Why this matters:

Emergency departments, or EDs, are becoming an initial contact for patients to get hospice and palliative care referrals and consultations when presenting to the hospital for care.

In the five years since COVID-19, hospice and palliative care consultations in hospital emergency departments have increased over 170%, although this trend has been growing since 2000.

Increasing access to hospice and palliative care from the ED can enhance quality of life for both patients and their families.

Roughly half of all FDA-approved drugs from 2000 onward rely on publications funded by grants that would have been cut assuming a 40% reduction in U.S. National Institutes of Health (NIH) funding in past decades, say authors of a new Policy Forum. In this piece, Pierre Azoulay and colleagues present an analysis of a hypothetical alternative history.  “Assuming that the near term resembles the recent past,” they say, “our analysis indicates that substantial NIH budget cuts – including those implemented at the funding margin – could curtail research linked to a large share of potential drug approvals.” The NIH, historically one of the world’s most consistently supported biomedical research funders, faces unprecedented uncertainty. In 2025, the agency began canceling existing grants and delaying new ones, with funding for competitive grants falling more than 40% below the previous year’s levels. What’s more, the Trump administration’s proposed FY2026 budget calls for a nearly 40% cut in spending.

To explore potential impacts of such cuts, Azoulay and colleagues performed a “what-if” scenario analysis to determine how these cuts would impact downstream drug development. Azoulay et al. focused on “at-risk” grants – those that would have likely been cut in a 40% smaller budget from the years 1980 to 2007 – for small-molecule drugs. The authors found that among 557 drugs approved between 2000 and 2023, 40 had at least one patent directly acknowledging NIH extramural funding, and 14 of these were supported by at-risk grants. And, when considering research citations, 331 cite at least one NIH-supported publication, and 286 reference research funded by grants that would have been cut under a hypothetical 40% budget reduction. These findings suggest that a large portion of modern pharmaceuticals rely on publicly funded science, often through indirect pathways that provide critical background knowledge, methods, or foundational research. Moreover, the authors show that the drugs linked to at-risk research are often highly valuable, demonstrating that NIH funding not only underpins a substantial share of medical innovation but also supports drugs that are clinically and economically important.

Some termites form symbiotic relationships with fungus. When harmful fungi invade their carefully cultivated crops, these fungus-farming termites fight back with the precision of skilled gardeners, a new study reveals, smothering them in soil clumps enriched with microbial allies that inhibit fungal growth. Fungus-farming termites, like Odontotermes obesus, maintain a vital symbiotic relationship with the fungus Termitomyces, cultivating it in specialized nutritional substrates called combs that provide both a reliable food source for the termites and an ideal habitat for the fungus. However, these nutrient-rich combs also attract invasive fungal weeds, particularly the fast-growing Pseudoxylaria, which can quickly overtake the crop if left unchecked. While Pseudoxylaria is typically suppressed in healthy combs under termite care, it rapidly spreads when termites are removed, suggesting a critical role of termite activity in maintaining their fungal gardens. While It’s thought that termites use microbial agents to manage these fungal weeds, while sparing their cultivated crop, the precise behavioral mechanism by which they achieve such selective control remains unknown. Through experiments exposing O. obesus to varying severities of Pseudoxylaria outbreaks, Aanchal Panchal and colleagues found that the termites employ a flexible set of behaviors to suppress weeds, adjusting their tactics depending on the severity of the invasion.

When faced with small infections, termites actively remove Pseudoxylaria from contaminated comb and bury it under soil clumps (boluses), which effectively isolates the harmful fungus in an oxygen-deficient soil environment, suppressing further growth. In the case of severe outbreaks, termites fully isolate infected portions from healthy combs and, if necessary, smother entire sections in soil boluses to contain the threat. Notably, the authors found that the soil boluses the insects use are not just barriers – they contain a diverse community of microbes, including termite-derived bacteria with fungistatic properties. Termites deploy these fungistatic boluses only when weeds threaten their gardens, not on healthy fungal combs. According to Panchal et al., this indicates that O. obesus has evolved a highly targeted defense strategy, enlisting microbial allies to selectively combat harmful fungi while sparing their beneficial crop. “The findings of Panchal et al. elucidate how microbial symbionts can be used as part of a multifaceted pest management strategy,” write Aryel Goes and Rachelle Adams in a related Perspective. “Efforts to understand the molecules involved, and their relationship to host fitness, may reveal beneficial microbes that lead to natural product discovery for medicine, agriculture, and bioremediation.”

Over 50 percent of small-molecule drug patents this century cite at least one piece of NIH-backed research that would likely have been vulnerable to the type of funding cuts currently proposed by the administration, according to a new study.