The Rundown Tech: Amazon’s awfully thirsty data centers


💧 Amazon’s awfully thirsty data centers
Image source: Amazon
The Rundown: Amazon disclosed for the first time that its data centers used 2.5B gallons of water worldwide last year — 5% of what metro Seattle uses annually — a number it’s framing as proof it cools server farms better than the competition.
The details:
Water use fell 2% from 2024 despite a bigger footprint, hitting 0.12 liters per kilowatt-hour — sevenfold better than the industry average, Amazon claims.However, it excludes colocation sites — a fifth of Amazon’s 2024 computing power — and the water burned generating its electricity.Amazon says it will be “water positive” by 2030 and claims it’s 75% of the way there; 26 data centers already run on reclaimed water, with projects underway.Amazon is the last of the big four to disclose water levels — Google, Meta, and Microsoft have reported the numbers since at least 2020.
Why it matters: The numbers land in the middle of a politically charged fight over data center resource use, with Amazon’s hometown of Seattle now weighing moratoriums on new construction. Researchers say, too, that only granular, site-level data will reveal what these facilities actually cost the communities around them.
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John Nosta, Psychology Today: AI Can Build the Science, But Not the Scientist


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AI Can Build the Science, But Not the Scientist

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John Nosta via Psychology Today <noreply@psychologytoday.com> UnsubscribeWed, Jun 10, 8:40 PM (2 days ago)
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A note from John

Discovery is key in science. But what will AI do to the person making the discovery? Read it. You might discover something about yourself. John AI Can Build the Science, But Not the Scientist

Discovery changes the discoverer in ways algorithms cannot replicate.

John NostaBy John Nosta

KEY POINTS:AI accelerates discovery, but the struggle to discover is what forms the scientist. Judgment can’t be transferred, but built through curiosity, error, and revision.The greatest invention may be the mind that makes invention possible.Image by David from Pixabay.
Source: Image by David from Pixabay.

Nikola Tesla once described a curious and remarkable habit. Before building a machine, he would build it in his mind. He would run it, test it, and find flaws without ever touching a physical prototype. The alternating current motor that would eventually help electrify our modern world existed first as an act of Tesla’s mental construction.

What interests me isn’t whether this was actually true in every detail. What interests me is the possibility that the process itself was the point. The motor wasn’t simply an invention waiting to be revealed. The time Tesla spent imagining and refining it may have been spent developing something else at the same time.

Tesla himself.

A recent article in Noema argued that human intuition remains essential to scientific discovery even as AI becomes increasingly capable. I agree. But the argument may stop one step short. The deeper question for me isn’t just if intuition helps produce discoveries. It’s whether the process of discovery helps produce the kind of mind capable of discovering anything at all. We tend to think of knowledge—the theory, the experiment, the breakthrough—as the primary output of science. Yet scientific work produces something else that rarely appears in journals or textbooks. It shapes the minds engaged in the pursuit. A researcher who spends years toiling with a difficult problem develops more than expertise; they develop judgment.

A feel for which intuitions deserve trust and which fail under closer scrutiny. They become, in ways that are hard to measure and easy to undervalue, different people than they were when they began.We may be misreading the role of difficulty. Confusion gets treated as the cost, and the answer as the reward. But patience and humility don’t arrive after the struggle; they emerge from it. Being wrong may not simply precede understanding; it might be the mechanism through which understanding and the individual form.

Imagine Tesla with access to modern simulation tools. The motor arrives sooner. Design flaws are caught instantly. And years of effort compressed into weeks. From the standpoint of productivity, it’s an obvious improvement. But would Tesla have developed his extraordinary capacity for mental simulation if the tools had done the simulating? Would the mind that produced those answers have formed in the same way if the answers had arrived more easily and earlier?

Knowledge and judgment are not the same thing. Knowledge can be transferred, but judgment must be cultivated. One can be delivered while the other must be developed through the very human constellation of curiosity, ambiguity, error, and revision.AI can generate science. That’s the good news and the bad news. What it can’t do is spend years toiling with a problem, getting it wrong, and then becoming someone capable of getting it right. That remains ours. ReferencesGenerative AI lacks the human creativity to achieve scientific discovery from scratch. Scientific Reports. Nature.
A. Wenxuan Ding et al. March 2025. John Nosta John NostaThe Digital SelfTechnology, Transformation and the Future You
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GZERO Europe: Is Putin running out of options in Ukraine. War in Ukraine now longer than WW1

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🪓 Scoop: How Pulte tried to fire Gabbard
 
Tweet by Donald J. Trump (blue check) on a white card against a purple background, accusing Democrats of holding national security hostage and naming William Pulte as acting DNI.
Via Truth Social
 
Tulsi Gabbard, the outgoing director of national intelligence, got an unexpected call Tuesday from her controversial successor, Bill Pulte. “Today is your last day,” he said.

Gabbard was surprised. She had announced she was leaving at month’s end, not Tuesday.

“I need to hear it from the president or the White House,” Gabbard told Pulte, two officials briefed on the discussion told Axios.

Why it matters: The call, unreported until now, was the latest flashpoint in the intelligence wars that erupted last week in D.C. after President Trump picked Pulte as Gabbard’s temporary replacement.📱 After the conversation with Pulte, Gabbard reached Trump, who didn’t request her immediate resignation. “What day works best for you?” the president asked, according to one of the sources.

Gabbard said June 19, and Trump then posted on Truth Social her new exit date.Keep reading.
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Belfast savage attack on Stephen Ogilve … enough to light the embers of the Troubles. 1998 The Good Friday Peace Agreement was signed. Nobody wants protests but then Government must listen to the people and what they have to say about migrants entering the country especially the North of Ireland.

The Conversation12 June 2026Global Edition
The ugly scenes coming out of Belfast this week had very recent echoes; just a week earlier, anti-immigrant hatred and violence flared in the English town of Southampton, also in relation to a violent stabbing incident.

But in Northern Ireland, the sight of masked men torching cars and houses evokes deeper-held memories, too. Belfast-based researcher Brendan Ciarán Browne has interviewed dozens of families displaced in “the Troubles” – the decades-long period of sectarian violence in Northern Ireland. Many of those families were “burned out” of their homes, in a similar fashion to what occurred in Belfast over the last few days.

He attributes the recent outpouring of xenophobia to a “drip-feed effect” from social media that has led to “a horrible outpouring of racist, targeted attacks against people who live in these communities: Doctors, nurses, hospitality workers, colleagues and students.

Our friends.”He adds: “Those who were responsible for Tuesday’s attacks would do well to become more aware, to educate themselves on the causes of division, to get out of the social media echo chamber. They could also listen to the stories of those who were ‘burnt out’ in the past.“And in case you weren’t aware, the FIFA World Cup is now underway.

The Conversation has been busy in recent weeks covering all aspects of the tournament. But during this first weekend of games, I’ll be paying special attention to Haiti, who takes on Scotland on Saturday in their first game in the tournament since 1974. The Haitian team, like others at the World Cup, tells the tale of global migration and diaspora politics

.Matt WilliamsSenior International Editor – New YorkTop story

Protesters burned vehicles, businesses and homes in Belfast. Sipa US/Alamy Live NewsBelfast violence: an uncomfortable reminder of the innocent people ‘burnt out’ during the Troubles Brendan Ciarán Browne, Trinity College Dublin. Families fled burning homes as violence flared in the city.
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Forbes: Abridge wants to be the operating system medicine – Nvidia and Eli Lilly are helping to build it

Startups & VentureHealth

Abridge wants to be the operating system for medicine—and NVIDIA and Eli Lilly are helping build it

Lily Mae Lazarus

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Lily Mae Lazarus

Reporter, News

June 11, 2026, 2:39 PM ET

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Dr. Shiv Rao speaks

Abridge has raised approximately $830 million to date, and has a $5.3 billion valuation.JIM WATSON—AFP/Getty Images

On Thursday morning in New York City, Dr. Shiv Rao stood before a room of health system executives and made a case that ambient AI—a technology that began largely as a transcription tool—was ready to do something far more consequential than writing a doctor’s notes.

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A More Potent Pipeline

Abridge, the startup Rao cofounded in 2018, announced a strategic investment from drugmaker Eli Lilly and what it is calling the first AI-native clinician intelligence platform: a system that both documents the patient-clinician conversation and uses it as the foundation for billing, clinical decision support, payer adjudication, and pharmaceutical trial screening. More than 300 health systemsincluding Northwestern Medicine, Emory Healthcare, and Johns Hopkins—are already live on the platform, supporting upward of 100 million clinical conversations annually and serving more than 250 million patients.

The company’s platform captures conversation between patients and doctors in real time and automatically generates the clinical note, billing codes, and patient summary before the doctor has left the hallway. What’s new is everything that flows from that moment. 

Before the visit, Abridge surfaces care gaps and prior clinical context for the clinician. During the encounter, the tech suggests discussion topics and surfaces relevant clinical guidelines without requiring the physician to switch applications. After the visit, it generates the documentation, flowsheets, and orders—all grounded in the actual words spoken.

“We’ve known all along we wanted to be able to connect the dots across the main stakeholders in healthcare, because the only thing that matters, I think, in terms of AI’s impact on healthcare is business model innovation.” Rao told Fortune. “If we can’t actually improve how healthcare is delivered, how it’s experienced, and how it’s paid for, then we haven’t really moved the needle on the problem.”

Behind the platform expansion is a war chest and a set of strategic bets. Abridge has raised approximately $830 million to date, most recently closing a $316 million Series E extension in April 2026 at a $5.3 billion valuation. NVentures, NVIDIA’s venture arm, is among its backers. 

On Thursday, NVIDIA announced it’s also co-developing with Abridge the first foundation model for clinical conversations: an AI model trained on the specific dynamics of doctor-patient dialogue, not a general large language model adapted for medicine.

Rao also announced a partnership with Artisight—an NVIDIA-backed smart hospital company that uses computer vision to automate patient monitoring and nursing workflows inside hospital rooms. Together, the two platforms give care teams a continuous feed of room sensor data and ambient documentation across an entire hospital stay.

Eli Lilly’s bet tracks closely with its own AI ambitions. The pharma giant is simultaneously building what it has called the industry’s most powerful AI supercomputer in partnership with NVIDIA, and Abridge’s new life sciences module—which can surface clinical trial eligibility from within the clinical conversation itself—represents the kind of patient-facing pipeline Lilly needs to accelerate enrollment for next-generation therapies.

“For us, the most important first priority that we would love to explore, that we are working to explore with them, is around clinical trials,” Rao said.

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The ambient clinical intelligence mark Abridge is chasing was valued at $7.24 billion in 2025 and is projected to reach $56.61 billion by 2035Microsoft, which acquired speech-recognition company Nuance for $19.7 billion in 2022, is the dominant enterprise incumbent. Ambience Healthcare, Suki, and Nabla are all also well-capitalized challengers. But the field is expected to consolidate within the next 12 to 18 months. The question is whether Abridge’s expansion into payments and life sciences creates a defensible moat, or simply a larger target.

“Now the priority is how much impact can we create, and speed is everything, so I think for the foreseeable future we’re just going to focus on the algorithm,” Rao told Fortune. 

The platform’s ambition is also its risk surface. Recording protected health conversations requires updated security assessments, state-specific patient consent, and business associate agreements governing how audio is stored. And AI-generated notes that slip past physician review become part of the permanent medical record—a liability that compounds as the platform moves from documentation into billing codes and clinical orders.

Beneath it all is a deeper governance question. Abridge is now positioning itself as neutral infrastructure connecting providers, payers, and life sciences companies through some of the most sensitive data in medicine: the conversation between a sick person and their doctor.

Whether that trust holds, at scale, is an untested hypothesis.

Subscribe to Fortune Gulf Brief. Every Tuesday, this new newsletter delivers clear-eyed, authoritative intelligence on the deals, decisions, policies, and power shifts shaping one of the world’s most consequential regions, written for the people who need to act on it. Sign up here.

About the Author

Lily Mae Lazarus

By Lily Mae LazarusReporter, News

Lily Mae Lazarus is a news reporter at Fortune.

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The Harvard Gazette: Constitution was made to be amended. So what’s stopping us?

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Jill Lepore
Jill Lepore.Photo by Richard Renaldi.

Nation & World

Constitution was made to be amended. So what’s stopping us?

Jill Lepore argues in her new Pulitzer-winning history that it desperately needs update, traces emergence of roadblocks

June 10, 2026 long read

Excerpted from “We the People: A History of the U.S. Constitution” by Jill Lepore, David Woods Kemper ’41 Professor of American History and Professor of Law at Harvard Law School.

We the People. The Constitution of the United States is made of things that are born, live, thrive, decay, and die: insects, animals, plants, ideas. In order to form a more perfect Union. Each of its elements began, long ago, in the loamy earth, hatching and creeping or slipping, slick and squealing, from the womb of the mind. Establish justice, ensure domestic tranquility. The text is written on parchment made from sheep, fleeced, their hides soaked in lime, stretched and dried. Provide for the common defense. The ink came from the buds of oak leaves, swollen to the size of musket balls by the eggs of wasps. Promote the general welfare. Its words were shaped by quills fashioned from the feathers of molting geese. Secure the blessings of liberty. Its lofty, momentous ideas came from the minds of men, long since dead, and from the books they read. To ourselves and our posterity. Of the nearly 200 written constitutions, the Constitution of the United States — the most influential constitution in the world — is also among the oldest, a relic, as brittle as bone, as hard as stone. Do ordain and establish.

But the U.S. Constitution is neither bone nor stone. It is an explosion of ideas. Parchment decays and ink fades, but ideas endure; they also change. The Constitution attempted to solve ancient problems having to do not only with the people and their rulers, the structure of government, and the nature of rights, but also with the knowability and endurance of law. Ingeniously, it accounted for the passage of time.

“But the U.S. Constitution is neither bone nor stone. It is an explosion of ideas.”

The U.S. Constitution was intended to be amended. “The whole purpose of the Constitution,” Supreme Court Justice Antonin Scalia once said, “is to prevent a future society from doing whatsoever it wants to do.” This is not true. One of the Constitution’s founding purposes was to prevent change. Another was to allow for change without violence. Amendment is so essential to the American constitutional tradition, so methodical and so entire a conception of endurance through adaptation, that it can best be described as a philosophy.

That philosophy has structured American constitutional and political development for two and a half centuries. It has done so in a distinctive, halting pattern of progression and regression in which constitutional change by way of judicial interpretation, in the form of opinions issued by the U.S. Supreme Court, alternates with formal amendment as a means of constitutional revision. This pattern has many times provided political stability, with formal amendment and judicial interpretation as the warp and weft of a sturdily woven if by now fraying and faded constitutional fabric. But this pattern, which features, at regular intervals, the perception by half the country that the Court has usurped the power of amendment, has also undermined the idea of representative government, increased the polarization of American politics, contributed to political violence, and led to the underdevelopment of the U.S. Constitution.

With only 27 amendments, the U.S. Constitution has one of the lowest amendment rates in the world. But since 1789, Americans have submitted nearly 10,000 petitions and countless letters, postcards, and phone and email messages to Congress calling for or opposing constitutional amendments, and they have introduced and agitated for thousands more amendments in the pages of newspapers and pamphlets, from pulpits, at political rallies, on websites, and over social media. Some 12,000 amendments have been formally introduced on the floor of Congress. During the era of rising polarization that began around 1968, members of Congress all but stopped bothering even to propose amendments. The more conservative the Court, the smaller the number of amendments proposed by members of Congress. Instead of arguing for amendments, legislators, lobbyists, and other advocates pursued different means of either securing or thwarting constitutional change: influencing the nomination and confirmation of Supreme Court justices and altering the method those justices use to interpret the Constitution.

“With only 27 amendments, the U.S. Constitution has one of the lowest amendment rates in the world.”

That only 27 amendments have ever been ratified is not because Americans are opposed to amending constitutions. Every U.S. state has its own constitution; these have been frequently revised and even replaced. One delegate to a 19th century constitutional convention in Missouri suggested that a state constitution ought to be rewritten every 14 years because every seven years “every bone, muscle, tissue, fibre, and nerve matter” — every cell in the human body — is replaced, and surely, in twice that time, every constitution ought to be amended, too. And that has nearly proven to be the case. Since 1776, the states have held some 250 constitutional conventions and have adopted 144 constitutions, or about three per state. Every state constitution
currently in place has an amendment provision. For most of American history, the states have been exceptionally busy holding constitutional conventions, but like the practice of amending the U.S. Constitution, the practice of holding state constitutional conventions has stagnated. (No U.S. state has held one since 1986.) Nevertheless, the practice of amendment by popular vote thrives in the states, where revision is exponentially easier to achieve. Since 1789, of more than 10,000 amendments formally proposed in the states, nearly 7,000 — well more than two out of three — have been ratified.

The difficulty of amending the federal constitution has had profound consequences. The U.S. Constitution is older than modern democracy and is burdened with all manner of vestigial provisions. Over time, both the U.S. states and other nation-states have amended their constitutions to replace aristocratic provisions. In the American federal government, such provisions — the Electoral College, the malapportionment of the Senate, and life tenure for Supreme Court justices — cannot be changed without first amending the Constitution and, in the case of the Senate, first amending Article V itself. (Article V places equal suffrage in the Senate effectively beyond amendment.) This impasse leaves Americans subject to what political scientists have called the “tyranny of the minority.” The Fifth Article was meant as a constitutional door, open to the people. After 1971, that door slammed shut.

The year 1971, the last time the U.S. Constitution was meaningfully amended, marked a turning point in the history of American constitutionalism. That year a method of constitutional interpretation that became known as originalism was put forward by a distinguished legal scholar, Yale law professor Robert Bork. The word originalism did not enter the English language until 1980, and it had virtually no currency before 1987, when Ronald Reagan nominated Bork to a seat on the U.S. Supreme Court. But it was in 1971 — just when formal amendment was becoming impossible — that Bork first advanced his theory that the only way to read the Constitution is to determine the original intentions of its framers and that every other method of interpretation amounts to amendment by the judiciary.

Originalism rose from the ashes of Article V. Originalists argued that if the Constitution requires changing, it ought to be done by the democratic method of Article V amendment rather than by nine unelected judges. This is an argument that, in earlier eras, liberals had made, too. (As with earlier progressives and midcentury liberals, conservatives’ objections to judicial power did not last past their acquisition of that power.) A problem with this argument, and it is not a small problem, is that Article V hasn’t worked since 1971. Scalia, asked in 2013 if he considered any part of the Constitution to be a flaw, pointed to Article V. It was “not originally a flaw,” he said, but it had become one because “the country has changed so much.” He said he’d run the numbers and concluded that, “if you picked the smallest number necessary for a majority in the least populous states, something like less than 2 percent of the population can prevent a constitutional amendment.” That is not a constitutional door. That is a constitutional barricade.

Bork’s method of constitutional interpretation came to be called “original intent originalism,” to distinguish it from “original meaning originalism” and “original understanding originalism.”

Notwithstanding the semantic schisms among originalists and the Senate’s rejection of Bork’s nomination, originalism steadily gained ground. “The Constitution means what the delegates of the Philadelphia Convention and the state ratifying conventions understood it to mean, not what we judges think it should mean,” said Supreme Court Justice Clarence Thomas in 2001. By then,
originalism had become not only the prevalent mode of interpretation on the federal bench but also strikingly familiar to the public, where, according to public opinion surveys, nearly half of Americans had come to see it as the only way to interpret the Constitution. Its outcomes mapped onto the policy agenda of conservatives, but as the liberal Supreme Court nominee Elena Kagan said during her Senate Judiciary Committee confirmation hearings in 2010, “We are all originalists.” By the 2020s, the dominance of originalism was so overwhelming that the constitutional scholar Cass Sunstein was left to ask, “If we are not originalists, what might we be?”

Originalists have not often agreed on what originalism is; it is also, perhaps surprisingly, quite changeable. The term is also confusing, since it is used to apply both to a serious and important set of arguments about constitutional interpretation and to a form of popular constitutionalism driven by views that range from patriotism and earnest admiration for the nation’s founding to xenophobia and white nationalism. As a method of constitutional interpretation, a great deal that has gone by the name of originalism is perfectly ordinary, unsurprising, and indispensable. All interpretation of the Constitution, like the interpretation of any piece of writing, involves a close inspection of a document’s text, meaning, purpose, and structure. These methods have been used since even before the death of the last surviving delegate to the 1787 Constitutional Convention, James Madison, in 1836. What was new about originalism as it emerged in the last decades of the 20th century — when the Fifth Article lay dormant — was its insistence that the only way to interpret the Constitution is to read it the way a probate judge reads a dead man’s last will and testament. Madison is that dead man.

Originalists deny that originalism is a method of constitutional change, insisting that it is, instead, a method of constitutional restoration. But originalism is a method of constitutional change; it provides a path to change by way of a new method of constitutional interpretation. That method is not original.

To interpret the Constitution — whether to determine the framers’ original intent, the document’s original meaning, or the public’s understanding of it — originalists consult the Constitution, Madison’s notes from the Philadelphia convention, the records of the ratifying conventions, and the Federalist Papers, 85 essays written in support of ratification by Madison, Alexander Hamilton, and John Jay, in 1787 and 1788. None of these sources were widely read in the 18th century, nor were they even widely available. The Federalist essays originally appeared only in New York newspapers. Madison’s notes were not published until 1840. Nineteenth-century law offices did not generally contain these materials. Before the 20th century, consulting sources like 18th-century dictionaries or the records of the ratifying conventions would have been impossible for most lawyers in the United States. Not until the 1980s, when many key historical collections began to be digitized, could these sources be extensively searched with ease, and not until the 21st century could they be searched at the stroke of a key by anyone with a laptop and access to the internet.

“The framers believed the Constitution to be not merely a text, words woven together, but also a set of unstated principles, no more material than a sunbeam or a shaft of light.”

At any rate, Madison himself did not endorse this method. The framers believed the Constitution to be not merely a text, words woven together, but also a set of unstated principles, no more material than a sunbeam or a shaft of light. They also warned against deference to the past. “Is it not the glory of the people of America,” a young Madison asked in 1787, “that, whilst they have paid a decent regard to the opinions of former times and other nations, they have not suffered a blind veneration for antiquity, for custom, or for names, to overrule the suggestions of their own good sense, the knowledge of their own situation, and the lessons of their own experience?”

Madison, the chief keeper of the records of the Constitutional Convention, did not believe those records had any bearing on the interpretation of the Constitution. “Whatever veneration might be entertained for the body of men who formed our Constitution,” he said, “the sense of that body could never be regarded as the oracular guide in expounding the Constitution.” He also warned against relying on the Federalist Papers, given, as he remarked, rather understating the case, that its authors had been “sometimes influenced by the zeal of advocates.” Late in his life, when both he and the Constitution were older — and when Madison sought specific political outcomes — he would on occasion urge deference to 1787. This isn’t evidence that Madison was an originalist; it’s evidence that both the meaning of the Constitution and the methods of discovering that meaning, far from being fixed, established, and beyond dispute, have never been anything other than changeable, contingent, and contested.

How James Madison, Thomas Jefferson, Alexander Hamilton, and John Quincy Adams came to their view of constitutionalism, and how Robert Bork, Antonin Scalia, and Clarence Thomas came to a very different view in the late 20th century, which they nonetheless claimed to belong to the late 18th century, is one of the stranger paradoxes of American constitutional history.

Copyright (c) 2025 by Jill Lepore. Used with permission of the publisher, Liveright Publishing Corporation/The Countryman Press, a division of W. W. Norton & Company, Inc. All rights reserved.

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The Harvard Gazette: A promising first for researchers probing mental illness

Samantha Baldi and Joseph Taylor.
Samantha Baldi and Joseph Taylor.Veasey Conway/Harvard Staff Photographer

Health

A promising first for researchers probing mental illness

Sy Boles

Harvard Staff Writer

June 10, 2026 4 min read

Anxiety finding a highlight as brain stimulation trial raises new hopes for precision care

Psychiatrists have long treated depression using transcranial magnetic stimulation — noninvasive magnetic pulses that stimulate neurons.

Now, new research is allowing them to fine-tune their approach, potentially targeting specific symptoms and opening new possibilities for precision care.

In a series of papers, including one in Nature Molecular Psychiatry, researchers stimulated two brain circuits — one widely targeted in TMS therapy, the other far more experimental — in people who had moderate to severe symptoms of both anxiety and depression. Both targets eased depression symptoms, but the novel target also led to significant improvements in symptoms of anxiety, suggesting that the new circuit may be a better treatment target for people with both conditions. It was the first time researchers selectively improved specific anxiety symptoms through targeted TMS. 

“This is important for the field because comorbidity is often the rule rather than the exception: Up to half of people who have one psychiatric illness also meet criteria for another,” said Joseph Taylor, lead author on the Molecular Psychiatry paper and a Harvard Medical School assistant professor of psychiatry at Brigham and Women’s Hospital. “That’s why we launched this trial: to take a little bit of a step toward precision medicine — to say, ‘OK, you have two different symptom clusters, we have two different circuits, let’s see if we can change selectively one symptom versus another.’”

TMS is a well-established treatment for major depressive disorder, especially when therapy and medication have failed. But delivery remains imprecise. Clinicians typically target brain regions by measuring the patient’s scalp, leading to incidental variation in where the brain is stimulated.

In previous research, BWH psychiatrists exploited that variation to link brain regions with symptom changes. They found that patients who received stimulation to the more traditional site — the dorsolateral prefrontal cortex — were more likely to see improvements in depressive symptoms: sadness, decreased interest in activities, and suicidality. But those stimulated at the dorsomedial prefrontal cortex, which is not a standard TMS target, were more likely to see improvements in a certain cluster of what they called “anxiosomatic” symptoms: irritability, sexual disinterest, insomnia. 

“These two circuits were derived in a data-driver manner, without going in with a predetermined idea of existing, recognized functional circuits in the brain,” explained Samantha Baldi, HMS postdoctoral fellow in psychiatry at Brigham and Women’s, who was not involved in the previous research but contributed to the latest findings. 

“Essentially, we found evidence that targeting different circuits may influence different symptoms, but we did not find evidence that larger changes in circuit connectivity led to larger symptom improvements.”Samantha Baldi

The new research shows that the two circuits can be targeted intentionally to drive symptom-specific results — though researchers noted that the findings should be taken cautiously, given the small sample size. 

Thirty-six patients who met FDA criteria for TMS treatment for depression and who also reported moderate to severe anxiety were randomized to receive targeting either at the standard stimulation site or the novel one. The patients received 30 daily treatments. As the researchers hypothesized, the relative change in depression versus anxiety was significantly different between the two groups. 

The findings are a promising sign that brain circuit imaging can eventually translate to clinical practice, ushering in a more personalized era of psychiatric treatment. But, the researchers said, major questions remain. Chief among them: Why does it work? 

“Clinical symptoms did change depending on which circuit was targeted, but those changes were not related to how much the brain circuits themselves changed with treatment,” Baldi said. “Essentially, we found evidence that targeting different circuits may influence different symptoms, but we did not find evidence that larger changes in circuit connectivity led to larger symptom improvements.”

In other words, the treatment worked, but there wasn’t a clear correlation between the symptom improvement and connectivity in the targeted brain circuit. 

In the field, Taylor said, that’s not surprising. “We have limited tools to understand how our treatments work, but we are starting to understand how to use our current tools, like functional magnetic resonance imaging, more effectively in terms of treatment planning.”

Still, he said, “Increasingly we’re recognizing brain stimulation as a new area of psychiatry, and the possibilities really are endless.”

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Axios: China saved the oil market

China saved the oil market
 
Illustration of the flag of China as a chart with the stars creating a ripple effect
Illustration: Sarah Grillo/Axios
 
China apparently kept the oil market from imploding in the wake of the Iran war, Axios’ Emily Peck reports.

The world’s second-largest economy sharply cut the amount of oil it imports, taking the pressure off worldwide demand for the commodity and keeping a lid on prices.

💰 The big picture: Even as the conflict enters its fourth month, the price of a barrel of oil is still trading below $100 — defying predictions of $200 back in March when the war began.

The U.S. national average for a gallon of gas is $4.11 — down 10%+ from its late-May peak.

China reduced oil consumption using three key levers:

Ramped up usage of electric vehicles and electric-powered rails.

Used coal instead of oil to produce certain chemicals.
Stopped aggressively stockpiling oil — as it did in the year before the war.📈 

Reality check: Energy prices are still way up since February, and have driven up global inflation.Go deeper.
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Axios: What’s in the Iran Deal:

What’s in the Iran deal
 
Ships are anchored yesterday in the Strait of Hormuz, as seen from Musandam, Oman. Photo: ReutersAxios’ Barak Ravid unpacks the Iran deal President Trump says is so close that he’ll dispatch Vice President JD Vance to sign it in Europe as soon as this weekend:

The U.S.-Iran memorandum of understanding calls for the Strait of Hormuz to reopen immediately without tolls, and for Iran to receive sanctions relief based on compliance, according to a diplomat from one of the mediating countries and a U.S. official.

Why it matters: The MOU would extend the ceasefire for 60 days, including in Lebanon. Nuclear negotiations would be held during that time. The text includes a framework for addressing Iran’s enriched uranium stockpile, though any action on Iran’s nuclear program would depend on a second, more detailed accord.

State of play: The diplomat from one of the mediating countries, who walked Axios through the latest text, said the U.S. and Iran “have agreed on the text of a deal,” but acknowledged the deal still needed final sign-off.

As of last evening, the deal had been approved on the Iranian side at high levels but likely not by Supreme Leader Mojtaba Khamenei, two knowledgeable sources said.

Zoom in: The MOU calls for the strait to be reopened immediately without tolls, with a return to pre-war shipping volumes within 30 days. In return, the U.S. blockade would also be lifted.

🖊 The deal, mediated by Qatar and Pakistan, will be called the Islamabad Agreement — if both sides ultimately agree to sign. Read on.
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