By Anne Snabes, asnabes@detroitnews.com

When he was to gather with family at his grandparents’ house for Christmas dinner this year, Edward Constantineau of Sterling Heights planned to be surrounded by the people who pushed him to fight to recover from the hardest thing he’s ever faced in his young life, a hurdle he’s still working to overcome.

Constantineau was just 19, working out at his local gym in March of this year, when he suffered the unimaginable for a teenager: a stroke. He underwent immediate surgery on a bleed in his brain and later went through six weeks of inpatient rehab at a facility in Detroit, learning how to move again, talk and regain fine motor skills.

But through it all, Constantineau said his biggest motivator as he’s gone through rehab and fought to recover has been “my family and friends.”

“My family was always there,” said Constantineau, now 20. “I mean, my mom never left my side.”

Henry Ford Health officials say Constantineau’s story highlights the importance of early detection and rapid treatment of strokes, only about 10-15% of which occur in people younger than 50. Constantineau’s stroke was caused by a rare condition called arteriovenous malformation, in which arteries and veins mesh together without capillaries connecting them, said his neurologist, Dr. Mohammed Rehman.

Constantineau didn’t know he had the malformation at the time, but it ruptured.

Rehman said that in Edward’s case, the gym receptionist called 911 “right away.”

“If you ever have a neurological deficit … or you think something is going on and something is off, don’t hesitate” to call 911, Rehman said.

Looking back on her son’s ordeal and how it started, Stephanie Constantineau, Edward’s mom, thinks he “saved his own life” by asking for help when he was in the gym and felt his arm weaken. He was the one who asked the receptionist to call 911.

“I definitely believe there was a stronger force with him, watching over him,” she said. “I don’t know, a guardian angel, if you will.”

And Rehman believes Constantineau’s steadfast support system and drive to get better have played a role in his “remarkable” recovery.

“That’s a very rare thing I see, because at his age, when you face something like this, it’s very tough to cope with a lot of things,” Rehman said. “And I could tell, Eddie was driven.”

The stroke

Constantineau, a 2023 graduate of Henry Ford II High School, where he played varsity baseball, said he doesn’t have any memory of the stroke, but he has been told that it started soon after he got to his gym, The Edge Fitness Clubs, on March 14.

As he was doing lat pulldowns, an exercise that involves pulling down a weighted bar attached to a gym machine while seated, he felt his left arm go weak. He asked the gym’s receptionist to call 911; she also called his parents.

Paramedics brought Constantineau to Henry Ford Macomb Hospital in Clinton Township, where they quickly performed surgery.

The next couple of days were “kind of a blur,” Stephanie Constantineau recalled. She describes them as “emotional” and “hard.” She felt helpless as a parent.

“I think the first 48 to 72 hours were really touch and go with him, like it was just like getting him through those first three days to see how, if he was going to recover from the surgeries,” she said.

A rare medical condition

Rehman, a neuroendovascular physician at Henry Ford Health, said most strokes are caused by a blockage of a blood vessel, while others are caused by a bleed in the brain. He said one of the rare causes of a bleed in the brain is an arteriovenous malformation.

Capillaries connect arteries to veins in the body. An arteriovenous malformation (AVM) is a jumble of arteries and veins with no capillaries between them, according to the Cleveland Clinic. The incidence of the condition is around 1 in 100,000 people. The malformations typically occur in the brain, and they’re usually present from birth, according to Henry Ford Health.

Rehman said AVMs often present in young people, and bleeding most commonly occurs between the ages of 10 and 40. He said the Henry Ford Health system sees three to five ruptured arteriovenous malformations a year, and it also sees around 40 to 50 people a year whose malformations haven’t ruptured. AVMs cause symptoms such as severe headaches, seizures or weakness as damage builds, he said.

Dr. Mark Goldberger, a neurosurgeon, did the initial surgery on Constantineau, removing a significant amount of blood from the brain. In the following weeks, his doctors did a few angiograms, or blood vessel tests. In the second angiogram, they discovered the AVM, Stephanie Constantineau said.

Rehman said it took Constantineau at least five to seven days to wake up from the initial surgery ― he was in a coma. Overall, he spent 27 days in the intensive care unit.

“It’s heartbreaking to see your son go through something like this and not know how it’s gonna end up,” Stephanie Constantineau said, tearfully. “Like I say, ‘You just put all your faith in God and the doctors, and just trust that everything’s going to be OK.’ But it’s hard, because we have two other kids.”

She said she never left her son’s side. She spent every night at the hospital and would return home briefly to shower.

The therapy process

After leaving the hospital, Constantineau spent 43 days in inpatient rehabilitation. He said the beginning of the recovery process was “the toughest.”

“I was at a stage where I couldn’t even sit up straight,” he said, referring to when he was in the hospital and the early days of rehab. “I had lost all my muscle and was just sitting in a wheelchair, which was tough every single day. I just felt like stuck in a place where I couldn’t even move.”

He said therapy was “intense” and “very constant,” occurring five or more days a week. He underwent occupational, physical and speech therapy, the latter of which was necessary because he had “no voice after coming off of intubation,” he said.

Constantineau said fine motor skills were “the most frustrating” part of therapy, and he’s still working on it.

“He still doesn’t have, like, mobility of his left hand, like the wrist and fingers, yet,” said Stephanie Constantineau, adding that the recovery takes “a good 18 months.”

“I mean, we haven’t lost hope,” she said. “He works hard every single day.”

At home, Constantineau continues to do therapy each day, he said. In his family’s basement, he does exercises his therapist has recommended and rides on a stationary bike.

“I’ve been trying to adjust to getting back into my regular life by hanging out with friends” and taking an online class at Macomb Community College this fall, he said.

The signs of stroke

Rehman said in an email that strokes can affect anyone at any age, though the likelihood of it increases with age. He said about 10-15% of strokes occur in people under 50. He urged everyone, including young people, to be aware of the signs of a stroke and shared the acronym F.A.S.T. It stands for “Facial drooping, Arm weakness, Slurred speech, Time to call 911.”

He said that if you or anyone around you experiences these symptoms, you should seek medical attention immediately.

“The fact that Eddie sought help immediately when he began experiencing symptoms is incredibly important,” he said. “That allowed 911 to be called and emergency care to be administered quickly. When a stroke occurs, every second counts. The faster a person seeks treatment, the better their outcome.”

His plans for the future

In January, Constantineau will resume in-person classes at MCC, where he is studying exercise science. He plans to re-do the classes he was taking when the stroke occurred earlier this year.

After finishing his associate’s degree, he plans to transfer to Oakland University and is planning to go into health care, either as a nurse or a physician assistant. Constantineau said he originally wanted to go into health care because of his interest in sports, but after everything he’s experienced since his stroke, it has reinforced his decision to go into the field.

Looking back on his experience, Constantineau said the early days of his recovery were “rough” — “I think I was stuck in that ‘why me?’ mentality” — but is now “very confident” with the progress he has made. But he also knows that recovery takes time.

“I think that’s the tough part … just waiting all that time, but … I’m definitely optimistic for the future,” he said.

 

By Mary McNamara, Los Angeles Times

LOS ANGELES — Even with inflation, endless air travel complaints and the recent flight cancellations caused by the government shutdown, millions of Americans, including me, will begin their holiday celebrations on a plane. And while some are already making their packing lists, I am more concerned about what I should watch. In addition to getting you where you want to go, those hours spent in uncomfortable seats — first at the gate and then on board — are a guilt-free opportunity to catch up on or revisit great shows and films.

In-flight viewing is a specific, and sometimes unintentionally communal, viewing experience; not everything works. Choose tearjerkers and musicals with care. Ugly crying over “The Notebook” or singing along with “Wicked” might feel great, but it can cause your fellow passengers unnecessary consternation and/or annoyance.

If you are traveling with or seated near children, you should avoid hard-R-rated fare — as I discovered while briefly attempting to watch “Game of Thrones” while seated beside my then-young son, nudity and beheadings don’t need the sound on to be inappropriate.

Likewise, avoid anything that involves tragic or problematic air travel — catch up on the “Final Destination” franchise another time — and you also might want to skip full-attention-demanding subtitles. The perfect airplane watch allows you to immerse yourself while also remaining aware of what’s happening around you. (Including and especially requests from flight attendants.)

With all these considerations in mind, here are some suggestions.

Watch at the gate

Comedy series are best, for obvious mood-sweetening reasons (should delays occur), but also because the episodes are short and tend not to have dramatic moments that might keep you watching even after your group number has been called.

“Schitt’s Creek” (Amazon)

Each episode of this perfectly addictive series about a once-rich (and very dysfunctional) family that finds itself forced to start anew in a small town will make you laugh no matter how many times you’ve seen it.

“Derry Girls” (Netflix)

Those unfamiliar with the Northern Ireland accent may find it necessary to use subtitles, which I just cautioned against. But this show is worth breaking the rules for. Living through the Troubles in 1990s Derry, five Catholic school friends and their families cope hilariously with everyday issues, including school life under the redoubtable eye of Sister Michael (Siobhán McSweeney).

“New Girl” (Hulu)

The shenanigans of friends/roomies Jess (Zooey Deschanel), Nick (Jake Johnson), Schmidt (Max Greenfield), Winston (Lamorne Morris) and Cece (Hannah Simone) are always a delight.

“Brooklyn Nine-Nine” (Netflix)

Any time’s a good time to watch the greatest police comedy series since “Barney Miller.” Andy Samberg’s Jake Peralta heads a misfit but inevitably successful team of New York detectives, headed by the driest, wisest chief in TV history — Captain Holt, played by the late, great Andre Braugher.

“Abbott Elementary” (Hulu)

Celebrate the holidays with this quick-witted, revelatory and very sweet teacher-centric mockumentary-comedy created by and starring Quinta Brunson. Compared with classroom chaos, even the airport will seem like an oasis of tranquility.

“What We Do in the Shadows” (Hulu)

If you somehow missed this hilariously unique comedy-horror mockumentary about a group of vampires living in modern-day Staten Island, now is the time to rectify that.

Watch on domestic flights

All of the above comedy series work here as well — but movies are best, especially if you can time it so the film begins when altitude is achieved and ends as you’re returning your seat backs and tray tables to their full upright positions.

FILMS:

“The Da Vinci Code” (AMC+)

The perfect in-flight film, “The Da Vinci Code” offers something like cultural edification (the Louvre! The Knights Templar! Biblical history!) while not forcing you to think too much. A tour of Paris, great action sequences, the always endearing Tom Hanks and a literally beatific conclusion.

“Spy” (Amazon)

Melissa McCarthy is an everywoman intelligence agent who chooses to go into the field for the first time in this strangely unsung hero of modern comedy. Guaranteed to make you laugh even if you’re stuck in the middle seat. (Also set in Paris, it’s a perfect double feature with “The Da Vinci Code” for those five-hour flights.)

“Crazy Rich Asians” (Netflix)

Jon M. Chu’s glorious romantic comedy will transport you into a world far beyond the dreary confines of contemporary air travel and make you feel, if only for a moment, that you too are flying in a first-class compartment that contains an actual double bed.

“Iron Man” (Disney+)

Travel back in time to the moment when Robert Downey Jr. jump-started the Marvel Cinematic Universe and remind yourself why. It really is that good.

“Sense and Sensibility” (Amazon)

The exquisite nature of the performances, writing, direction, cinematography and score has made one of the best Jane Austen adaptations a go-to comfort film for when you’re feeling ill. Which is why it’s perfect while flying.

“Paddington” and/or “Paddington 2” (Netflix)

Come for the adorable bear (voiced by Ben Whishaw), stay for the adventure and sweet hijinks (and, in “Paddington 2,” Hugh Grant!). You will reach your destination feeling more kindly to your fellow travelers, which can only improve any trip.

“Edge of Tomorrow” (Netflix)

Tom Cruise teams up with Emily Blunt to battle an alien invasion, with some help from time travel. Classic dystopian thriller with several clever twists. If you’re feeling hot and cramped, just think of Cruise and Blunt in those super suits.

“The Martian” (Netflix)

Feel bad that your flight got delayed and you might not make your connection? A little time spent with Matt Damon’s astronaut, stranded for years on Mars, will put everything in perspective. At least you don’t have to figure out how to grow potatoes in hostile soil.

“Jumanji: Welcome to the Jungle” (Amazon)

The ultimate full-immersion movie sees four teenagers sucked into a survival adventure game in which their avatars are played by Dwayne Johnson, Jack Black, Kevin Hart and Karen Gillan.

“Skyfall” (Amazon)

Honestly, most Bond films are a good choice but Daniel Craig is my favorite Bond and “Skyfall” features a more-than-usual presence of M (Judi Dench). Also, the song.

“Knives Out” (Amazon)

A classic manor house mystery, which revived the genre when it became a hit in 2019, “Knives Out” is the ideal blend of mystery and wit, with a cast of characters to keep you company.

SHOWS:

“Hawkeye” (Disney+)

If you’re looking for a five-hour (or so) miniseries with plenty of Marvel action and a holiday theme, look no further. A year after the events of “Avengers: Endgame,” Hawkeye super fan Kate Bishop (Hailee Steinfeld) teams up with her reluctant hero, Clint Barton (Jeremy Renner), to face down enemies new and old. Oh, and celebrate Christmas in New York.

“Black Mirror” (Netflix)

This sci-fi anthology series is perfect plane viewing because a.) It’s so very good and b.) Each episode is its own story, so you can construct however many hours you need (and, perhaps, catch up on a show so many people continue to talk about).

“Sherlock” (PBS)

Same principle — each episode is essentially a short film and you get to wallow in the wonder of Benedict Cumberbatch (Sherlock), Martin Freeman (Watson), Mark Gatiss (Mycroft) and all the rest as they solve crimes in modern twists on the classic tales.

Watch on international flights

For flights six hours and longer, you can hunker down and make your way through a film franchise or an entire season or seasons of a television series.

FILMS:

“The Lord of the Rings” trilogy (HBO Max)

Pick the director’s cut of all three and your journey through Middle-earth will take you almost 12 hours, which is about as long as it takes to fly from L.A. to New Zealand, where it was filmed.

“Hunger Games” (HBO Max)

The four films in which Katniss Everdeen (Jennifer Lawrence) and friends attempt to wrest a shattered land from the tyranny of President Snow (Donald Sutherland) clock in at about nine hours total, which, with bathroom and meal breaks, should get you from L.A. to London or Paris.

“Mission Impossible” films (Amazon and other platforms)

Although they often include mishaps in the air, the fantastic (in both senses of the word) nature of “Mission: Impossible” makes these films an ideal high-altitude binge. From first to last, they run more than 18 hours, which is, quite frankly, far too many hours of consecutive movie viewing. But with plenty of installments to choose from, you can accept whichever assignments (and Cruise stunts) appeal to you.

“Harry Potter” (HBO Max)

However one feels about J.K. Rowling’s politics, this is a delightful film franchise that’s even longer than “Mission; Impossible” — about 20 hours. But you can start, and stop, the series wherever you want (though I would urge you not to skip the underrated “Order of the Phoenix”).

SHOWS:

“Black Doves” (Netflix)

Keira Knightley and Whishaw play highly unlikely but ruthlessly skilled mercenary spies who work for an ice-cold Sarah Lancashire. The six-hour-long series tells a complete tale (though Season 2 is in the works) and as the events take place in London as Christmas approaches, makes a fine holiday thriller.

“House”

Pick a season, any season (there are eight of them, with an average of 22 episodes each) and the wit, wisdom and scathing insanity of Dr. Gregory House (Hugh Laurie) and his team will carry you through to any destination. And unlike other medical shows, most of the ailments are so bizarre that you won’t have to worry if that cough or twinge is a sign that you’re getting one of them.

“The Durrells in Corfu” (PBS)

It’s 1935 and young widow Louisa Durrell (Keeley Hawes) decides that the answer to her financial straits is to move herself and her four children to the island of Corfu. Sweet and scenic hilarity ensues, and includes the young Josh O’Connor (“The Crown”) and Callum Woodhouse (“All Creatures Great and Small”) as two of Louisa’s sons. Four seasons, 26 episodes. You’re welcome.

“Call the Midwife” (Netflix)

Seasonal purists could just download the dozen or so Christmas episodes of this long-running and still-exceptional drama about a group of midwives working out of a convent in London’s East End. (Between the nuns and the babies, the specials are always wonderful.) But if you haven’t seen the series, best to start with Season 1 and keep going.

“Mare of Easttown” (HBO Max)

If you somehow missed Kate Winslet’s turn as a small-town Pennsylvania cop (with a great Delco accent) who is trying to solve a brutal murder, then this is your chance. If you didn’t, well, it’s time for an eight-hour rewatch in which you can use the time you spent wondering who dunit to admire all the terrific acting.

“Slow Horses” (Apple TV)

The butt-numbing hours will fly by like minutes when you immerse yourself in the TV adaptation of the first five of Mick Herron’s Slough House novels. Gary Oldman is having a blast as Jackson Lamb, the greasy, rumpled, sharp-tongued and strategically flatulent keeper of a den of MI5 misfits. Who somehow manage to save the day.

“The Crown” (Netflix)

Think your flight is long? Consider the reign of the late Queen Elizabeth, played over the course of six seasons by Claire Foy, Olivia Colman and Imelda Staunton. For a full immersive experience, it’s tough to beat the royal settings, period clothes and changing times. And with 60 hours at your fingertips, you can move through history without ever leaving your seat.

“30 Rock” (Hulu)

Tina Fey’s send-up of a fictional “Saturday Night Live”-type show, and satirical look at the television business in general, is just as biting and gimlet-eyed as it was when it premiered almost 20 years ago. It got better as it aged, so for purposes of downloading, look to Seasons 4 and 5.

“Parks and Recreation” (Peacock/Amazon)

Life is always better when you spend some time with Leslie Knope (Amy Poehler), Ron Swanson (Nick Offerman), April Ludgate (Aubrey Plaza) and the many fine public servants in Pawnee, Indiana’s city government. The mockumentary series found its feet in Season 2, so you might want to start there.

“The Wire” (HBO Max)

David Simon’s five-season Baltimore-based crime drama is definitely R-rated (thus breaking one of our earlier stated rules) but it is the show that is consistently listed as one of the best — if not the best — TV dramas ever. So if a long-haul flight demands that you binge, why not binge big?

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©2025 Los Angeles Times. Visit latimes.com. Distributed by Tribune Content Agency, LLC.

By Maria Salette Ontiveros, The Dallas Morning News

DALLAS — A new version of the common flu is spreading globally, and health officials are monitoring this evolving strain of influenza A(H3N3) Subclade K, which has been increasingly detected worldwide.

Seasonal influenza activity has increased globally in recent months, with influenza A viruses accounting for the majority of detections, according to the World Health Organization.

Health officials are closely monitoring a growing subgroup of influenza A(H3N2) viruses known as J.2.4.1, also referred to as Subclade K.

The WHO says detections of this subclade have risen rapidly since August 2025 based on genetic sequence data shared through the global GISAID database.

Current epidemiological data do not indicate increased disease severity associated with subclade K, the WHO says, though its spread reflects the continued evolution of seasonal influenza viruses.

What is subclade K?

Subclade K is a genetically distinct subgroup of influenza A(H3N2) viruses, according to the WHO.

These viruses have drifted genetically from related J.2.4 viruses and carry several amino acid changes in the haemagglutinin protein, which plays a key role in the virus’s attachment to human cells.

Influenza viruses commonly undergo such changes over time. Global surveillance tracks these shifts to assess potential impacts on transmission, severity, and vaccine effectiveness.

Where is subclade K circulating?

The WHO reports that subclade K viruses were first detected at increased levels beginning in August 2025, particularly in Australia and New Zealand.

Since then, the viruses have been identified in more than 34 countries over the past six months, including the U.S.

Detections are increasing in many regions of the world, except so far in South America, according to the WHO.

What is happening in America?

Data from the U.S. Centers for Disease Control and Prevention show that influenza activity in North America remains relatively low but is increasing, driven mainly by detections of influenza A viruses.

During the 2025 southern hemisphere influenza season in the Americas, transmission exceeded the seasonal threshold in mid-March and mainly remained at low to moderate levels, the CDC says.

The CDC reports a predominance of influenza A(H3N2) in both the United States and Canada, with growing detections of the A(H3N2) subclade K.

Are symptoms different?

The WHO says there is no evidence that infections caused by subclade K produce symptoms that differ from or are more severe than those caused by other seasonal influenza A(H3N2) viruses.

Seasonal influenza symptoms typically include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headache and fatigue. Severity can vary based on age, underlying health conditions and immune status.

Do vaccines still protect?

Early estimates cited by the WHO suggest that seasonal influenza vaccines continue to protect against severe illness and hospitalization in both children and adults.

While effectiveness against symptomatic infection may vary from season to season, health officials say vaccination remains one of the most effective public health measures, particularly for people at higher risk of influenza complications and their caregivers.

Even when circulating viruses differ genetically from vaccine strains, vaccines may still reduce the risk of severe outcomes, the WHO says.

What happens next?

The WHO says it continues to monitor global influenza activity and viral evolution, while supporting countries in surveillance efforts and updating guidance as new data emerge.

Health officials note that changes in circulating influenza viruses are expected each season and are routinely assessed through international monitoring systems.

©2025 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.

By Maya Averbuch, Eric Martin and Jennifer A. Dlouhy, Bloomberg News

The U.S. has pursued a third oil tanker off the coast of Venezuela, intensifying a blockade that the Trump administration hopes will cut off a vital economic lifeline for the country and isolate the government of President Nicolás Maduro.

The U.S. Coast Guard chased the U.S.-sanctioned Bella 1 on Sunday as it was en route to Venezuela. It boarded Centuries, a ship owned by a Hong Kong-based entity, on Saturday — the first non-sanctioned vessel to be targeted. Another very large crude carrier, the Skipper, was intercepted on Dec. 10.

The moves on three separate vessels represent the most concerted attempt to date to sever the financial links sustaining a government that Washington says is led by a drug-trafficking cartel, and one that it has also recently designated as a foreign terrorist organization. Maduro has so far withstood the onslaught, but the blockade is beginning to limit hard currency and to hurt an already battered economy.

State-owned Petróleos de Venezuela SA, known as PDVSA, ships most of its cargoes to China, usually through intermediaries using so-called dark-fleet tankers, older vessels with obscure ownership that ferry sanctioned oil from Venezuela as well as Iran and Russia. Imports of feedstock from Russia are also vital to dilute Caracas’ thick crude.

“Washington calculates that Maduro depends far more on oil exports than the US or China depends on his barrels,” said Bob McNally, president of Rapidan Energy Group. “With global balances loosening and prices falling, the U.S. judges it has growing leverage and is likely to intensify pressure on the Maduro regime.”

Washington’s campaign has caught the attention of oil traders, but Venezuela’s exports have dwindled over the years and now account for less than 1% of global demand. The market is also well supplied, and China has multiple alternative options. Oil prices advanced only marginally in early trade in Asia on Monday, with Brent crude climbing toward $61 a barrel.

Maduro has called the Trump administration’s recent moves — deadly strikes on boats allegedly carrying drugs, the authorization of the Central Intelligence Agency to conduct covert operations and Trump’s order to block tankers — a bid to take Venezuela’s oil and install a puppet government.

“This escalation and stronger enforcement point towards a decline in the volume of exports,” said Francisco Monaldi, an energy expert at Rice University in Houston. “These days are going to be critical.”

The Trump administration’s military deployment in the Caribbean is the largest in the region in decades. The weekend’s maritime offensives are aimed at signaling that all tankers in the waters around Venezuela are at risk of interdiction and seizure, according to a person familiar with this month’s operations, who asked not to be identified discussing deliberations that have not been made public.

U.S. Defense Secretary Pete Hegseth said the blockade of sanctioned oil tankers would remain in “full force,” according to a post on X on Dec. 20.

The U.S. Treasury imposed oil sanctions on Venezuela in January 2019, during Donald Trump’s first presidential term. Later, the Biden administration adopted a carrot-and-stick approach to try to reverse Venezuela’s democratic backsliding, granting a waiver to Chevron Corp. in 2022 that allowed it to resume oil operations.

This year, U.S. officials reissued its license after it expired, but sought to guarantee that the Houston-based firm pays no royalties or taxes in cash to the Venezuelan government. Chevron has said its “operations in Venezuela continue without disruption and in full compliance with laws and regulations applicable to its business, as well as the sanctions frameworks provided for by the U.S. government.”

Venezuela’s oil industry has seen a dramatic decline in recent years, but Maduro’s administration has weathered sanctions and the exodus of up to eight million Venezuelans.

The country’s oil production reached the government’s 1.2 million barrels per day target, Venezuelan Vice President and Oil Minister Delcy Rodriguez said on Saturday. Production fell to around 400,000 barrels per day after the 2019 sanctions, but rebounded in later years, said Clayton Seigle, a senior fellow at the Center for Strategic and International Studies in Washington.

Both ships intercepted over the weekend had Panamanian flags, though people familiar with the matter said a Chinese company holds title to the oil that was aboard the first ship, the Centuries supertanker. A White House spokesperson said the tanker was flying a false flag and carrying sanctioned oil.

“What they’re hoping for is a campaign of maximum pressure that will eventually make the regime collapse, without the need of putting boots on the ground,” said Dany Bahar, a senior fellow at the Center for Global Development in Washington. “They’re trying to create a credible threat that will make this structure of power collapse, or high-level military turn around and decide to stand up to Maduro, and say, ‘You have to leave.’”

A right-wing shift in recent elections in Latin America is deepening Venezuela’s diplomatic isolation. Argentina, Bolivia, Ecuador and others signed a statement over the weekend demanding Venezuela respect democratic processes.

Some leaders in the region have still been critical of the campaign. Mexican President Claudia Sheinbaum has said she opposes foreign intervention into sovereign nations, when asked about her stance on opposition leader Maria Corina Machado, the recipient of this year’s Nobel Peace Prize. Brazil’s President Luiz Inacio Lula da Silva said at Saturday’s Mercosur summit in his country that armed conflict in Venezuela would set “a dangerous precedent for the world.”

Maduro’s embattled government will have to reduce production quickly if it cannot export its oil as storage facilities are unable to hold much more crude.

(With assistance from Devika Krishna Kumar.)

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©2025 Bloomberg L.P. Visit bloomberg.com. Distributed by Tribune Content Agency, LLC.

By Gretchen McKay, Pittsburgh Post-Gazette

PITTSBURGH — Thiago Leite has a simple philosophy when it comes to making cocktails, and it applies whether you’re hosting a fancy dinner party for friends or simply curling up on the couch for a quiet night with your partner and Netflix.

“Make what you like,” he says.

Consider the Caipiroska he was stirring together on a test run for Fairmont Pittsburgh’s holiday cocktail classes.

Leite, who is both the Downtown hotel’s banquet director and restaurant manager, was born in the U.S., but he spent every summer of his childhood in Brazil with his family. The national drink there is the Caipirinha, a sweet and tangy cocktail made with fresh lime, sugar and cachaca, a vegetal distilled spirit made from fresh sugarcane juice.

Like most bartenders, Leite is a fan of vodka, a “sponge” spirit that readily takes on the flavors of whatever it is mixed with. On this day, he was tweaking the long-established recipe by using Absolut Elyx instead of cachaca, and brown sugar in place of the superfine cane sugar that traditionally sweetens the drink.

Known for its refreshing quality, this twist on a Caipirinha might seem like an odd choice in Pittsburgh in December. But remember Leite’s No. 1 rule about following your bliss.

“Christmas is hot in Brazil. We’re in sandals and flip-flops,” he explained as he muddled wedges of lime and slices of orange with what looked to be heaps of the caramel-colored sugar in a rocks glass.

Here, it’s hot chocolate and hot toddies, but there everything is iced.”

After a taste test, you, too, would have to agree it’s delicious.

A second cocktail featuring whiskey felt a little bit more like Christmas.

Called the Bashful Boulevardier, the spirit-forward drink is also known as a whiskey-based Negroni because it includes Campari, a bitter bright-red Italian aperitif. Here, rich cherry syrup adds a sweet and tangy twist and a dash of raspberry-flavored Chambord lends a definite luxe, holiday feel.

“It’s what we call a conversation drink,” explained Leite.

That is, a sipping cocktail that encourages social interaction while it is enjoyed over time instead of quickly gulped down.

A Prohibition-era drink generally made with rye whiskey, the Boulevardier is also a perfect “freezer door” cocktail that makes entertaining a breeze, he added, because it can be made in advance in large batches. You can scale up the recipe to serve eight, 10 or even 12 people, depending on the size of your guest list.

This is the second year for the hotel’s holiday cocktail classes. Depending on the day, each will feature one of four spirits — vodka, gin, whiskey or tequila.

“Since it’s a cocktail class, you’ll learn to pour from the bottle,” Leite said.

Attendees also will get instruction on blending ingredients, flavors and botanicals, and try their hand at fundamental techniques like shaking, stirring and muddling.

Aromatics used to flavor drinks also will be addressed “since you remember things through smell more than anything,” he said.

One example: cinnamon sticks that are scorched lightly on one end with a lighter and added to espresso martinis in the Fairmont’s upscale bar fl.2. (They sell more than 1,000 a month.)

Once you’ve got the recipes down pat, Leite will offer tips for setting up a home bar so you can create your favorite cocktail whenever the mood strikes. They include:

—Be sure to have the fundamentals: whiskey, vodka, gin, rum and tequila.

—Have the right tools at the ready, including a good shaker for mixing cocktails. He recommends either a two-piece Boston shaker (a metal tin and a mixing glass) or a three-piece cobbler shaker featuring a metal container, a lid with built-in strainer and a cap.

—A muddler to gently mash and mix ingredients like fruit and sugar. The stainless-steel ones used at the hotel have a “tenderizer” head to better crush herbs and fruits.

—A long-handled spoon for stirring cocktails with spirits, liqueurs and vermouth (like a martini, Old Fashioned or Manhattan). Stirring chills and dilutes a cocktail without introducing air bubbles.

—A jigger to precisely measure ingredients. A double-sided, 1 ounce over 2 ounce measuring vessel allows you to maintain consistency and quality in every drink.

—Love cocktails that contain fresh juice, cream, milk or egg whites? A strainer is essential for straining out ice and other solid ingredients in shaken cocktails.

—No bar is complete without a corkscrew for opening wine bottles and some spirits.

—Mixers including bitters (Angostura is considered the standard), tonic water, soda and ginger beer.

—Finally, a selection of glassware — highball and lowball glasses for mixed drinks, martini and coupe glasses for cocktails, and wine and champagne glasses for celebrating special occasions.

Below, we share the recipes for Leite’s cocktails, along with two others that will be served this holiday season at two local restaurants, Downtown’s Ritual House and Shorty’s Pins x Pints on the North Shore.

Happy holidays!

Caipiroska

PG tested

Christmastime is hot in Brazil, so holiday celebrations usually feature iced cocktails instead of hot toddies. This refreshing cocktail from the Fairmont Pittsburgh is a vodka-based twist on the Caipirinha, a classic Brazilian cocktail made with cachaca, sugar and lime.

You can make it sweeter or more tart, depending on the amount of brown sugar.

• 1/2 lime, cut into wedges
• 1 slice orange
• 1-2 tablespoons brown sugar
• 2 ounces vodka
• Dried lime slice, for garnish

Place lime wedges in a sturdy glass, such as a rocks glass, or a cocktail shaker. Add orange slice and sugar, and using a muddler, gently crush them together to release the juice and essential oils from the rind. (But be careful not to over-muddle the rind, which can make the drink bitter.)

Pour vodka into the glass or shaker with the muddled lime mixture.

Fill the glass with crushed ice. If using a shaker, add ice and shake well to chill and dilute the mixture.

Pour all contents (liquid, lime pieces and ice) into an old-fashioned or rocks glass filled with ice.

Garnish with dried lime slice and serve immediately.

Serves 1.

— Thiago Leite, Fairmont Pittsburgh

Bashful Boulevardier

PG tested

• 2 ounces whiskey
• 1/2 ounce Luxardo cherry syrup
• 1/2 ounce Chambord
• 1 ounce Campari
• 3 dashes bitters

Add whiskey, cherry syrup, Chambord, Campari and bitters into a mixing glass.

Fill the glass with ice and stir until the mixture is well chilled and silky.

Strain into a rocks glass over a large ice cube to keep the drink cold without diluting too quickly.

Finish with a Luxardo cherry or a gentle twist of orange peel for a subtle aromatic lift.

Serves 1.

— Thiago Leite, Fairmont Pittsburgh

Nutella Espresso Martini

PG tested

This sweet and creamy martini can double as a dessert. It includes Kahlua and Buttershots, a butterscotch-flavored schnapps.

• 1 scoop Nutella
• 1 ounce espresso, cooled
• 1 ounce vodka
• 1 ounce Kahlua coffee liqueur
• 1/2 ounce Buttershots

Add 1 generous scoop of Nutella to your shaker.

Add espresso, then give it a quick stir to help the Nutella blend smoothly.

Pour in vodka, Kahlua and Buttershots.

Fill the shaker with ice and shake vigorously until the mixture is chilled and velvety.

Strain into a martini glass for a clean, glossy finish.

Garnish with a light drizzle of Nutella or a few espresso beans for an elegant touch. You also can line the rim of the martini glass with Nutella and roll in crushed nuts or cookies.

Makes 1 cocktail.

— Thiago Leite, Fairmont Pittsburgh

Shorty’s Gingerbread Smash

This festive cocktail is Shorty’s Pins x Pints’ riff on a classic Old Fashioned. It brings together the warm spice of gingerbread cookies and the smoothness of whiskey in a cocktail that’s perfect for the holiday season.

To make simple syrup, combine equal parts sugar and water in a medium saucepan over medium heat. Bring to a boil, stirring, until sugar has dissolved, then allow to cool. Store in the refrigerator for up to 1 month.

• 2 ounces Bird Dog Gingerbread Whiskey
• 1 ounce simple syrup
• 2 dashes orange bitters
• Sliced lemon, for muddling
• Orange rind, for garnish

Combine whiskey, simple syrup and bitters into a mixing glass.

Add a lemon wedge, and muddle.

Add ice, and stir for 14 rotations, until the dilution is at desired consistency.

Strain into a glass filled with fresh ice.

Rub the rim of the cocktail glass with an orange rind to express it, then drop into the glass.

Serves 1.

— Shorty’s Pins x Pints, North Shore

Ritual House Holiday Beach Margarita

Margaritas are one of the most popular and recognizable cocktails. This one from Ritual House, Downtown, gets the holiday treatment with coconut milk and a cinnamon-brown sugar syrup. It’s best served in a rocks glass.

• 1 1/2 ounces tequila blanco
• 1 ounce coconut milk
• 1 ounce cinnamon brown sugar vanilla syrup
• 3/4 ounce lime juice
• 1/4 ounce Cointreau
• 3-4 dashes orange bitters

Combine tequila, coconut milk, syrup, lime juice, Cointreau and bitters in a cocktail shaker and shake hard.

Strain into a glass over ice. Garnish with cinnamon stick and fresh grated nutmeg.

Serves 1.

— Ritual House, Downtown

©2025 PG Publishing Co. Visit at post-gazette.com. Distributed by Tribune Content Agency, LLC.

By Stephanie Armour, Amanda Seitz, KFF Health News

Maddy Olcott plans to start a career once she graduates from college. But the junior at the State University of New York-Purchase College is so far not planning to start a family — even with the Trump administration dangling inducements like thousand-dollar “baby bonuses” or cheaper infertility drugs.

“Our country wants us to be birthing machines, but they’re cutting what resources there already are,” said Olcott, 20. “And a $1,000 baby bonus? It’s low-key like, what, bro? That wouldn’t even cover my month’s rent.”

The Trump administration wants Americans to have more babies, and the federal government is debuting policy initiatives to reverse the falling U.S. fertility rate. In mid-October, the White House unveiled a plan to increase access to in vitro fertilization treatment. President Donald Trump has heralded such initiatives, calling himself “the fertilization president.”

But reproductive rights groups and other advocacy organizations say these efforts to buttress the birth rate don’t make up for broader administration priorities aimed at cutting federal programs such as Medicaid, its related Children’s Health Insurance Program, and other initiatives that support women and children. The pro-family focus, they say, isn’t just about boosting procreation. Instead, they say, it’s being weaponized to push a conservative agenda that threatens women’s health, reproductive rights, and labor force participation.

Some predict these efforts could deter parenthood and lead to increases in maternal mortality.

“The religious right wants more white Christian babies and is trying to curtail women’s reproductive freedom in order to achieve that aim,” said Marian Starkey, a spokesperson for Population Connection, a nonprofit that promotes population stabilization through increased access to birth control and abortion. “The real danger is the constant whittling down of reproductive rights.”

The White House did not respond to repeated interview requests.

A slate of federal programs that have long helped women and children are also being targeted by Trump and Cabinet members who say they champion pronatalist policies.

Medicaid work requirements, for instance, put in place by the Republicans’ One Big Beautiful Bill Act, a budget law enacted in July, will lead to extra paperwork and other requirements that, according to the Congressional Budget Office, will cause millions of eligible enrollees to lose coverage. Medicaid covers more than 4 in 10 births in the U.S.

The measure also cuts federal funding for a national program that provides monthly food benefits. Almost 40% of recipients in fiscal 2023 were children.

GOP spending cuts and staffing freezes have hampered Head Start, a federal education program that provides day care and preschool for young, low-income children, even as U.S. adults implore the government to curtail ballooning child care costs.

And the GOP halted Medicaid funding to Planned Parenthood of America for one year because it provides abortion services, forcing roughly 50 clinics around the country to close since the beginning of 2025. Planned Parenthood provides a wide range of women’s health services, from wellness exams to breast cancer screenings and initial prenatal care.

Groups that advocate for women’s health and reproductive rights say the actions by the administration and congressional Republicans to attack these programs are making it harder for families to get the support and medical care they need.

“There is a lot of rhetoric about who is worthy of public assistance, and to many policymakers, it’s not the single mother,” said Allyson Crays, a public health law and policy analyst at the Milken Institute School of Public Health at George Washington University.

The pronatalist perspective generally supports government intervention to encourage procreation and is rooted in a belief that modern culture has failed to celebrate the nuclear family. The movement’s supporters also say policies to encourage childbearing are an economic necessity.

A Declining Birth Rate

The national birth rate has largely been on a downward trajectory since 2007, with the number of births declining by an average 2% per year from 2015 through 2020, according to the Centers for Disease Control and Prevention, although the rate has fluctuated since.

The concepts that shape the movement can be found in Project 2025, a political initiative led by the conservative Heritage Foundation that has seen many of its proposals adopted by Trump. The document asserts that children fare best in a “heterosexual, intact marriage.”

“Married men and women are the ideal, natural family structure because all children have a right to be raised by the men and women who conceived them,” it says.

Project 2025 also includes many proposals that critics say aren’t friendly toward women’s health. For instance, it calls for eliminating access to mifepristone, a drug commonly used in abortions as well as in the management of miscarriages, and encourages states to block Planned Parenthood facilities from receiving Medicaid funding.

The “more babies” mantra is being embraced at the highest levels of the federal government.

“I can’t remember any other administration being so tied to the pronatalist movement,” said Brian Dixon, Population Connection’s senior vice president for government and political affairs.

Just days after he was sworn in, Vice President JD Vance declared, “I want more babies in the United States of America.” He has also criticized the decision-making of women and men who opt not to start families.

The White House in October did announce a discount on certain drugs used in IVF treatments through TrumpRx, a yet-to-debut government website that aims to connect consumers with lower-priced drugs. Mehmet Oz, who heads Medicare and Medicaid, heralded a possible future of “Trump babies,” resulting from the lower-priced infertility drugs.

The administration also announced it would encourage employers to move to a new model for offering fertility benefits as a stand-alone option in which employees can enroll. But that is far from Trump’s earlier pledge to make infertility treatments free and may not be enough to overcome other long-term financial worries that often guide decisions about whether to have children.

Angel Albring, a mother of six, says her dream of having a big family always hinged on her ability to work and avoid child care costs. Her career as a freelance writer enabled her to do so while still contributing to the family’s income, working during nap times and at night, while the rest of her household slept.

“The whole thing of ‘sleep when the baby sleeps’ never applied to me,” Albring said.

Some of her friends, though, aren’t so fortunate. They fear they cannot afford children because of climbing costs for day care, groceries, and housing, she said.

Delivering on ‘Baby Bonuses’?

The Trump administration, meanwhile, has advanced another policy aimed at giving children a future financial boost.

The One Big Beautiful Bill Act establishes a tax-advantaged “Trump account” seeded with $1,000 in federal funds — often called a “baby bonus” — on behalf of every eligible American child. The initial deposits are scheduled to start in 2026 with the federal government automatically opening an account for children born after Dec. 31, 2024, and before Jan. 1, 2029.

Parents could contribute up to $5,000 a year initially to the account, with employers able to annually contribute up to $2,500 of that amount. The accounts reportedly would be vehicles for long-term savings. Details are still being ironed out, but funds could not be withdrawn before the child turns 18. After that, the accounts would likely become traditional IRAs.

On Tuesday, billionaires Michael and Susan Dell of Dell computer fame said they would give $250 to 25 million children age 10 and under in the U.S. The donations will be aimed at encouraging participation in the Trump accounts.

Pronatalism extends to other parts of the federal government, too.

Transportation Secretary Sean Duffy, who has nine children, instructed his department to prioritize federal funds for communities with high marriage and birth rates, though it has not yet announced any projects directly related to the initiative. For a time, the administration considered bestowing national medals on mothers with six or more children.

Except there’s one hitch: Data suggests the policies and programs the Trump administration has proposed won’t necessarily work.

Other countries have offered more robust programs to encourage childbearing and ease parenting but haven’t seen their birth rates go up, noted Michael Geruso, an economist for the University of Texas-Austin who hopes to see the global population increase. Israel, for example, has offered free IVF treatment for roughly three decades, yet its birth rates have stayed statistically stagnant, at just under three children for every woman, he said.

France and Sweden have extensive social safety-net programs to support families, including paid time off and paid paternity and maternity leave, and subsidized child care and health care, but their fertility rates are also falling, said Peggy O’Donnell Heffington, a University of Chicago assistant senior instructional professor in the history department who wrote a book on non-motherhood.

“Nobody yet knows how to avoid depopulation,” Geruso said.

Some point to a different solution to reverse the United States’ declining population: boost immigration to ensure a younger labor force and stronger tax base. The Trump administration, however, is doing the opposite — revoking visas and creating an environment in which immigrants who are in the U.S. legally feel increasingly uncomfortable because of heavy-handed policies, analysts say.

The country’s immigrant population this year fell for the first time since the 1960s, according to a Pew Research Center analysis.

Meanwhile, to critics of the administration, the focus on encouraging childbirth allows the Trump administration and Republicans to sound as if they support families.

“You’re not seeing policies that support families with children,” said Amy Matsui, vice president of income security and child care at the National Women’s Law Center, a nonprofit focused on gender rights. “It’s a white, heterosexual, fundamentalist Christian, two-parent marriage that’s being held up.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Luke Ramseth, The Detroit News

New car prices didn’t spike after President Donald Trump announced sweeping tariffs in the spring, as some experts and dealers projected.

But prices on many models are now pushing notably higher — and analysts said carmakers recouping Trump’s higher import costs is a key factor.

Consider a recent analysis that found automakers are implementing more aggressive price increases on 2026 model-year vehicles compared to when 2025s were hitting dealership lots last year.

Cloud Theory, which tracks car inventory on dealer websites across the country, found the average marketed price increase on 2026 models was nearly $2,000, compared to an approximately $400 uptick during last year’s model year changeover. This year, 23 models have at least a $2,000 price hike; last year there were just nine.

“What I think is different this year is you have a lot of cost increases that are $1,000 or $1,500 or more, $2,000 or more,” said Rick Wainschel, Cloud Theory’s vice president of data and analytics, whose analysis looked at 2026 models with at least 2,000 vehicles in inventory.

“I think that’s a big change and a big shift that’s occurred, and it’s hard to point to any other catalyst for that (except for) tariff costs that the OEMs have had to absorb for the last eight months, and will likely have to absorb going forward,” he said.

Any increase comes on top of average car prices that were already hovering around $50,000. Pair that with stubbornly high interest rates, and the average monthly car payment is now $766, according to Edmunds.com Inc., up more than 3% from a year ago. A record share of subprime borrowers has been falling behind on their auto loans this fall.

Yet the huge car sticker price increases tied to tariffs — which analysts originally warned might tally anywhere from an extra $5,000 to $15,000 per vehicle — haven’t come to pass.

Among the reasons: competitive pressures between rival automakers, concern over blowback from Trump, large pre-tariff vehicle inventories that gave companies a lag time before pricing adjustments were needed, as well as policy adjustments that reduced the pain of the tariffs themselves.

Automakers opted to absorb many of the extra costs in the near term.

But if you’re shopping for a new car right now or plan to in the coming months, experts said it is likely tariffs will cost you in one way or another, even if it’s tough to discern exactly how. Automakers haven’t been eager to publicly disclose any connection between tariffs and their pricing adjustments.

Vehicle destination charges — those mandatory fees for transporting the car to the dealership — are rising, revealing one area where automakers “might be trying to make up a little bit of the costs,” said Erin Keating, an executive analyst at Cox Automotive Inc.

There are also signs of automakers pulling features out of certain models in a bid to trim costs while holding the same sticker price, a phenomenon known as shrinkflation. And then there are indications of carmakers offsetting their tariff costs with higher 2026 model-year MSRPs.

“Automakers really held their prices throughout the ’25 model year, and we’re starting to see a bit (of an impact) in ’26,” said Stephanie Brinley, an auto analyst with S&P Global Mobility. “But it’s being wrapped up in different ways, so it’s very difficult to suss out.”

Car companies often adjust pricing on new model-year vehicles, whether due to minor repackaging of features and trim levels, or full overhauls that include new technology and freshened sheet metal. Brinley said that means there’s no clear way for consumers to figure out where those extra tariff costs might’ve been tacked on.

Keating agrees the tariff impacts have been hard to pin down. Average car prices have been rising steadily much of this year — with September reaching an all-time high above $50,000 — but she said some of that uptick would have been expected anyway because of normal inflation.

The analyst now feels confident those initial shocking projections of price hikes in the 10% to 15% range aren’t going to happen: “The market just won’t bear it,” she said.

Automakers appear to be settling into their new normal under Trump. They’ve secured at least some tariff relief on parts and vehicles imported from certain countries, while simultaneously feeling the benefits of Trump’s moves to loosen federal vehicle emissions and fuel economy standards.

A September J.P. Morgan report estimated combined tariff costs on vehicles and parts will amount to $41 billion in the first year, rising to $45 billion in year two and $52 billion in year three.

The bank expects automakers and consumers to ultimately share the burden equally, which could lead to a 3% increase in new vehicle prices: “This will hit consumers hard,” the report said, “especially as many are already struggling to afford new vehicles.”

Wainschel, the Cloud Theory analyst, said average prices listed on dealer websites have only increased a few hundred dollars per vehicle since the tariffs took effect in early April. But that’s because automakers have pushed an increasing number of affordable models and trims into the market, which has helped hold the overall average price down.

If the current mix of vehicle types listed for sale was the same as it was back in April, Wainschel said, average prices would, in fact, look approximately $1,300 higher now: “So there are some things that are masking the increases that are taking place, the segment mix being a big part of it.”

Brendan Harrington, president of Autobahn Fort Worth in Texas, which sells Porsche, BMW, Mini, Volvo, Volkswagen, Jaguar and Land Rover brands, said big price hikes didn’t occur early on as companies fretted over losing market share.

But now, carmakers are beginning to make larger changes in response to tariffs, he said, including trimming back slower-selling models and increasing MSRPs where they can. He said Porsche and Land Rover are two examples of brands that have upped prices in response to tariffs.

And carmakers are also passing through higher destination charges, he said — increases that are adding $200 to $300 to the cost of a car. Tariffs also are contributing to steadily rising costs for Harrington’s parts and service departments.

“Until now, every OEM has really tried to hold the line,” he said. “But we are seeing prices now come up.”

(Detroit News Staff Writer Grant Schwab contributed.)

©2025 www.detroitnews.com. Visit at detroitnews.com. Distributed by Tribune Content Agency, LLC.

By Amy Maxmen, KFF Health News

The United States is poised to lose its measles-free status next year. If that happens, the country will enter an era in which outbreaks are common again.

More children would be hospitalized because of this preventable disease. Some would lose their hearing. Some would die. Measles is also expensive. A new study— not yet published in a scientific journal — estimates that the public health response to outbreaks with only a couple of cases costs about $244,000. When a patient requires hospital care, costs average $58,600 per case. The study’s estimates suggest that an outbreak the size of the one in West Texas earlier this year, with 762 cases and 99 hospitalizations, costs about $12.6 million.

America’s status hinges on whether the country’s main outbreaks this year stemmed from the big one in West Texas that officially began Jan. 20. If these outbreaks are linked, and go on through Jan. 20 of next year, the U.S. will no longer be among nations that have banished the disease.

“A lot of people worked very hard for a very long time to achieve elimination — years of figuring out how to make vaccines available, get good vaccine coverage, and have a rapid response to outbreaks to limit their spread,” said Paul Rota, a microbiologist who recently retired from a nearly 40-year career at the Centers for Disease Control and Prevention.

Instead of acting fast to prevent a measles comeback, Robert F. Kennedy Jr., a lawyer who founded an anti-vaccine organization before taking the helm at the Department of Health and Human Services, has undermined the ability of public health officials to prevent and contain outbreaks by eroding trust in vaccines. The measles vaccine is safe and effective: Only 4% of more than 1,800 confirmed U.S. cases of measles this year have been in people who had received two doses.

Kennedy has fired experts on the vaccine advisory committee to the CDC and has said, without evidence, that vaccines may cause autism, brain swelling, and death. On Nov. 19, scientific information on a CDC webpage about vaccines and autism was replaced with false claims. Kennedy told The New York Times that he ordered the change.

“Do we want to go back into a prevaccine era where 500 kids die of measles each year?” asked Demetre Daskalakis, a former director of the CDC’s national immunization center, who resigned in protest of Kennedy’s actions in August. He and other scientists said the Trump administration appears to be occupied more with downplaying the resurgence of measles than with curbing the disease.

HHS spokesperson Andrew Nixon said in a statement that vaccination remains the most effective tool for preventing measles and that the “CDC and state and local health agencies continue to work together to assess transmission patterns and ensure an effective public health response.”

Looking for Links

CDC scientists are indeed tracking measles, alongside researchers at health departments and universities. To learn whether outbreaks are linked, they’re looking at the genomes of measles viruses, which contain all their genetic information. Genomic analyses could help reveal the origin of outbreaks and their true size, and alert officials to undetected spread.

Scientists have conducted genomic analyses of HIV, the flu, and COVID for years, but it’s new for measles because the virus hasn’t been much of a problem in the U.S. for decades, said Samuel Scarpino, a public health specialist at Northeastern University in Boston. “It’s important to get a surveillance network into place so that we could scale up rapidly if and when we need it,” he said.

“We are working with the CDC and other states to determine whether what we’re seeing is one large outbreak with continued spread from state to state,” said Kelly Oakeson, a genomics researcher at the Utah Department of Health and Human Services.

At first glance, the ongoing outbreak in Utah and Arizona, with 258 cases as of Dec. 1, seems linked to the one in Texas because they’re caused by the same strain of measles, D8-9171. But this strain is also spreading throughout Canada and Mexico, which means the outbreaks could have been sparked separately from people infected abroad. If that happened, this technicality could spare the U.S. from losing its status, Rota said. Being measles-free means the virus isn’t circulating in a country continuously year-round.

Canada lost its measles-elimination status in November because authorities couldn’t prove that various outbreaks from the D8-9171 strain were unrelated, said Daniel Salas, executive manager of the comprehensive immunization program at the Pan American Health Organization. The group, which works with the World Health Organization, includes health officials from countries in North, South, and Central America, and the Caribbean. It makes a call on measles elimination based on reports from scientists in the countries it represents.

Early next year, PAHO will hear from U.S. scientists. If their analyses suggest that measles has spread continuously for a year within the U.S., the organization’s director may revoke the country’s status as measles-free.

“We expect countries to be transparent about the information they have,” Salas said. “We will ask questions, like, ‘How did you determine your findings, and did you consider other angles?’”

In anticipation of PAHO’s assessment, Oakeson and other researchers are studying how closely the D8-9171 strains in Utah match others. Instead of looking at only a short snippet of genes that mark the strain, they’re analyzing the entire genome of the measles virus, about 16,000 genetic letters long. Genetic mutations occur naturally over time, and the accumulation of small changes can act like a clock, revealing how much time has ticked by between outbreaks. “This tells us the evolutionary history of samples,” Oakeson said.

For example, if one child directly infects another, the kids will have matching measles viruses. But measles viruses infecting people at the start of a large outbreak would be slightly different than those infecting people months later.

Although the Texas and Utah outbreaks are caused by the same strain, Oakeson said, “more fine-grained details are leading us to believe they aren’t super closely related.” To learn just how different they are from each other, scientists are comparing them with measles virus genomes from other states and countries.

Ideally scientists could pair genetic studies with shoe-leather investigations into how each outbreak started. However, many investigations have come up dry because the first people infected haven’t sought care or contacted health departments. As in West Texas, the outbreak in Utah and Arizona is concentrated in close-knit, undervaccinated communities that are leery of government authorities and mainstream medicine.

Researchers are also trying to learn how many measles cases have gone undetected. “Confirmed cases require testing, and in some communities, there’s a cost to going to the hospital to get tested: a tank of gas, finding a babysitter, missing work,” Andrew Pavia, an infectious disease doctor at the University of Utah, said. “If your kid has a measles rash but isn’t very sick, why would you bother?”

Subtle Surveillance

Pavia is part of a nationwide outbreak surveillance network led by the CDC. A straightforward way to figure out how large an outbreak is would be through surveys, but that’s complicated when communities don’t trust public health workers.

“In a collaborative setting, we could administer questionnaires asking if anyone in a household had a rash and other measles symptoms,” Pavia said, “but the same issues that make it difficult to get people to quarantine and vaccinate make this hard.”

Instead, Pavia and other researchers are analyzing genomes. A lot of variation suggests an outbreak spread for weeks or months before it was detected, infecting many more people than known.

A less intrusive mode of surveillance is through wastewater. This year, the CDC and state health departments have launched efforts to test sewage from households and buildings for measles viruses that infected people shed. A study in Texas found that this could function as an early warning system, alerting public health authorities to an outbreak before people show up in hospitals.

The quiet research of CDC scientists stands in stark contrast to its dearth of public-facing actions. The CDC hasn’t held a single press briefing on measles since President Donald Trump took office, and its last publication on measles in the agency’s Morbidity and Mortality Weekly Report was in April.

Rather than act fast to limit the size of the Texas outbreak, the Trump administration impeded the CDC’s ability to communicate quickly with Texas officials and slowed the release of federal emergency funds, according to investigations by KFF Health News. Meanwhile Kennedy broadcast mixed messages on vaccines and touted unproven treatments.

Daskalakis said that as the outbreak in Texas worsened, his CDC team was met by silence when they asked to brief Kennedy and other HHS officials.

“Objectively they weren’t helping with the Texas outbreak, so if we lose elimination, maybe they’ll say, ‘Who cares,’” Daskalakis said.

Nixon, the HHS spokesperson, said Kennedy responded strongly to the Texas outbreak by directing the CDC to help provide measles vaccines and medications to communities, expediting measles testing, and advising doctors and health officials. The U.S. retains its elimination status because there’s no evidence of continuous transmission for 12 months, he added.

“Preliminary genomic analysis suggests the Utah and Arizona cases are not directly linked to Texas,” the CDC’s acting director, Deputy HHS Secretary Jim O’Neill, wrote on the social platform X.

Given Kennedy’s distortions of data on vitamin A, Tylenol, and autism, Daskalakis said the Trump administration may insist that outbreaks aren’t linked or that PAHO is wrong.

“It will be quite a stain on the Kennedy regime if he is the health secretary in the year we lose elimination status,” he said. “I think they will do everything they can to cast doubt on the scientific findings, even if it means throwing scientists under the bus.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Renuka Rayasam and Katheryn Houghton and Samantha Liss, KFF Health News

Alejandro Santillan-Garcia is worried he’s going to lose the aid that helps him buy food. The 20-year-old Austin resident qualified for federal food benefits last year because he aged out of the Texas foster care system, which he entered as an infant.

The Supplemental Nutrition Assistance Program — commonly referred to as food stamps, or SNAP — helps feed 42 million low-income people in the United States. Now, because of changes included in the One Big Beautiful Bill Act, to keep his food benefits Santillan-Garcia might soon have to prove to officials that he’s working.

He said he lost his last job for taking time off to go to the doctor for recurrent stomach infections. He doesn’t have a car and said he has applied to a grocery store, Walmart, Dollar General, “any place you can think of” that he could walk or ride his bike to.

“No job has hired me.”

Under the new federal budget law, to be eligible for SNAP benefits, more people are required to show that they are working, volunteering, or studying. Those who don’t file paperwork in time risk losing food aid for up to three years. States were initially instructed to start counting strikes against participants on Nov. 1, the same day that millions of people saw their SNAP benefits dry up because of the Trump administration’s refusal to fund the program during the government shutdown. But federal officials backtracked partway through the month, instead giving states until December to enforce the new rules.

The new law further limits when states and counties with high unemployment can waive recipients from requirements. But a legal battle over that provision means that the deadline for people to comply with the new rules varies depending on where recipients live, even within a state in some cases.

The U.S. Department of Agriculture did not respond to a detailed list of questions about how the new rules around SNAP will be implemented, and the White House did not respond to a request for comment about whether the rules could kick off people who rely on the program. The law did extend exemptions to many Native Americans.

Still, states must comply with new rules or accrue penalties that could force them to pay a bigger share of the program’s cost, which was about $100 billion last year.

President Donald Trump signed the massive budget bill, along with the new SNAP rules, into law on July 4. States initially predicted they would need at least 12 months to implement such significant changes, said Chloe Green, an assistant director at the American Public Human Services Association who advises states on federal programs.

Under the law, “able-bodied” people subject to work requirements can lose access to benefits for three years if they go three months without documenting working hours.

Depending on when states implement the rules, many people could start being dropped from SNAP early next year, said Lauren Bauer, a fellow in economic studies at the Brookings Institution, a policy think tank. The changes are expected to knock at least 2.4 million people off SNAP within the next decade, according to the Congressional Budget Office.

“It’s really hard to work if you are hungry,” Bauer said.

Many adult SNAP recipients under 55 already needed to meet work requirements before the One Big Beautiful Bill Act became law. Now, for the first time, adults ages 55 to 64 and parents whose children are all 14 or older must document 80 hours of work or other qualifying activities per month. The new law also removes exemptions for veterans, homeless people, and former foster care youths, like Santillan-Garcia, that had been in place since 2023.

Republican policymakers said the new rules are part of a broader effort to eliminate waste, fraud, and abuse in public assistance programs.

Agriculture Secretary Brooke Rollins said in November that in addition to the law, she will require millions to reapply for benefits to curb fraud, though she did not provide more details. Rollins told Newsmax that she wants to ensure that SNAP benefits are going only to those who “are vulnerable” and “can’t survive without it.”

States are required to notify people that they are subject to changes to their SNAP benefits before they’re cut off, Green said. Some states have announced the changes on websites or by mailing recipients, but many aren’t giving enrollees much time to comply.

Anti-hunger advocates fear the changes, and confusion about them, will increase the number of people in the U.S. experiencing hunger. Food pantries have reported record numbers of people seeking help this year.

Even when adhering to the work rules, people often report challenges uploading documents and getting their benefits processed by overwhelmed state systems. In a survey of SNAP participants, about 1 in 8 adults reported having lost food benefits because they had problems filing their paperwork, according to the Urban Institute. Some enrollees have been dropped from aid as a result of state errors and staffing shortfalls.

Pat Scott, a community health worker for the Beaverhead Resource Assistance Center in rural Dillon, Montana, is the only person within at least an hour’s drive who is helping people access public assistance, including seniors without reliable transportation. But the center is open only once a week, and Scott says she has seen people lose coverage because of problems with the state’s online portal.

Jon Ebelt, a spokesperson with the Montana health department, said the state is always working to improve its programs. He added that while some of the rules have changed, a system is already in place for reporting work requirements.

In Missoula, Montana, Jill Bonny, head of the Poverello Center, said the homeless shelter’s clients already struggle to apply for aid, because they often lose documentation amid the daily challenge of carrying everything they own. She said she’s also worried the federal changes could push more older people into homelessness if they lose SNAP benefits and are forced to pick between paying rent or buying food.

In the U.S., people 50 or older are the fastest-growing group experiencing homelessness, according to federal data.

Sharon Cornu is the executive director at St. Mary’s Center, which helps support homeless seniors in Oakland, California. She said the rule changes are sowing distrust. “This is not normal. We are not playing by the regular rules,” Cornu said, referring to the federal changes. “This is punitive and mean-spirited.”

In early November, a federal judge in Rhode Island ordered the Trump administration to deliver full SNAP payments during the government shutdown, which ended Nov. 12. That same judge sought to buffer some of the incoming work requirements. He ordered the government to respect existing agreements that waive work requirements in some states and counties until each agreement is set to end. In total, 28 states and the District of Columbia had such exemptions, with different end dates.

Adding to the confusion, some states, including New Mexico, have waivers that mean people in different counties will be subject to the rules at different times.

If states don’t accurately document SNAP enrollees’ work status, they will be forced to pay later on, Green said. Under the new law, states must cover a portion of the food costs for the first time — and the amount depends on how accurately they calculate benefits.

During the government shutdown, when no one received SNAP benefits, Santillan-Garcia and his girlfriend relied on grocery gift cards they received from a nonprofit to prioritize feeding his girlfriend’s baby. They went to a food pantry for themselves, even though many foods, including dairy, make Santillan-Garcia sick.

He’s worried that he’ll be in that position again in February when he must renew his benefits — without the exemption for former foster care youths. Texas officials have yet to inform him about what he will need to do to stay on SNAP.

Santillan-Garcia said he’s praying that, if he is unable to find a job, he can figure out another way to ensure he qualifies for SNAP long-term.

“They’ll probably take it away from me,” he said.

What You Should Know

Changes to SNAP removed work-requirement exemptions for:

• People ages 55 to 64.
• Caretakers of dependent children 14 or older
• Veterans
• People without housing
• People 24 or younger who aged out of foster care

What SNAP Participants Should Do:

• Check with public assistance organizations to find out when the new rules go into effect in your region. Your benefits may be checked at recertification, but you may be required to meet the monthly work reporting rules long before that.
• Let your state know if you’re responsible for a dependent child younger than 14 who lives in your home; pregnant; a student at least half the time; attending a drug or alcohol treatment program; physically or mentally unable to work; a Native American; or a caretaker of an incapacitated household member. If so, you may still be exempt.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Jonathan Shorman, Stateline.org

Four Republican states have agreed to help the Trump administration gain access to state driver’s license data through a nationwide law enforcement computer network as part of the administration’s hunt for alleged noncitizen voters.

The Trump administration said as recently as October that federal officials wanted to obtain driver’s license records through the network.

The commitment from officials in Florida, Indiana, Iowa and Ohio comes as part of a settlement agreement filed on Friday in a federal lawsuit. The lawsuit was originally brought by the states last year alleging the Biden administration wasn’t doing enough to help states verify voter eligibility.

The settlement, between the states and the U.S. Department of Homeland Security, requires the federal department to continue its development of a powerful citizenship verification program known as SAVE. Earlier this year, federal officials repurposed SAVE into a program capable of scanning millions of state voter records for instances of noncitizen registered voters.

In return, the states have agreed to support Homeland Security’s efforts to access the National Law Enforcement Telecommunications System, an obscure computer network that typically allows law enforcement agencies to search driver’s license records across state lines. Nlets — as the system is known — lets police officers easily look up the driving records of out-of-state motorists.

The Trump administration and some Republican election officials have promoted the changes to SAVE as a useful tool to identify potential noncitizen voters, and Indiana had already agreed to provide voter records. Critics, including some Democrats, say the Trump administration is building a massive database of U.S. residents that President Donald Trump or a future president could use for spying or targeting political enemies.

Stateline reported last week, before the settlement agreement was filed in court, that Homeland Security publicly confirmed it wants to connect Nlets to SAVE.

A notice published Oct. 31 in the Federal Register said driver’s licenses are the most widely used form of identification, and that by working with states and national agencies, including Nlets, “SAVE will use driver’s license and state identification card numbers to check and confirm identity information.”

A federal official also previously told a virtual meeting of state election officials in May that Homeland Security was seeking “to avoid having to connect to 50 state databases” and wanted a “simpler solution,” such as Nlets, according to government records published by the transparency group American Oversight.

The new settlement lays out the timeline for how the Trump administration could acquire the four states’ records.

Within 90 days of the execution of the agreement, the four states may provide Homeland Security with 1,000 randomly selected driver’s license records from their state for verification as part of a quality improvement process for SAVE.

According to the agreement, the states that provide the records will “make best efforts to support and encourage DHS’s efforts to receive and have full use of state driver’s license records from the National Law Enforcement Telecommunications System” and state driver’s license agencies.

The language in the agreement is open-ended and doesn’t make clear whether the pledge to help Homeland Security obtain access to Nlets is limited to drivers from those four states or is intended to require the states to help the agency acquire the records of drivers nationwide.

An agreement to help

The agreement could pave the way for Republican officials in other states to provide access to license data.

Nlets is a nonprofit organization that facilitates data sharing among law enforcement agencies across state lines. States decide what information to make available through Nlets, and which agencies can access it. That means the four states could try to influence peers to share Nlets data with the Trump administration.

“They’re not just talking about driver’s license numbers, they’re talking about the driver’s records. What possible reason would DHS have in an election or voting context — or any context whatsoever — for obtaining the ‘full use of state driver’s license records,’” said David Becker, executive director of the nonpartisan Center for Election Innovation & Research.

Iowa Secretary of State Paul Pate, a Republican, said in a statement to Stateline that the settlement agreement provides another layer of election integrity and protection as officials seek to ensure only eligible voters are registered. He didn’t directly address questions about Nlets access.

“The SAVE program provides us with critical information, but we must also continue to utilize information from other state and federal partners to maintain clean and accurate lists,” Pate said in the statement.

Two weeks before the Nov. 5, 2024, election, Pate issued guidance to Iowa county auditors to challenge the ballots of 2,176 registered voters who were identified by the secretary of state’s office as potential noncitizens. The voters had reported to the state Department of Transportation or another government entity that they were not U.S. citizens in the past 12 years and went on to register to vote, according to the guidance.

In March, Pate said his office gained access to the SAVE database and found 277 of those people were confirmed to not have U.S. citizenship — just under 12% of the individuals identified as potential noncitizens.

Homeland Security and the U.S. Department of Justice didn’t immediately respond to requests for comment Monday.

Matthew Tragesser, a spokesperson for U.S. Citizenship and Immigration Services — the agency under Homeland Security that oversees SAVE — told Stateline last week that USCIS was committed to “eliminating barriers to securing the nation’s electoral process.”

“By allowing states to efficiently verify voter eligibility, we are reinforcing the principle that America’s elections are reserved exclusively for American citizens,” Tragesser said in a statement.

The SAVE program — Systematic Alien Verification for Entitlements — was originally intended to help state and local officials verify the immigration status of individual noncitizens seeking government benefits. In the past, SAVE could search only one name at a time. Now it can conduct bulk searches; federal officials in May also connected the program to Social Security data.

“It’s a potentially dangerous mix to put driver’s license and Social Security number and date of birth information out there … where we really don’t know yet how and when and where it’s going to be used,” Minnesota Democratic Secretary of State Steve Simon said in an interview on Monday.

Democratic states object

As the Trump administration has encouraged states to use SAVE, the Justice Department has also demanded states provide the department with unredacted copies of their voter rolls. The Trump administration has previously confirmed the Justice Department is sharing voter information with Homeland Security.

The Justice Department has sued six, mostly Democratic, states for refusing to turn over the data. Those lawsuits remain pending.

On Monday, 12 state secretaries of state submitted a 29-page public comment, in response to SAVE’s Federal Register notice, criticizing the overhaul. The secretaries wrote that while Homeland Security claims the changes make the program an effective tool for verifying voters, the modifications are “likely to degrade, not enhance” states’ efforts to ensure free, fair and secure elections.

“What the modified system will do … is allow the federal government to capture sensitive data on hundreds of millions of voters nationwide and distribute that information as it sees fit,” the secretaries wrote.

The secretaries of state of California, Connecticut, Massachusetts, Maine, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington signed on to the comment.

The settlement agreement purports to make this year’s changes to SAVE legally binding.

The agreement asks that a federal court retain jurisdiction over the case for 20 years for the purposes of enforcing it — a move that in theory could make it harder for a future Democratic president to reverse the changes to SAVE.

But Becker, of the Center for Election Innovation & Research, said he doesn’t expect the settlement agreement would make it more difficult for a future administration to undo the overhaul.

“Should a different administration come in that disagrees with this approach,” Becker said, “I would expect that they would almost certainly completely change how the system operates and how the states can access it and what data the federal government procures.”

Iowa Capital Dispatch reporter Robin Opsahl contributed to this report. Stateline reporter Jonathan Shorman can be reached at jshorman@stateline.org.

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Stateline is part of States Newsroom, a national nonprofit news organization focused on state policy.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Sarah Hepola, The Dallas Morning News

DALLAS — One of the happier narrative arcs in Hollywood belongs to Macaulay Culkin, who shot to superstardom as a kid in the 1990 smash “Home Alone.” It’s hard to endure the fame machine at only 10 years old, but Culkin turned out OK. These days, he lives in Los Angeles with his partner, Brenda Song, another former child star (Disney’s “The Suite Life of Zack & Cody”), and their two little boys.

After years of distancing himself from “Home Alone’s” Kevin McCallister, the precocious boy left behind on a family Christmas trip to Paris, Culkin has learned to accept his fate as the (screaming) face of a generation.

I spoke with Culkin by phone on Nov. 17, a day after “Home Alone’s” 35th anniversary. When I mentioned this, there was a beat of silence as he checked the date. “What do you know? I missed it!” He laughed. “Thank you for reminding me.” He’d spent the previous day with Song at a Los Angeles Rams game that the team won by two points. “Man, that was a nailbiter,” he said.

Q: Everyone has to deal with growing older, but you’re like a mirror held up to the rest of the world. As you grow older, we grow older, too.

A: Exactly. I am the opposite of Dorian Gray. This movie being 35 years old doesn’t just age me, it ages everyone else. Someone at the grocery store will ask how old I am, and I’ll say, aw, man, you don’t want to know. I’m 45, and sometimes, it’s a little punch in the gut.

Q: You pushed away from “Home Alone” for a long time. What convinced you to come back?

A: I’ve been embracing it a lot over the last few years, because I have kids of my own [Dakota, 4, and Carson, 2]. I show it to them, and my kids don’t even know it’s me. I’m taller now, I’m bearded, so they don’t quite put it together. My oldest thinks he’s Kevin. I’ll ask him if he remembers sliding down the stairs on the sled, and he’s like, sure do. What a liar! [Laughs.]

But the movie has taken on a different meaning for me. It’s fun getting people together to see this movie in a theater. Laughter is infectious. I did the tour last year, and I was touched by the reception. People want to share it with their kids the way I want to share it with my kids.

It’s a different experience watching it as an adult. There are a number of jokes that go past the kids’ heads. And slapstick is funny. Watching people get smashed in the face and fall on their butts — who doesn’t love that?

Q: I’m curious if you have any memories attached to Dallas.

A: Dallas was the first city I flew on a plane to visit. I went there to work on Oliver Stone’s “Born on the Fourth of July.” I was cast in that movie, and they cut my part out. I’ve never seen the scene in any DVD extras, so Lord knows it’s probably lost to time.

Q: No way! What was your role?

A: I was probably just “boy in the crowd No. 1.” It was the third movie I’d done, so this would have been like 1988. I think Tom Cruise was in a parade or something, and my line was, “Mom, when I grow up I wanna be just like him,” and the mother turns to me and says, “No you don’t.”

Q: OK, rank these things: Dallas Cowboys, “Dallas” the TV show and the Von Erich wrestling family.

A: Ooh, the Von Erichs are No. 1 for sure. I’ve been a wrestling fan since I was a kid. I even got [my partner] Brenda into wrestling. So wrestling is a part of my DNA, and there’s quite a legacy in Texas.

Now, I don’t want to alienate any of your readers, but I’m going to say the show “Dallas” next, and I’m going to put the Cowboys last, simply because: Go Rams! Also, I grew up a Giants fan, because I’m from New York, and at the same time, the Rams are me and Brenda’s team. I can’t for the life of me put the Cowboys anywhere but last.

Q: I think a lot of our readers will agree with that ranking. Last question: You’re the one leaving your kids home for the holidays now. What will you miss most?

A: Everything. They’re such a fun age, where they believe in magic. Christmas is their favorite. Being away from them is tricky, but I make sure to go home, three days on, four days off. Last year I didn’t do that, and it was kind of a grind. Last year we had to get a plastic tree, because I’m the one who takes care of the tree. This year we got a real tree.

©2025 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.

By Robbie Sequeira, Stateline.org

When six Southern public university systems this summer formed a new accreditation agency, the move shook the national evaluation model that higher education has relied on for decades.

The news wasn’t unexpected: It arrived a few months after President Donald Trump issued an executive order in April overhauling the nation’s accreditation system by, among other things, barring accreditors from using college diversity mandates. It also came after U.S. Secretary of Education Linda McMahon in May made it easier for universities to switch accreditors.

The accreditation process, often bureaucratic, cumbersome and time consuming, is critical to the survival of institutions of higher education. Colleges and their individual departments must undergo outside reviews — usually every few years — to prove that they meet certain educational and financial standards. If a school is not accredited, its students cannot receive federal aid such as Pell grants and student loans.

Some accreditation agencies acknowledge the process needs to evolve. But critics say the Trump administration is reshaping accreditation for political reasons, and risks undermining the legitimacy of the degrees colleges and universities award to students.

Trump said during his campaign that he would wield college accreditation as a “secret weapon” to root out DEI and other “woke” ideas from higher education. He has made good on that pledge.

Over the summer, for example, the administration sent letters to the accreditors of both Columbia and Harvard universities, alleging that the schools had violated federal civil rights law, and thus their accreditation rules, by failing to prevent the harassment of Jewish students after Hamas’ Oct. 7, 2023, terror attack on Israel.

The administration’s antipathy toward DEI has prompted some accreditors to remove diversity requirements. The Association to Advance Collegiate Schools of Business, for instance, removed diversity and inclusion language from its guiding principles earlier this year. Under White House pressure, the American Bar Association this year suspended enforcement of its DEI standards for its accreditation of law schools and has extended that suspension into next year.

But state legislatures laid the groundwork for public university accreditation changes even before Trump returned to the White House.

In 2022, Florida enacted a law requiring the state’s public institutions to switch accreditors every cycle — usually every few years — forcing them to move away from the Southern Association of Colleges and Schools Commission on Colleges, known as SACSCOC.

North Carolina followed suit in 2023, with a law prohibiting the 16 universities within the University of North Carolina system and the state’s community colleges from receiving accreditation from the same agency for consecutive cycles.

Then, the consortium of six Southern university systems this summer launched its new accreditation agency, called the Commission for Public Higher Education. The participating states include Florida and North Carolina, along with Georgia, South Carolina, Tennessee and Texas.

Florida Republican Gov. Ron DeSantis said in a news release that the commission will “break the ideological stronghold” that other accreditation agencies have on higher education. Speaking at Florida Atlantic University, he said the new organization will “upend the monopoly of the woke accreditation cartels.”

“We care about student achievement; we care about measurable outcomes; we care about efficiency; we care about pursuing truth; we care about preparing our students to be citizens of our republic,” DeSantis said.

Jan Friis, senior vice president for government affairs at the Council for Higher Education Accreditation, which represents accrediting agencies, said the century-old system is in the midst of its most significant changes since the federal government tied accreditation to student aid after World War II.

“If the student picks a school that’s not accredited by a recognized accreditor, they can’t spend any federal aid there,” Friis said. “Accreditation has become the ‘good housekeeping seal of approval.’”

What’s next for the new accreditor

Dan Harrison, who is leading the startup phase of the Commission for Public Higher Education, described accreditation as “the plumbing of the whole higher ed infrastructure.”

“It’s not dramatic. It’s not meant to be partisan. But it’s critical to how schools function,” said Harrison, who is the University of North Carolina System’s vice president for academic affairs.

Though the founding schools of the new commission are all in the South, Harrison said, he expects accreditation to shift away from the long-standing geography-based model. In the past, universities in the South were accredited by SACSCOC simply because of location. In the future, he said, public universities across the country might instead be grouped together because they share similar governance structures, funding constraints and oversight.

“In 2025, if you were designing accreditation from scratch, you wouldn’t build it around geography,” Harrison said. “Public universities have more in common with each other across states than they do with private or for-profit institutions in their own backyard.”

The Commission for Public Higher Education opened with an initial cohort capped at 10 institutions within the first six states. Harrison said that based on the interest, the group could have accepted 15 to 20.

“I thought we’d be at six or seven. We reached 10 quickly and across a wider range of institutions than expected,” he said. “We already have an applicant outside the founding systems. That’s well ahead of where I thought we would be.”

That early interest, he said, reflects frustration among public institutions around finances. In particular, public universities are mandated to undergo audits from the state, but also feel burdened by audits required by accreditors.

“Public universities already undergo multiple audits and state budget oversight,” he said. “Then accreditation requires them to do the same work again. It feels like reinventing the wheel and it pulls faculty and staff away from teaching and research.”

Harrison estimates it will take five to seven years for the new accreditor to be fully up and running, and that institutions will need to maintain dual accreditation to avoid risking Pell Grants and federal loans.

The commission is busy assembling peer review teams made up primarily of current and former public university leaders such as governing board members, system chancellors, provosts, chief financial officers, deans and faculty. In contrast to regional accreditors, which typically draw reviewers from both public and private institutions, the new commission is prioritizing reviewers from public universities.

“Ultimately, we want to be a true nationwide accreditor,” Harrison said. “Not a regional one. Not a partisan one. Just one that is organized around sector and peer expertise.”

While the creation of a public university accreditor is new, the concept of sector-specific accreditation exists in other parts of higher education, including for two-year colleges.

Mac Powell, president of the Accrediting Commission for Community and Junior Colleges, said that tailoring accreditation to a sector can make the peer-review model more meaningful, because reviewers can identify with similar challenges. He said reviewers have been moving away from measuring resources and bureaucratic compliance toward assessing what students actually get out of their education.

“The big shift was moving from counting inputs to asking, ‘Did students actually learn what we said they would learn?’” said Powell, whose organization accredits 138 colleges across Arizona, California, New York and the Pacific.

The most important metric all accreditation models should value is how they transition their students into the workforce, he said.

“Every accreditor today is paying much more attention to retention, persistence, transfer, career outcomes and return on investment,” Powell said. “It’s becoming less about how many books are in the library and more about whether students can find a pathway to the middle class.”

The institution evolves

Stephen Pruitt is in his first year as the president of SACSCOC, the accreditation organization that the half-dozen Southern state university systems just left. Pruitt, a Georgia native, jokes that his “Southern accent and front-porch style” has helped him break down the importance of accreditation to just about anyone.

In simple terms, he said, accreditation is the system that makes college degrees real. But he feels he has to clarify a misconception about the role of accreditation agencies like SACSCOC.

“There’s this myth that I’m sitting in Atlanta deciding if institutions are good or not,” he said. “That’s not how American accreditation works. Your peers evaluate you. People who do the same work you do.”

At the same time, Pruitt isn’t dismissing the concerns that prompted states such as Florida and North Carolina to explore alternatives to SACSCOC. According to Pruitt, institutions have long raised concerns about slow turnaround times, redundant paperwork and standards that have not always adapted quickly to the evolving landscape in higher education.

“Some of the frustration is real. Institutions want less redundancy and more responsiveness. Competition isn’t something we’re afraid of,” he said. “We’re doing a full audit of our processes. We have to be more contemporary. Faster approvals, more flexibility, more transparency. Accreditation shouldn’t just be the stick. It should be the carrot too.”

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Miriam Fauzia, The Dallas Morning News

DALLAS — The saying goes that you should stay out of the kitchen if you can’t take the heat, but new research suggests otherwise — for the sake of your blood pressure.

In a study published in the Journal of Applied Physiology, researchers at UNT Health Fort Worth found at-home heat therapy may hold the key to lowering blood pressure. A group of older adults wore heated pants for an hour a day, four days a week. After eight weeks, their blood flow improved and their systolic blood pressure, which measures blood flow when the heart beats, dropped by around 5 points.

The study comes at a time when nearly 120 million American adults have high blood pressure, but only one in four of those adults has it under control. In Texas, about 32% of adults report being told by a health care professional they have high blood pressure. And in 2023, high blood pressure was a primary or contributing cause in over 664,000 deaths in the United States, according to the Centers for Disease Control and Prevention.

Exploring ways to reduce the risks of high blood pressure — like stroke and heart attack — is crucial, and “this is an important proof-of-concept study,” said Dr. Amit Khera, a cardiologist and professor of medicine at UT Southwestern Medical Center, who was not involved in the research.

Khera doesn’t see heat therapy “as a replacement for blood pressure medicine,” he said, but he does find it intriguing. “It could be a potential adjunctive treatment for other heart diseases and problems.”

Crank up the heat

Anyone who’s stepped out of a sauna or settled into a hot tub knows heat can feel good. Research backs that up: A 2025 study found soaking in hot water can lower blood pressure, stimulate the immune system and, over time, improve how the body handles heat stress.

Other studies similarly found heat therapy can improve cardiovascular function in middle-aged and older adults — whether or not they have chronic diseases — and that its benefits can be comparable to aerobic exercise, said Scott Romero, an associate professor of physiology and anatomy at UNT Health, who led the study.

“The crazy thing is, the cardiovascular responses to heat exposure are almost identical to exercise,” Romero said. “Heart rate changes, blood flow changes, muscle changes. It’s almost identical, which is one of the reasons why we think that heat therapy is efficacious, especially in a clinical population, because it almost mimics exercise.”

Raising your core temperature with heat therapy usually means regular time in a sauna or hot tub — tough if you don’t have either. To make heat therapy more accessible, Romero and Ysabella Ruiz, the study’s first author and a graduate student in Romero’s lab, tested whether pants lined with tubes that circulate hot water could deliver similar cardiovascular benefits. (The pants, Romero said, were adapted from suits developed by NASA to study cardiovascular function during heat stress.)

The researchers recruited 19 adults, aged 55 to 80, without a diagnosed condition of high blood pressure and split them into two similarly aged groups. One wore heated pants circulating water at nearly 124 degrees Fahrenheit, which raised skin temperature to about 104 degrees. (Romero and Ruiz chose that setting based on earlier work showing it nudged up core body temperature by about one to two degrees Fahrenheit over an hour in older adults.) The other group wore pants that were mildly warm, with the water heated near 88 degrees Fahrenheit and skin temperatures just over 90 degrees. Romero said these pants would feel pleasant but wouldn’t make people sweat like in the heat therapy group.

Participants had their blood pressure checked three ways: at the start of the study, during the day while active and after eight weeks. The researchers also used ultrasound before and after the treatment to see how well it helps widen the endothelium, or inner lining, of a blood vessel to let blood flow. Problems with this lining are among the earliest signs of aging in the circulatory system and can appear even without the usual risk factors for heart disease. When the lining stops functioning normally, the risk of clogged arteries, cardiovascular disease and complications such as stroke or death goes up.

The participants kept their normal routines, setting aside an hour a day, four days a week, to wear the pants. After eight weeks, when they returned to the lab for final tests, the results stood out: systolic blood pressure was about 5 points lower for the heat therapy group, and on ultrasound, the inner lining of the blood vessels among those group members seemed much improved, dilating better than before.

Further studies needed

Romero and Ruiz aren’t sure why the heated pants led to these results. One possibility, Romero said, is that the brain adjusts how tense or springy blood vessels are in response to heat. Another is that the vessels change and improve with repeated heat exposure.

“We think that some of those things are actually changing long term,” Romero said. “We didn’t actually measure the mechanisms,” since the study focused on whether the therapy would be effective in this population.

Khera is curious how the results would translate to people with diagnosed hypertension. There’s also a question of the clinical significance of a modest drop in blood pressure when treating patients one on one.

“On a population level, if you treated 100,000 people, 5 points help,” Khera said. “But on an individual level, [blood pressure] pills are much stronger than that. … If your blood pressure is modestly high and you want to start with this as a feasible first step, as they continue to do more studies, this could be a potential treatment.”

Khera added it’s unclear how long the benefits of heat therapy last. Romero and Ruiz acknowledged that’s something they hope to determine as they investigate the underlying biology behind the results.

The researchers’ longer-term goal with at-home heat therapy is to create an accessible way for older adults to acclimate to heat.

“We know that older folks are most at risk for heat-related illnesses, especially in Texas, where we have really hot summers,” Romero said. “Those older folks are the ones who are getting sick and the ones that are dying during heat waves. Our idea is to be proactive about these heat waves and have individuals heat acclimate themselves at home.”

Romero said preliminary data from his lab suggests that at-home heat therapy can help older adults build better resilience to heat stress. That matters because heat-related deaths disproportionately affect older adults, and research from 2024 projects that as many as 246 million more people in this demographic will face dangerous levels of heat by 2050.

Miriam Fauzia is a science reporting fellow at The Dallas Morning News. Her fellowship is supported by the University of Texas at Dallas. The News makes all editorial decisions.

©2025 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.

By Claudia Boyd-Barrett, KFF Health News

In July, federal immigration agents took Milagro Solis-Portillo to Glendale Memorial Hospital just outside Los Angeles after she suffered a medical emergency while being detained. They didn’t leave.

For two weeks, Immigration and Customs Enforcement contractors sat guard in the hospital lobby 24 hours a day, working in shifts to monitor her movements, her attorney Ming Tanigawa-Lau said.

ICE later transferred the Salvadoran woman to Anaheim Global Medical Center, against her doctor’s orders and without explanation, her attorney said. There, Tanigawa-Lau said, ICE agents were allowed to stay in Solis-Portillo’s hospital room round-the-clock, listening to what should have been private conversations with providers. Solis-Portillo told her attorney that agents pressured her to say she was well enough to leave the hospital, telling her she wouldn’t be able to speak to her family or her attorney until she complied.

“She described it to me as feeling like she was being tortured,” Tanigawa-Lau said.

Legal experts say ICE agents can be in public areas of a hospital, such as a lobby, and can accompany already-detained patients as they receive care, illustrating the scope of federal authority. Detained patients, however, have rights and can try to advocate for themselves or seek legal recourse.

Earlier this year, California set aside $25 million to fund legal services for immigrants, and some local jurisdictions — including Orange County, Long Beach, and San Francisco— have put money toward legal aid efforts. The California Department of Social Services lists some legal defense nonprofits that have received funds.

Sophia Genovese, a supervising attorney and clinical teaching fellow at Georgetown Law, said law enforcement officers, including federal immigration agents, can guard and even restrain a person in their custody who is receiving health care, but they must follow constitutional and health privacy laws regardless of the person’s immigration status. Under those laws, patients can ask to speak with medical providers in private and to seek and speak confidentially with legal counsel, she said.

“ICE should be stationed outside of the room or outside of earshot during any communication between the patient and their doctor or medical provider,” Genovese said, adding that the same applies to a patient’s communication with lawyers. “That’s what they’re supposed to do.”

ICE guidelines

When it comes to communication and visits, ICE’s standards state that detainees should have access to a phone and be able to receive visits from family and friends, “within security and operational constraints.” However, these guidelines are not enforceable, Genovese said.

If immigration agents arrest someone without a warrant, they must tell them why they’ve been detained and generally can’t hold them for more than 48 hours without making a custody determination. A federal judge recently granted a temporary restraining order in a case in which a man named Bayron Rovidio Marin was monitored by immigration agents in a Los Angeles hospital for 37 days without being charged and was registered under a pseudonym.

In the past, perceived violations by agents could be reported to ICE leadership at local field offices, to the agency’s headquarters, or to an oversight body, Genovese said. But earlier this year, the Department of Homeland Security cut staffing at ombudsman offices that investigate civil rights complaints, saying they “obstructed immigration enforcement by adding bureaucratic hurdles.”

The assistant secretary for public affairs at DHS, Tricia McLaughlin, said that agents arrested Marin for being in the country illegally and that he admitted his lack of legal status to ICE agents. She said agents took him to the hospital after he injured his leg while trying to evade federal officers during a raid. She said officers did not prevent him from seeing his family or from using the phone.

“All detainees have access to phones they can use to contact their families and lawyers,” she said.

McLaughlin said the temporary restraining order was issued by an “activist” judge. She did not address questions about staffing cuts at the ombudsman offices.

DHS also said Solis-Portillo was in the country illegally. The department said she had been removed from the United States twice and arrested for the crimes of false identification, theft, and burglary.

“ICE takes its commitment to promoting safe, secure, humane environments for those in our custody very seriously,” McLaughlin said. “It is a long-standing practice to provide comprehensive medical care from the moment an alien enters ICE custody. This includes access to medical appointments and 24-hour emergency care.”

Protections in California

Anaheim Global Medical Center did not respond to a request for comment. In a statement, Dignity Health, which operates Glendale Memorial Hospital, said it “cannot legally restrict law enforcement or security personnel from being present in public areas which include the hospital lobby/waiting area.”

California enacted a law in September that prohibits medical establishments from allowing federal agents without a valid search warrant or court order into private areas, including places where patients receive treatment or discuss health matters. But many of the most high-profile news reports of immigration agents at health care facilities have involved detained patients brought in for care.

Erika Frank, vice president of legal counsel for the California Hospital Association, said hospitals have always had law enforcement, including federal agents, bring in people they’ve detained who need medical attention.

Hospitals will defer to law enforcement on whether a patient needs to be monitored at all times, according to association spokesperson Jan Emerson-Shea. If law enforcement officers overhear medical information about a patient while they’re in the hospital, it doesn’t constitute a patient-privacy violation, she added.

“This is no different, legally, from a patient or visitor overhearing information about another patient in a nearby bed or emergency department bay,” Emerson-Shea said in a statement.

She didn’t address whether patients can demand privacy with providers and attorneys, and she said hospitals don’t tell family and friends about the detained patient’s location, for safety reasons.

Sandy Reding, who is president of the California Nurses Association and visited the Glendale facility when Solis-Portillo was there, said nurses and patients were frightened to see masked immigration agents in the hospital’s lobby. She said she saw them sitting behind a registration desk where they could hear people discuss private health information.

“Hospitals used to be a sanctuary place, and now they’re not,” she said. “And it seems like ICE has just been running rampant.”

The Los Angeles County Board of Supervisors is scheduled to vote Nov. 18 on a proposal to provide more protections for detainees at county-operated health facilities. These include limiting the ability of immigration officials to hide patients’ identities, allowing patients to consent to the release of information to family members and legal counsel, and directing staff to insist immigration agents leave the room at times to protect patient privacy. The county would also defend employees who try to uphold its policies.

Solis-Portillo’s lawyer, Tanigawa-Lau, said her client ultimately decided to self-deport to El Salvador rather than fight her case, because she felt she couldn’t get the medical care she needed in ICE custody.

“Even though Milagro’s case is really terrible, I’m glad that there’s more awareness now about this issue,” Tanigawa-Lau said.

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Jonathan Shorman, Stateline.org

A day after President Donald Trump took office, U.S. Immigration and Customs Enforcement issued a new directive to its agents: Arrests at courthouses, restricted under the Biden administration, were again permissible.

In Connecticut, a group of observers who keep watch on ICE activity in and around Stamford Superior Court have since witnessed a series of arrests. In one high-profile case in August, federal agents pursued two men into a bathroom.

“Is it an activity you want to be interfering with, people fulfilling their duty when they’re called to court and going to court? For me, it’s insanity,” said David Michel, a Democratic former state representative in Connecticut who helps observe courthouse activity.

Fueled by the Stamford uproar, Connecticut lawmakers last week approved restrictions on civil arrests and mask-wearing by federal law enforcement at state courthouses. And on Monday, a federal judge tossed a lawsuit brought by the U.S. Department of Justice that had sought to block similar restrictions in New York.

They are the latest examples of a growing number of Democratic states, and some judges, pushing back against ICE arrests in and around state courthouses. State lawmakers and other officials worry the raids risk keeping people from testifying in criminal trials, fighting evictions or seeking restraining orders against domestic abusers.

The courthouse arrests mark an intensifying clash between the Trump administration and Democratic states that pits federal authority against state sovereignty. Sitting at the core of the fight are questions about how much power states have to control what happens in their own courts and the physical grounds they sit on.

In Illinois, lawmakers approved a ban on civil immigration arrests at courthouses in October. In Rhode Island, lawmakers plan to again push for a ban after an earlier measure didn’t advance in March. Connecticut lawmakers were codifying limits imposed by the state Supreme Court chief justice in September. Democratic Gov. Ned Lamont is expected to sign the bill.

States that are clamping down on ICE continue to allow the agency to make criminal arrests, as opposed to noncriminal civil arrests. Many people arrested and subsequently deported are taken on noncriminal, administrative warrants. As of Sept. 21, 71.5% of ICE detainees had no criminal convictions, according to the Transactional Records Access Clearinghouse, a data research organization.

Some states, such as New York, already have limits on immigration enforcement in courthouses that date back to the first Trump administration, when ICE agents also engaged in courthouse arrests. New York’s Protect Our Courts Act, in place since 2020, prohibits civil arrests of people at state and local courthouses without a judicial warrant. The law also applies to people traveling to and from court, extending protections beyond courthouse grounds.

“One of the cornerstones of our democracy is open access to the courts. When that access is denied or chilled, all of us are made less safe and less free,” said Oren Sellstrom, litigation director at Lawyers for Civil Rights, a Boston-based group that works to provide legal support to immigrants, people of color and low-income individuals.

But in addition to challenging the New York law, the Justice Department is prosecuting a Wisconsin state judge, alleging she illegally helped a migrant avoid ICE agents.

“We aren’t some medieval kingdom; there are no legal sanctuaries where you can hide and avoid the consequences for breaking the law,” U.S. Department of Homeland Security Assistant Secretary for Public Affairs Tricia McLaughlin said in a statement to Stateline. “Nothing in the constitution prohibits arresting a lawbreaker where you find them.”

Some Republican lawmakers oppose efforts to limit ICE arrests in and near courthouses, arguing state officials should stay out of the way of federal law enforcement. The Ohio Senate in June passed a bill that would prohibit public officials from interfering in immigration arrests or prohibiting cooperation with ICE; the move came after judges in Franklin County, which includes Columbus, imposed restrictions on civil arrests in courthouses.

“The United States is a nation of immigrants, but we are also a nation of law and order. To have a civilized society, laws must be respected, this includes immigration laws,” Ohio Republican state Sen. Kristina Roegner, the bill’s sponsor, said in a news release at the time.

Roegner didn’t respond to Stateline’s interview request. The legislation remains in a House committee.

Knowing where a target will be

Courthouses offer an attractive location for ICE to make immigration arrests, according to both ICE and advocates for migrants.

Court records and hearing schedules often indicate who is expected in the building on any given day. Administrative warrants don’t allow ICE to enter private homes without permission, but the same protections don’t apply in public areas, such as courthouses. And many people have a strong incentive to show up for court, knowing that warrants can potentially be issued for their arrest if they don’t.

“So in some respects, it’s easy pickings,” said Steven Brown, executive director of the ACLU of Rhode Island.

In June, ICE arrested Pablo Grave de la Cruz at Rhode Island Traffic Tribunal in Cranston. A 36-year-old Rhode Island resident, he had come from Guatemala illegally as a teenager.

“They pulled up on him like he was a murderer or a rapist,” friend Brittany Donohue told the Rhode Island Current, which chronicled de la Cruz’s case. “He was leaving traffic court.”

An immigration judge has since granted de la Cruz permission to self-deport.

McLaughlin, the Homeland Security assistant secretary, said in her statement that allowing law enforcement to make arrests “of criminal illegal aliens in courthouses is common sense” — conserving law enforcement resources because officers know where a target will be. The department said the practice is safer for officers and the community, noting that individuals have gone through courthouse security.

Still, ICE’s directive on courthouse arrests sets some limits on the agency’s activity.

Agents “should, to the extent practicable” conduct civil immigration arrests in non-public areas of the courthouse and avoid public entrances. Actions should be taken “discreetly” to minimize disruption to court proceedings, and agents should generally avoid areas wholly dedicated to non-criminal proceedings, such as family court, the directive says.

Crucially, the directive says ICE can conduct civil immigration arrests “where such action is not precluded by laws imposed by the jurisdiction.” In other words, the agency’s guidance directs agents to respect state and local bans on noncriminal arrests.

Trump administration court actions

But the Trump administration has also gone to court to try to overcome state-level restrictions.

The Justice Department sued in June over New York’s Protect Our Courts Act, arguing that it “purposefully shields dangerous aliens” from lawful detention. The department says the law violates the U.S. Constitution’s supremacy clause, under which federal law supersedes state law.

New York Democratic Attorney General Letitia James argued the state law doesn’t conflict with federal law and sought the lawsuit’s dismissal.

U.S. District Court Judge Mae D’Agostino, an appointee of President Barack Obama, on Monday granted James’ motion. The judge wrote that the “entire purpose” of the lawsuit was to allow the federal government to commandeer New York’s resources — such as court schedules and court security screening measures — to aid immigration enforcement, even though states cannot generally be required to help the federal government enforce federal law.

“Compelling New York to allow federal immigration authorities to reap the benefits of the work of state employees is no different than permitting the federal government to commandeer state officials directly in furtherance of federal objectives,” the judge wrote.

The Justice Department didn’t immediately respond to a request for comment.

The department is also prosecuting Wisconsin Judge Hannah Dugan, who prosecutors allege helped a person living in the country illegally avoid ICE agents in April inside a Milwaukee courthouse by letting him exit a courtroom through a side door. (Agents apprehended the individual near the courthouse.) A federal grand jury indicted Dugan on a count of concealing an individual and a count of obstructing a proceeding.

In court documents, Dugan’s lawyers have called the prosecution “virtually unprecedented and entirely unconstitutional.”

Dugan has pleaded not guilty, and a trial is set for December.

Lawmakers seek ‘order’ in courthouses

Rhode Island Democratic state Sen. Meghan Kallman is championing legislation that would generally ban civil arrests at courthouses. The measure received a hearing, but a legislative committee recommended further study.

Kallman hopes the bill will go further next year. The sense of urgency has intensified, she said, and more people now understand the consequences of what is happening.

“In order to create a system of law that is functioning and that encourages trust, we have to make those [courthouse] spaces safe,” she said.

Back in Connecticut, Democratic state Rep. Steven Stafstrom said his day job as a commercial litigator brings him into courthouses across the state weekly. Based on his conversations with court staff, other lawyers and senior administration within the judicial branch, he said “there’s a genuine fear, not just for safety, but for disruptions of orderly court processes in our courthouses.”

Some Connecticut Republicans have questioned whether a law that only pertains to civil arrests would prove effective. State Rep. Craig Fishbein, the ranking Republican on the House Judiciary Committee, noted during floor debate that entering the United States without permission is a criminal offense — a misdemeanor for first-time offenders and a felony for repeat offenders. Because of that, he suggested the measure wouldn’t stop many courthouse arrests.

“The advocates think they’re getting no arrests in courthouses, but they’ve been sold a bill of goods,” he said.

Stafstrom, who chairs the Judiciary Committee, said in response that he believed the legislation protects many people who are in the country illegally because that crime is often not prosecuted.

“All we’re asking is for ICE to recognize the need for order in our courthouses,” Stafstrom said.

Stateline reporter Jonathan Shorman can be reached at jshorman@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Patti Nickell, Tribune News Service

Mark Van Osdal is a tree whisperer. Owner of Carolina Bound Adventures, he is leading a small group of us on the Deep Creek hike on the North Carolina side of the Great Smoky Mountains National Park near Bryson City.

During the hike, we will see waterfalls, a picturesque bridge over Deep Creek, the last of the summer wildflowers, and one rather belligerent squirrel, angry that he dropped the black walnut he was munching on right in the middle of our group.

Oh yes, and trees … lots of them. Van Osdal says that the national park (America’s most visited) has some 100 native species of trees, more than the entire European continent. And he appears to be on a first-name basis with all of them.

Van Osdal is just one of the people waiting to welcome visitors to Bryson City, known as “the quiet side of the Smokies.” Although just 45 miles from Gatlinburg, across the Tennessee line, it seems a world apart in its peaceful serenity.

And in its welcoming residents who can’t wait to make your stay as authentic as possible. People such as Rita Jones, director of the Swain County Visitor Center & Heritage Museum.

Make it your first stop — you can’t miss the imposing white-columned building on Everett Street, which doubles as both a resource for visitors seeking the area’s best hiking, rafting, canoeing and biking spots and a museum of western Carolina heritage.

And then there’s Rita, pink-cheeked and smiling, looking just like the adorable elf she dresses up as during the town’s celebrated Christmas festivities.

Make a stop at Nantahala Outdoor Center, starting point for all of the adrenaline-boosting adventures people come here for. If you’re lucky, you will meet marketing manager Betsy Bevis and reservations manager Chris Aldridge, who joined me for lunch at the Riverside Restaurant overlooking the Nantahala River.

Munching on my catfish sandwich, I noted that the Nantahala is much more benign from a window table than from an overturned canoe, courtesy of my last experience on it.

The 500-acre NOC is a one-stop shop for all things outdoor — whether it be rafting, mountain biking, zip lining, etc.; eating at one of the two restaurants; buying outdoor gear, or overnighting in the new mountaintop Hemlocks bungalows.

Guests wanting to be closer to the river and trails can book private cabins, and for the truly adventurous, there are primitive campsites within the Nantahala National Forest.

Fun fact: NOC’s founder Payson Kennedy was a stunt double in the film “Deliverance,” and if you remember the scenes filmed on the nearby Chattooga River, you’ll understand why Burt Reynolds and the other actors were keen to leave the paddling to those stunt doubles.

Although the movie may suggest otherwise, Bevis and Aldridge say the 1971 film was responsible for a surge in the popularity of whitewater rafting.

Back on dry land, you would be fortunate indeed if you crossed paths with Scott Mastej and experienced a dose of his southern hospitality. Along with his partner Ron LaRoque, he is the owner of the Everett Hotel, a luxury 10-room boutique property repurposed from a 1908 bank building.

While I didn’t stay at the Everett, I did enjoy a dinner (lobster bisque and Carolina mountain trout) and a conversation with Scott in the chic Everett Bistro, the hotel’s in-house restaurant.

Dinner another night was at the historic Fryemont Inn, a Bryson City fixture and a nostalgic trip back to the 1920s, where there are no TVs in most of the rooms and no air conditioning as the mountain breezes provide natural cooling.

This is rustic luxury at its best, with the large fireplace in the lobby and even larger open porch off that lobby competing for favorite guest hangout.

Dinner included an entrée plus choice of soup or salad and two family-style sides of the day.

If you can, track down co-owner Monica Brown, and ask her about the lavish Halloween festivities she organizes where repeat guests return every year for the spooky fun.

Should you opt for a stay in a bed-and-breakfast, you will find a charming one in the Folkestone Inn. Those charms include a serene garden for sipping your morning coffee, the 15-minute driving distance to the Smoky Mountains National Park and innkeeper Toni Rowe’s delectable breakfast Croque Madame.

Since I had my two sisters on this trip with me, we opted for one of Bryson City’s many cabin accommodations. Our cabin in the Bryson City Village lived up to its name, Creekside Delight.

The two-bedroom, two-bath cabin had a large kitchen/dining area and a large living room with a deck and hot tub overlooking a small creek.

While many visitors prefer a cabin nestled in the mountains, this one had definite advantages, being just a short walk into town and the train depot.

The latter is important as it makes it easy if you book the area’s top attraction, the Great Smoky Mountain Railroad Nantahala Gorge Excursion.

The 44-mile excursion is a four-and-a-half-hour trip (including a stopover at the Nantahala Outdoor Center). The scenery from your car’s window is breathtaking – the Nantahala River and along the shore of Fontana Lake before crossing the 426-foot Fontana Trestle into the Nantahala Gorge.

The leaves were just starting to turn during my excursion, and I could only imagine what this would look like in peak season, the view a tapestry of gold, orange, scarlet and russet.

If you book a first-class car like Harper, you’ll get lunch and a chance to engage with Steven, the personable host.

Finally, there’s no better trip-ender than toasting the sun setting behind the mountains with a not-to-be-forgotten experience at Long View Resort.

The Nordic-themed experience features a massage on the deck of the spa, where birdsong was the only music needed to lull me into a semi-slumber as every muscle in my body went along for the ride.

Post-massage, I had only to cross the deck and ease into the hot tub facing the mountains in preparation for my 90-minute sunset soak. To say that this is a transcendental experience is not overstating the case.

The only interruption to my zen-like solitude was the attendant bringing me a glass of ice water and a small charcuterie board to nibble on.

After four days in this part of the Smokies, I left feeling relaxed, reinvigorated and wanting to return soon to this authentic mountain destination.

©2025 Tribune Content Agency, LLC.

By Gretchen McKay, Pittsburgh Post-Gazette

This seasonal dessert marries two Mediterranean flavors: fresh, ripe figs and sweet peaches.

The pastry crust is very forgiving and comes together in just a few minutes (though it has to be chilled for an hour).

If you have really sweet fruit, you can cut back on the amount of sugar in the filling; if it’s on the under-ripe side, increase it.

The recipe calls for demerara sugar (a partially refined raw cane sugar characterized by its large, light-brown crystals) but you can substitute another large-crystal sugar like turbinado.

Equally delicious warm or at room temperature, the tart can be served with a scoop of vanilla bean ice cream or a dollop of whipped cream for a touch of pizzazz. Also great with your morning coffee!

Fig and Peach Tart

PG tested

Figs are in season from late summer to early fall. You usually can find them at specialty groceries like Whole Foods and Trader Joe’s.

For pastry

2 cups all-purpose flour, plus more to dust

1/4 cup demerara sugar

1/4 teaspoon salt

1/2 cup plus 2 tablespoons cold unsalted butter

1 extra-large egg yolk (reserve white for glazing)

1 tablespoon cold water

For filling

2 ripe and sweet small peaches

5 ripe figs

1 teaspoon vanilla

1/2 teaspoon cinnamon

1 tablespoon lemon juice

1/2 cup demerara sugar

3 tablespoons cornstarch

For glaze

1 extra-large egg white, lightly beaten

2 tablespoons demerara sugar

Make pastry: Place flour, sugar, salt and butter in a large bowl and rub together with your fingertips until it resembles breadcrumbs.

Lightly beat egg yolk and cold water, then add to the bowl, using your hands to lightly knead everything together into a soft ball of dough.

Wrap in plastic wrap and transfer to the fridge for 1 hour.

Preheat oven to 400 degrees.

Slice peaches into 3/4 -inch-thick slices, removing the pits, and quarter the figs. Place the fruit in a bowl and toss with the vanilla, cinnamon, lemon juice, demarara sugar and cornstarch.

Place a sheet of parchment paper on a work surface and put the ball of pastry on it. Lightly flour a rolling pin and use it to roll out the pastry into a circle around 1/4 -inch thick and 14 inches in diameter. Don’t worry if edges are rough. If pastry starts coming apart, just squish it back together with your fingers.

Place parchment paper with the dough on baking sheet, and arrange peach and fig slices in the center of the circle, leaving a 2-inch border. (Either pile all in the middle or make a pattern with circles.)

Fold the edges of the pastry over the fruit. Use your finger to bring the pasty together where you have gaps.

Use a pastry brush to lightly coat the top of the pasty with beaten egg and sprinkle with sugar.

Bake for around 40 minutes, until the top of the pastry is an even dark golden-brown color. Serve warm or at room temperature.

Makes 1 tart.

— “Ripe Figs: Recipes and Stories from Turkey, Greece and Cyprus” by Yasmin Khan

©2025 PG Publishing Co. Visit at post-gazette.com. Distributed by Tribune Content Agency, LLC.

Arthur Allen, KFF Health News

VENICE, Fla. — MAGA and MAHA are happily married in Florida, and nowhere more at home than in Sarasota County, where on a humid October night a crowd of several hundred gathered to honor state Surgeon General Joseph Ladapo, his wife, and an unlicensed Canadian radiologist who treats cancer with horse paste.

The event, titled “The 3 Big C’s: Courage, Censorship & Cancer,” was sponsored by the We the People Health and Wellness Center, a clinic, funded by a Jan. 6 marcher, where patients can bask in red light, sit in ozone-infused steam baths, or get their children treated for autism with an experimental blood concentrate.

In Venice, in Sarasota County, a “medical freedom” movement forged in opposition to COVID lockdowns blends wellness advocates, vaccine-haters, right-wing Republicans, and angry parents in a stew of anti-government absolutism and mystical belief.

Ladapo’s wife, Brianna, a self-proclaimed “spiritual healer” who says she speaks with angels and has prophetic visions, chaired a panel at the event at the Venice Community Center. The keynote speech was by William Makis, a litigious COVID conspiracist who, after losing his medical license in 2019, has made a living treating cancer patients with antiparasitic drugs including ivermectin, which was also championed in some circles as a COVID treatment during the pandemic.

Clinical trials showed that ivermectin didn’t work, but COVID skeptics viewed medicine’s rejection of it as part of a conspiracy by Big Pharma against a cheap, off-patent drug. Some of the patients in his care have what he calls “turbo cancers,” Makis says, blaming alleged impurities in mRNA vaccines that he says have killed millions of people.

For Makis, it’s all one big conspiracy — the virus, the vaccine, and the suppression of his therapies.

Brianna Ladapo has her own take on medicine, based on the idea of good and bad spiritual energy. She wrote in a memoir that as the pandemic began she intuited that it had been planned by “sinister forces” to “frighten the masses to surrender their sovereignty to a small group of tyrannical elites.” She has written that the government hides vaccination’s risks.

She sees “dark forces” all over the place, including, she said in a podcast interview earlier this year, in “chemtrails” shaped like a pentagram. “They’ve been plastering it in the sky right outside our house for the last few weeks,” Ladapo said. The chemtrails “they are dumping on us,” she said, had sickened her and her three sons. “The dark side are no fans of ours.”

(“Chemtrails” are a favorite topic of conspiracy theorists who say they think that contrails, the condensation formed around commercial airplane exhaust, contain toxic substances poisoning people and the terrain. Although there is zero evidence of that, Health and Human Services Secretary Robert F. Kennedy Jr. plans to look into whether they are part of a clandestine effort to use toxic chemicals to change the weather.)

Ladapo’s husband hasn’t publicly endorsed all her beliefs, but as surgeon general he’s reversing decades of accepted public health practice in Florida and embracing untested therapies. “We’re done with fear,” Joseph Ladapo said after being named surgeon general in 2021. He wants to ban mRNA vaccines in Florida, and on Sept. 3 he announced plans to end childhood vaccination mandates in the state.

A few days after the Venice event, Ladapo said he hoped to support Makis’ work — though his treatments are unproven and potentially dangerous — through a new $60 million cancer research fund created by Florida Gov. Ron DeSantis and his wife, Casey.

Vic Mellor, CEO of a local concrete business, founded and owns We the People. He’s an associate of retired Army Lt. Gen. Michael Flynn, who was briefly President Donald Trump’s national security adviser in 2017 before being dismissed for lying to the FBI about his contacts with Russians. Trump later pardoned him, and Flynn since has become a leader of the Christian nationalist movement.

We the People provides vitamin shots but no vaccines. In fact, many of its offerings are treatments for supposed vaccine injuries. Part of the We the People building is a broadcasting studio, where conservatives hold forth on what they see as the villainy of liberals and the American Academy of Pediatrics.

Mellor was at the U.S. Capitol during the riot on Jan. 6, 2021 — he said he “just knocked on front doors,” according to a Facebook post described by The Washington Post. He returned home and started building a 10-acre complex that hosts weddings and right-wing assemblies, with playgrounds, a butterfly garden, a zip line over a pond visited by alligators, and an attached, separately owned gun range.

Visitors who travel down a dirt road to The Hollow — named for the hollow-core concrete that made Mellor wealthy — can enter the compound through a dark, cavernous passage lined with neon signs illuminating maxims from the likes of Thomas Jefferson, Thomas Paine, and Flynn.

The Hollow has hosted clinics for unvaccinated kids and events for Ladapo, anti-vaccine activist Sherri Tenpenny (who in 2021 told legislators at an Ohio House hearing that COVID vaccine made people magnetic), and other “medical freedom” advocates. Mellor created a medical home for such ideas by opening We the People in 2023.

The year before, three “medical freedom” candidates had won seats on the board overseeing Sarasota’s public hospital and health care system, after protests over the hospital’s refusal to treat COVID patients with ivermectin and other drugs of choice for COVID contrarians.

On a recent afternoon at The Hollow, manager Dan Welch was clearing brush when approached by KFF Health News. As a foe of vaccinations, he welcomed Ladapo’s move to end vaccine mandates. “Maybe in their inception, vaccines were created to prevent what they were supposed to prevent,” Welch said. “But now there’s so much more in there, the metals, aluminum, mercury. Since they started vaccination, the autism rate went through the roof, and I believe these vaccines are part of it.”

The theory that vaccines cause autism has been debunked, and manufacturers removed mercury from childhood vaccines 24 years ago, although Welch said he doesn’t believe it.

Vaccination faces additional challenges in a century-old Sarasota County neighborhood of low-slung bungalows called Pinecraft, home to about 3,000 Mennonites — and double that number when Amish snowbirds arrive in the winter. Pastor Timothy Miller said that while Sarasota’s Mennonites are less culturally isolated than the Mennonite community in West Texas, site of a measles outbreak in January, many in his community also shun vaccination.

His cousin Kristi Miller, 26, won’t vaccinate her 9-month-old daughter or any of the other children she hopes to have, she said, because she thinks vaccines probably cause autism and other harms.

As for vaccine-preventable diseases like measles, she doesn’t worry about them. Like the Ladapos, “I don’t live in fear,” she said. “I have a God who’s bigger than everything.”

(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Robert Snell

MediaNews Group

Two Dearborn men and a group of alleged co-conspirators hatched a plan to commit a terrorist attack in support of the Islamic State, according to a federal criminal case filed Monday that described reconnaissance, firearms and fears the group was targeting an LGBTQ+ nightclub in Ferndale.

The case against Dearborn residents Mohmed Ali and Majed Mahmoud was filed three days after high-profile raids by members of an FBI Joint Terrorism Task Force in Dearborn and Inkster and comments from FBI Director Kash Patel that investigators had thwarted a violent plot tied to international terrorism that was planned over the Halloween weekend.

The criminal complaint describes a group of five co-conspirators, including a juvenile, training with and stockpiling weapons and scouting potential attack locations in downtown Ferndale. The popular downtown is filled with restaurants, bars, clubs and shops and is known as a haven for members of the LGBTQ+ community.

“Based on my investigation in this case, this information is consistent with (the juvenile), Ali and Mahmoud scouting possible LGBTQ+-friendly attack locations in Ferndale,” FBI Special Agent Nicholas Czech wrote in the complaint.

The men, whose ages were not immediately available, were charged with receiving and transferring, and attempting and conspiring to transfer firearms and ammunition while knowing or having reasonable cause to believe the weapons would be used to commit an act of terrorism. The felony carries a maximum 15-year federal prison sentence.

The charge was filed three days after FBI agents raided two homes in Dearborn and an Inkster storage facility and arrested five people ages 16-20.

Mahmoud’s lawyer Bill Swor declined to comment until he had a chance to read the criminal complaint.

Attorney Amir Makled, who represents a 20-year-old Dearborn man, has denied the men were involved in terrorism.

“One thing is for sure, they didn’t have a plan to attack and are not part of a terror cell,” Makled told The News.

Ali, Mahmoud and others are accused of using online encrypted communications and social media apps to share extremist and ISIS-related material that encouraged terror attacks.

Based on the chats, an attack appeared scheduled for Halloween, according to the government, and Ali and the juvenile “sought guidance from the father of a local Islamic extremist ideologue…on this question,” the FBI agent wrote.

The ideologue is not identified by name but “has publicly proclaimed his support for the Islamic extremist ideology espoused by ISIS,” the agent wrote.

Since the raids, provocative statements from FBI Director Kash Patel and other Trump administration officials, a lack of criminal charges or details about alleged wrongdoing, or names of the accused, led criminal defense lawyers in Metro Detroit to question the legitimacy of the investigation and deny there was a terrorist plot.

The court filing describes talk of a terror attack, firearms and training.

The investigation dates to July, when investigators discovered encrypted chats in which Ali and a juvenile were said to be planning a terrorist attack in the U.S. on behalf of the Islamic State, according to the 73-page criminal complaint.

FBI agents alleged Mahmoud and others conspired to commit the attack.

Amid those chats, Ali purchased an AR-15-style rifle and accessories in August and September, according to the government.

“Then in October 2025, Mahmoud purchased over 1,600 rounds of ammunition that could be used in the AR-15 style rifles he and Ali had purchased,” the complaint reads.

Investigators allege Ali, Mahmoud, the juvenile and two others practiced shooting firearms at gun ranges, a stop investigators believe was to develop the skills to aid in the attack.

The investigation is the latest in Metro Detroit, a region where several residents in recent years have been accused of providing or trying to provide support to the Islamic State or launching failed attempts to kill people.

“Through swift action and close coordination with our local partners, a potential act of terror was stopped before it could unfold,” Patel said in a social media post. “The vigilance of this FBI prevented what could have been a tragic attack — and thanks to their dedication, Michigan will have a safe and happy Halloween.”

In the wake of the raid, Makled faulted Patel for making “premature” comments about the investigation. The five people arrested by the FBI ― all U.S. citizens ― were not planning an attack, he said.

“There was never any planned mass-casualty event or terrorism plot of any kind that I’m aware of,” Makled said. “They might have been on some websites or online chat groups that they shouldn’t have been, but nothing that is illegal.”