult male, Bobby, kept Gary at bay. They all had a taste of the ripe breadfruit in the vicinity in the end.

The paper, which appears in the journal Current Biology with the title “Wild chimpanzees share fermented fruits”, asks the question: “Do the origins of feasting behaviour derive from a shared common ancestor?”

Hockings said: “We need to find out more about whether the chimpanzees deliberately seek out ethanolic fruits and how they metabolise it, but this behaviour could be the early evolutionary stages of feasting. If so, it suggests the human tradition of feasting may have its origins deep in our evolutionary history.”

She said the number of observations was small but they could lead to “an explosion” of research into the topic.

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China sends back new Boeing jet made more expensive by tariffs

With estimated $55m price set to balloon by 125%, 737 Max returns to Seattle production hub still wearing the colours of Xiamen Airlines

A Boeing jet intended for a Chinese airline landed back at the planemaker’s US production hub on Sunday, a victim of the tit-for-tat bilateral tariffs launched by Donald Trump.

The 737 MAX, which was meant for China’s Xiamen Airlines, landed at Seattle’s Boeing Field at 6.11pm, according to a Reuters witness. It was painted with Xiamen livery.

The jet, which made refuelling stops in Guam and Hawaii on its 5,000-mile (8,000-km) return journey, was one of several 737 MAX jets – Boeing’s bestselling model – that had been waiting at Boeing’s Zhoushan completion centre for final work and delivery.

Trump this month raised baseline tariffs on Chinese imports to 145%. In retaliation, China imposed a 125% tariff on US goods.

A Chinese airline taking delivery of a Boeing jet could be crippled by the tariffs, given that a new 737 MAX has a market value of around $55m, according to IBA, an aviation consultancy. Beijing is reportedly considering ways to support airlines that lease Boeing jets and are facing higher costs.

Last week it was reported that China’s government had asked Chinese airlines to pause purchases of aircraft-related equipment and parts from American companies like Boeing. China holds about 20% of the expected global demand for aircraft over the next two decades.

Boeing’s order book had 130 planes scheduled for deliver to Chinese companies at the end of March for both commercial airlines and leasing firms, Airways Mag reported.

It was not clear which party made the decision for the aircraft to return to the US. Boeing and Xiamen had not responded to Reuters requests for comment at time of publication.

Just hours before Trump detailed his so-called “liberation day” tariffs, Boeing chief executive, Kelly Ortberg, told a US Senate hearing that the company sold about 80% of its planes overseas and wanted to avoid getting into a situation where “certain markets become closed to us”.

Ortberg said there was about half a trillion dollars in backlogged orders at the time.

Confusion over changing tariffs could leave many aircraft deliveries in limbo, with some airline CEOs saying they would defer delivery of planes rather than pay duties, analysts say.

Michael O’Leary, the group chief executive of budget airline Ryanair, told the Financial Times last week that the company was due to receive 25 Boeing aircraft from August but “we might delay them and hope that common sense will prevail”.

With Reuters in Seattle

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China sends back new Boeing jet made more expensive by tariffs

With estimated $55m price set to balloon by 125%, 737 Max returns to Seattle production hub still wearing the colours of Xiamen Airlines

A Boeing jet intended for a Chinese airline landed back at the planemaker’s US production hub on Sunday, a victim of the tit-for-tat bilateral tariffs launched by Donald Trump.

The 737 MAX, which was meant for China’s Xiamen Airlines, landed at Seattle’s Boeing Field at 6.11pm, according to a Reuters witness. It was painted with Xiamen livery.

The jet, which made refuelling stops in Guam and Hawaii on its 5,000-mile (8,000-km) return journey, was one of several 737 MAX jets – Boeing’s bestselling model – that had been waiting at Boeing’s Zhoushan completion centre for final work and delivery.

Trump this month raised baseline tariffs on Chinese imports to 145%. In retaliation, China imposed a 125% tariff on US goods.

A Chinese airline taking delivery of a Boeing jet could be crippled by the tariffs, given that a new 737 MAX has a market value of around $55m, according to IBA, an aviation consultancy. Beijing is reportedly considering ways to support airlines that lease Boeing jets and are facing higher costs.

Last week it was reported that China’s government had asked Chinese airlines to pause purchases of aircraft-related equipment and parts from American companies like Boeing. China holds about 20% of the expected global demand for aircraft over the next two decades.

Boeing’s order book had 130 planes scheduled for deliver to Chinese companies at the end of March for both commercial airlines and leasing firms, Airways Mag reported.

It was not clear which party made the decision for the aircraft to return to the US. Boeing and Xiamen had not responded to Reuters requests for comment at time of publication.

Just hours before Trump detailed his so-called “liberation day” tariffs, Boeing chief executive, Kelly Ortberg, told a US Senate hearing that the company sold about 80% of its planes overseas and wanted to avoid getting into a situation where “certain markets become closed to us”.

Ortberg said there was about half a trillion dollars in backlogged orders at the time.

Confusion over changing tariffs could leave many aircraft deliveries in limbo, with some airline CEOs saying they would defer delivery of planes rather than pay duties, analysts say.

Michael O’Leary, the group chief executive of budget airline Ryanair, told the Financial Times last week that the company was due to receive 25 Boeing aircraft from August but “we might delay them and hope that common sense will prevail”.

With Reuters in Seattle

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Three people killed after Russia resumes attacks in Ukraine

Attack in Kherson comes as Russia says it will continue ‘special military operation’ despite calls to extend ceasefire

Russia has resumed its attacks on Ukraine, killing at least three people in the southern Kherson region, after a 30-hour Easter ceasefire that Kyiv said Moscow’s armed forces repeatedly violated.

In a statement on Monday, Russia’s military said it was continuing “the special military operation” – Vladimir Putin’s phrase for his 2022 full-scale invasion. Over the weekend Russian troops “strictly observed” the pause in fighting, it claimed.

The ceasefire expired at midnight on Monday. The announcement means the Kremlin has rejected an offer – made by Volodymyr Zelenskyy and endorsed on Sunday by the US state department – to extend the truce by 30 days.

Writing on social media, Zelenskyy said was ready for a “complete, full and honest ceasefire”. He suggested both sides refrain from carrying out strikes with missiles and drones against civilian infrastructure.

“The nature of Ukraine’s actions will remain symmetrical: ceasefire will be met with ceasefire, and Russian strikes will be met with our own in defense. Actions always speak louder than words,” he posted on X.

Putin said Moscow would consider the Ukrainian ceasefire proposal, but accused Kyiv of using civilian sites for military purposes.

“We will analyse everything and take the corresponding decisions,” Putin told state reporters in Moscow.

Moscow appears to be deliberately stalling the peace talks, betting that continued battlefield gains will bolster its position and enable it to demand greater concessions at the negotiating table.

Zelenskyy said Russia had launched numerous attacks using artillery and drones, as well as infantry. The most active part of the Easter frontline was near the city of Pokrovsk, in the eastern Donetsk region, he said.

Enemy forces continued combat operations in Russia’s Kursk region, he added, where Ukrainian units hold a small amount of territory. Russia has claimed Ukraine broke the ceasefire.

Ukrainian soldierssaid their sectors had come under sustained Russian fire. They added that Russian troops used the pause to repair damaged logistical crossings and to prepare for new offensive operations.

“For us, it’s just another day of war, with shelling from various types of weapons and an even one attempt to assault our positions,” Denys Bobkov, from the 37th separate marine brigade said on Sunday.

Putin addressed Russia’s missile strike on the eastern Ukrainian city of Sumy, where 35 people, including two children, were killed, for the first time on Monday. He acknowledged that Moscow had hit civilian infrastructure but claimed the site was being used for military purposes. The twin strikes on Sumy were the deadliest incident this year in Russia’s war against Ukraine.

The Kremlin’s apparent position is that the White House will not take any punitive measures against it. Since returning to office in January, Donald Trump has demanded concessions from Kyiv while putting no similar pressure on Moscow.

Trump has described Zelenskyy as a dictator and has blamed him for starting the war alongside Joe Biden. Last week Trump played down a devastating Russian missile strike on the Ukrainian city of Sumy – in which 35 people were killed – calling it “a mistake”.

Leaks suggest the Trump administration is now pushing for a “peace deal” which heavily favours Russia. The deal would include a pause to the conflict along the existing 1,000km frontline, recognition that Crimea belongs to Moscow, and a veto on Ukraine’s Nato membership.

There are also unconfirmed reports that the Zaporizhzhia nuclear power station – which Russia seized in 2022 – would be part of a “neutral” zone. Talks on a possible peace settlement featuring US envoys are due to take place later this week in London.

Speaking on Monday, Putin’s press secretary, Dmitry Peskov, welcomed the US’s sympathetic stance. Russia has also called for Zelenskyy’s removal and Ukraine’s “demilitarisation”.

“We have heard from Washington at various levels that Ukraine’s membership in Nato is excluded. Of course, this is something that causes our satisfaction and coincides with our position,” Peskov said.

After a brief period of relative calm over the weekend, Russia resumed its aerial bombardment of Ukrainian cities and towns. Ukraine’s air force said 96 drones and three missiles were launched overnight at central and eastern regions.

There were air raid alerts across much of the country. In Kherson, three people were killed and three injured in Russian attacks, the region’s governor Oleksandr Prokudin reported in a post on Telegram. A residential area and a store were hit, he said.

Among those killed in the Kherson region was a woman who was struck by a drone while walking down the street, according to Gyunduz Mamedov, a former deputy prosecutor general of Ukraine. Four people were wounded in strikes in Donetsk.

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‘Trust is gone’: fears grow as police on some Florida campuses trained by Ice

At least 11 state colleges enroll in program that trains officers for ‘limited’ involvement in immigration operations

Fears of a new wave of deportations and student visa cancellations are rising at a number of Florida’s most diverse universities after administrators signed agreements recasting campus police as federal immigration agents.

Miami’s Florida International University (FIU) is one of at least 11 state colleges to enroll in the top tier of the Immigration and Customs Enforcement (Ice) 287(g) program that trains local police departments for “limited” involvement in immigration operations.

The partnerships give campus officers broad new powers to stop, question and detain students about their immigration status, and share information directly with Ice, which students and faculty members believe could escalate the Trump administration’s assault on those studying in the US from abroad.

Nationally, more than 1,400 international students and recent graduates perceived by the government to be pro-Palestinian have had their F-1 or J-1 visas canceled by the homeland security department, according to a tally by Inside Higher Ed, with the Miami New Times reporting dozens in Florida.

Additionally, a series of prominent arrests, detentions and deportations of students, alumni and scholars have sparked outrage and protests on campuses nationwide. They include Mahmoud Khalil, Rümeysa Öztürk and Mohsen Mahdawi.

At the University of Florida (UF), which confirmed its collaboration with Ice earlier this month, students have organized several demonstrations against the agreement, and in support of Felipe Zapata Velázquez, a Colombian third-year student deported after he was arrested last month by local police for alleged traffic offenses and handed over into Ice custody.

Maxwell Frost, a Democratic Florida congressman, decried what he called Velázquez’s “government-funded kidnapping”. Protesters say his deportation is part of an ongoing Trump administration purge of overseas students, many for minor infractions.

Earlier this year, the government reactivated the taskforce model of the Ice partnership program that was discontinued by Barack Obama in 2012 for racial profiling, and which the American Civil Liberties Union has argued is unconstitutional.

Ron DeSantis, Florida’s rightwing Republican governor, directed state law enforcement agencies in February to sign up, and the Miami Herald reported on Thursday that almost every college with its own campus law enforcement agency is enrolled.

“That the University of Florida has signed on to the highest level of these agreements is atrocious,” Stephen Sykes, the chair of the UF chapter of the Young Democratic Socialists of America, said.

“There’s no rule in Florida that any group sign on at this level, which effectively makes the police force a wing of Ice itself.”

Sykes continued: “Even across activist communities at UF that generally don’t have the best relationships with police, they were seen as kind of the good people. They protected activists during our Palestine encampment, they were just there hanging out. It felt more like they were protecting us than trying to box us in. Now a lot of that trust is definitely gone.

“Students are scared to come out now, because to even speak up is to risk deportation.”

Activists at FIU share Sykes’s concerns that international students in particular will be reluctant to seek help from campus law enforcement, or to report crimes.

“What will they do with any information they receive? Who will they send it to?” said Bayan Abedulazis, the president of FIU’s Students for Justice in Palestine chapter.

“Things are very uncertain, and there is a lot of fear, just because of the fact that FIU is an international university. Most students either have a background of family not coming from the US or are directly coming from out of the country, and they’ve just kind of detached from a lot of these spaces, like SJP or the like, because they don’t want to be caught or have risk for themselves or their families.”

FIU has almost 3,800 international students from more than 142 countries, according to its website. Madeline Baró, the senior director of media relations, told the Guardian that the visas of 18 students had been revoked, but would not comment about the university’s agreement with Ice.

There was a “no Ice on campus” protest on Tuesday, but Abedulazis said her group had advised international students not to take part.

“For SJP specifically, Palestine is such a big international issue, and we have a lot of international students that have wanted to be involved, or have been involved in the past,” she said.

“This past semester we’ve advised students not to attend any kind of public demonstrations, specifically in regards to Palestine, or just in the general sense, because of the kind of risk that it’s been posing for students to speak out publicly in any kind political manner.”

Educators joined the midweek protest at FIU, with members of its Union Faculty of Florida chapter displaying placards opposing the Ice agreement.

“Universities have usually been considered free spaces, open spaces,” Terrence Peterson, a history professor, told WLRN.

“ We want our students to show up. It’s hard enough to get them to show up anyways if they’re afraid to come because they might be arrested and deported.”

Rogelio Tovar, the chair of FIU’s board of trustees, defended the agreement to colleagues during their meeting on Tuesday, WLRN reported.

“No student should be fearful if they’re here legally and they’re in compliance with the law,” he said.

The university recently acceded to a request from DeSantis to appoint Jeanette Nuñez, a close political ally and his former lieutenant governor, as interim president, sparking allegations of cronyism.

The activist group Florida Student Power Network has also been helping organize campus resistance to Ice integration with university administrators, and lobbying Florida’s state legislators in Tallahassee.

“University campuses do not have to comply to these agreements,” the group said in a statement ahead of a protest at Boca Raton’s Florida Atlantic University (FAU).

“It is clear that schools are bowing down to a racist agenda rather than prioritizing the safety of their students. This won’t stop at FAU. We need to fight back.”

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Netanyahu demanded loyalty before trying to fire me, Shin Bet chief claims

Ronen Bar, head of Israel’s internal security service, says he was also asked to spy on anti-government protesters

The director of Israel’s internal intelligence agency, Shin Bet, has alleged that Benjamin Netanyahu fired him for refusing to pledge his loyalty to the prime minister over the courts and use the agency to spy on anti-government protesters.

The battle between Netanyahu and Ronen Bar, the head of Shin Bet, has pushed Israel to the brink of a constitutional crisis, after the supreme court blocked a decision by the cabinet to dismiss Bar from his post – the first Shin Bet head to be fired.

Bar had alleged that the decision to fire him was driven by Netanyahu’s “personal interests”. On Monday, Bar submitted an 11-page affidavit to the supreme court, which halted his firing last month. The affidavit detailed his version of the events that led to the breakdown of his relationship with Netanyahu and his dismissal.

Among the most serious allegations made in Bar’s affidavit was the claim that “on several occasions” Netanyahu explicitly told Shin Bet to conduct surveillance on citizens involved in anti-government protests, which he refused to do. Bar said the prime minister demanded the agency “provide details regarding the identities of Israeli citizens, protest activists” involved in any demonstrations against the Netanyahu government, and monitor those deemed to be “protest funders”.

Bar also alleged that Netanyahu had made clear to him that in a constitutional crisis, his loyalty must be to the prime minister and not the high court of justice. He also said “an effort was made to coerce me” to sign a document that would have helped Netanyahu avoid publicly testifying in court in a corruption case against him, which Bar pushed back on.

Bar alleged that Netanyahu would voice these demands at the ends of meetings, away from any official documentation. “It was clearly intended to prevent any record of the conversation,” said Bar.

“To this day, the reason for my firing is not clear to me,” he wrote in the affidavit. “But, the developments that took place over the last few months indicate one thing: at some point late last year, the decision to fire me was consolidated. It was not rooted in any professional metric, but out of an expectation by Netanyahu that I would be personally loyal to him.”

In the buildup to Monday’s submission to the courts, it was reported Bar had been put under immense pressure by Netanyahu’s government not to submit his affidavit. He had initially been due to submit it on Sunday, but requested an extra day. It was also leaked to Israeli media that Bar intended to resign in mid-May, which was immediately denied by Shin Bet.

Netanyahu’s office hit back instantly at Bar’s allegations, calling them “a complete lie” and saying the “false affidavit” would be refuted. The government has until Thursday to submit its response to the courts. Netanyahu has said he had lost all trust in Bar’s capacity to lead Shin Bet and accused him of a conflict of interest and politicising the agency.

The relationship between Bar and Netanyahu had become increasingly acrimonious after the 7 October 2023 attacks by Hamas militants in southern Israel. In a report on the events, Shin Bet admitted the agency’s own failures but also criticised policies of the Netanyahu government that it said had enabled a buildup of Hamas in Gaza.

Netanyahu has never accepted any responsibility for Israel’s worst national security disaster, which killed 1,200 people, mostly civilians, and led to 251 being abducted and held hostage in Gaza.

Bar’s authorisation for Shin Bet to open an investigation into Netanyahu’s close aides for allegedly taking payments from Qatar to promote its interests in Israel, at the same time that Qatar was partly financing Hamas in Gaza, was said to only strengthen the prime minister’s animosity. With Netanyahu already facing a multitude of corruption charges in court, political opponents have alleged he wanted to remove Bar in order to sabotage the investigation.

In his affidavit, Bar stood by the actions taken by Shin Bet. “The incitement that has accompanied the investigations, against me and all those tasked with protecting state secrets, demonstrates the connection between the investigations and the timing of my dismissal,” he said.

On Sunday night, Shlomo Karhi, a minister in Netanyahu’s Likud party, told Israeli media that the courts should not be interfering with the cabinet decision to dismiss Bar. “Those who talk about the high court of justice, how it’s the be-all and end-all, what is democratic about that?” he said.

In a press conference, Yair Lapid, the leader of the opposition, spoke out against the direct threats of violence that Bar was facing for standing up to the Netanyahu government. “The level of incitement and insanity are without precedent,” he said. “The red line has been crossed. If we don’t stop this, there will be a political assassination, possibly more than one. Jews will kill Jews.”

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New research finds alarming levels of toxic chemicals in children’s mattresses

A study shows that toxic flame retardants used in mattresses can seep into air and be absorbed by children

Alarming levels of highly toxic phthalates, flame retardants and UV filters in the air in small children’s bedrooms likely stems from kids’ mattresses off-gassing the chemicals, new research suggests.

The peer-reviewed study measured air in the rooms of children under four years old, and the highest volumes were detected around the kids’ beds. An accompanying study checked for the same chemicals in 16 common kids mattress brands, and found them at concerning levels in each.

The chemicals are semi-volatile, meaning they can lift off objects and seep into the air over time, and a simulation then found the warmth and weight of a sleeping child could increase the off-gassing.

The chemicals can then be inhaled, absorbed by the skin, or attach to dust and be ingested.

Researchers were “very surprised” by the chemical levels, said Miriam Diamond, a study co-author and environmental chemist at the University of Toronto. One mattress’s weight was 3% flame retardant.

“We were really shocked to find what was in the mattresses,” Diamond said. “The kids are getting quite a dose of this stuff.” The study was done in partnership with the Green Science Policy Institute in California.

Phthalates and flame retardants are classes of chemicals with compounds linked to serious health issues like cancer, reproductive harm, genital malformation, neurological damage, hormonal disruption and early puberty. Exposure to some types of flame retardants is strongly linked to lower IQs in children.

Phthalates are typically used as plasticizers that help materials bend, and are added to plastic mattress covers, but they were also detected in non-plastic covers, which surprised the authors, Diamond said.

Some types of phthalates are restricted for use in children’s products in the US because of their high toxicity, and the levels in four mattresses exceeded those. No limits exist for other concerning phthalate compounds.

UV filters are added to textiles to prevent dyes from deteriorating, and research has increasingly raised concerns about potential health effects.

Mattresses need to meet flammability standards to prevent fires from spreading, so most companies use flame retardants. However, public health advocates and even some firefighting organizations say flame retardants are largely ineffective and do more harm than good because of their toxicity both to people exposed to them in products, and firefighters who encounter them in smoke.

No federal limits for flame retardant levels in mattresses exist in the US or Canada, but several types of flame retardants that are outright banned in one of the countries, or restricted from use in kids’ products, were found in the mattresses. TCEP, for example, constituted 1% of the weight of one mattress.

Researchers didn’t name the mattress companies but said the products were among common brands sold in the US and Canada for under $150. The mattresses contained materials from unknown countries in addition to China, Turkey and Mexico, so the country of production is unlikely to make a difference, Diamond said.

For those seeking to take some steps to protect themselves, look for mattresses that don’t have flame retardants, or use an alternative, like wool – though those mattresses are typically more expensive. Mattresses made of natural materials such as cotton or latex are less likely to have phthalates, though it’s not a guarantee.

Setting mattresses outside to off-gas after purchase can help get rid of some chemicals, but not all, as phthalates and flame retardants could take years to seep away. Diamond said adding a protective barrier like a terry cloth towel that’s good at absorbing chemicals can be helpful.

But ultimately, “the onus is on the mattress manufacturers” to stop using toxic chemicals, Diamond said.

“The mattress manufacturers need to be more vigilant,” she added.

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Help to reduce high blood pressure lowers dementia risk, study finds

Lifestyle changes and medications found to reduce risk of cognitive disease by about 15%

People given intensive help to reduce their high blood pressure such as medication and coaching have a lower risk of dementia, researchers have found.

According to the World Health Organization, 57 million people around the world had dementia in 2021.

However, experts have long stressed dementia is not an inevitable consequence of ageing. Researchers found about half of cases could be prevented or delayed by addressing 14 risk factors including hearing impairment, smoking, obesity, excessive alcohol consumption and social isolation – as well as high blood pressure.

Now researchers say tackling the last of these could reduce the risk of dementia by 15%.

“Antihypertensive treatment can prevent dementia in patients with uncontrolled hypertension,” said Prof Jiang He, the co-author of the study, from the University of Texas Southwestern Medical Center. “Given the high prevalence of uncontrolled hypertension worldwide, this effective intervention should be widely adopted and scaled up to reduce the global burden of dementia.”

Writing in the journal Nature Medicine, the researchers in China and the US reported how the trial involved 33,995 people aged 40 years and over with uncontrolled high blood pressure, spread across 326 villages in rural China.

The team randomly selected 163 of these villages, with the 17,407 participants who lived there given intensive blood pressure management from non-physician community healthcare providers, often called “village doctors”.

This included free or cheap medications to lower blood pressure, given at tailored doses, health coaching to help them stick to medications and lifestyle modifications – such as weight loss, alcohol reduction and reducing salt intake – and equipment and instructions to monitor blood pressure at home.

The other 163 villages – encompassing 16,588 participants – received “usual care” – meaning participants’ blood pressure was managed in their normal clinical settings. While lifestyle changes were recommended and some took blood pressure-lowering drugs, this group did not receive free at-home blood pressure monitors or medications, or coaching.

When the researchers followed up with the participants after four years, they found 668 of those in the intensive blood pressure management group had dementia, compared with 734 in the usual care group – with analyses suggesting the former group had a 15% lower risk of dementia. Further work revealed this group had a 16% lower risk of cognitive impairment without dementia.

While the team noted that the cognitive function of participants was not assessed at the start of the study, they said the similarity of participants in the two groups means this is unlikely to skew the findings.

However, Prof Joanna Wardlaw, of the University of Edinburgh, who was not involved in the work, said the study could not unpick the relative contribution of optimal blood-pressure control and lifestyle changes on the reduction in dementia risk, suggesting the results reflected a combined effect.

Others said similar research should now be carried out with longer follow-up periods, and added that the approach also needed to be trialled in other countries.

Prof Tara Spires-Jones, the director of the Centre for Discovery Brain Sciences at the University of Edinburgh, said the research “provides further strong evidence supporting the importance of managing blood pressure and other cardiovascular risks to protect the brain during ageing”.

But, she added: “It is important to note that treating high blood pressure was not a foolproof guarantee as some people receiving treatment still developed dementia.”

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