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Stephen Hahn speaks during the daily briefing on the novel coronavirus on March 19, 2020.By Brendan Smialowski/AFP/Getty Images.
"A Tsunami of Randoms": How Trump's COVID Chaos Drowned the FDA in Junk Science
Over its 114-year history, the U.S. Food and Drug Administration has become a global paragon when it comes to drug regulation. In the most consequential year of its existence, however, the agency—and its rookie director—was besieged and almost swallowed by all manner of Trump cronies pushing pet projects, according to new interviews and previously undisclosed documents. A special report.
By Katherine Eban
As Dr. Stephen Hahn, commissioner of the Food and Drug Administration, stepped to the White House lectern on March 19, for his first star turn in the Trump administration's pandemic response, he seemed alert to the risks of serving as the president's "miracle cure" consigliere. That day President Trump was touting an old malaria drug, hydroxychloroquine, for showing "tremendous promise" against COVID-19, lavishing praise on Hahn as "fantastic" for moving swiftly and slashing red tape to make the drug more widely available. Beaming from the acclaim, and introducing himself to a panicked nation, the affable former oncologist spoke of his own medical background. "One thing that was really important is to provide hope," he said. "What's also important is not to provide false hope…. And as a doctor, that's the way I come to this."
He then made a point that he'd repeat throughout the coming months: The FDA would rigorously follow data in approving only safe and effective treatments. In other words, despite the frantic search for COVID-19 remedies, there would be no back door to FDA approval: Every product would get the same scrupulous scientific vetting, regardless of who was pushing it.
In the moment Hahn received plaudits for appearing to straddle the perilous divide between hype and science. In retrospect, however, that press conference now seems like an upmarket hostage video, with Hahn not yet fully understanding that he was sharing the stage with his captors. For the former chief medical executive of the MD Anderson Cancer Center and a political neophyte, his one-year stint at the FDA's helm during a catastrophic public health crisis would be a dark journey into the heart of a science-eviscerating political machinery that he would come to confidentially describe as "evil" to colleagues. Vanity Fair's reporting, based on interviews with 30 current and former FDA officials, as well as those familiar with the agency's inner workings, and a review of dozens of internal FDA emails, text messages, and calendar entries, provides the most detailed look yet at an agency on the brink of surrender to Trump's political priorities.
It is hard to say exactly when the rookie FDA commissioner lost his footing. But on March 18, the day before the press conference, he joined an Oval Office meeting with Trump, his son-in-law and special adviser, Jared Kushner, and a number of other top White House and health officials. As they discussed how to quickly greenlight hydroxychloroquine as a COVID-19 treatment, Secretary of Health and Human Services Alex Azar, to whom Hahn reported, arrived late, breathless and sweaty, according to five people familiar with the meeting. "I can get this done, Mr. President," Azar offered, proposing that he could short-circuit FDA review and unilaterally approve the drugs. "I was shocked," one participant recounted.
But in the meeting Hahn remained mute. It fell to former FDA commissioner Dr. Scott Gottlieb, and Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, joining the meeting by phone, to defend the FDA's authority and argue that approving a drug without the agency's review would erode public confidence. As the group debated, Trump held a finger to his own lips, directing Azar to be silent, a signal that he was prepared to subjugate his health officials to his will. (A senior administration official said that Azar had not been invited to the meeting and learned of it from a White House ally, which was why he was late, but wanted to apprise the president of his options. Fauci did not respond to a request for comment. Gottlieb declined to comment.)
At the next day's press conference, Trump made his desired plan clear. He announced that hydroxychloroquine would be "given out to large groups of people, perhaps in New York and other places," even while it was still being studied. In less than two weeks, the FDA issued an emergency use authorization, approving hydroxychloroquine to treat COVID-19 patients in certain limited circumstances.
With that partial greenlight, the Trump administration had wedged open a side door to the agency. Though Hahn likely did not realize it then, the White House was about to bulldoze in the agency's back door and crash through the windows too. Just hours after Hahn's Oval Office meeting, a special White House email address, intended to route VIP COVID-19 proposals and pitches to the FDA and other agencies, was being launched. The email address, set up by the White House chief of staff's office, and approved by White House lawyers, would get its first beta test on March 18 at 3:22 p.m., when Deputy National Security Adviser Matthew Pottinger wrote to it: "Team, A first test case from me for our new 'concierge service' on these offers and requests. Please let me know how it flows through our flow chart. Best, Matt." (Pottinger later told Vanity Fair that the email and flowchart were intended to "remove the effect of VIPs getting special treatment," and to direct the plugs for COVID products bombarding the White House to experts who could appropriately vet them, without their being either fast-tracked or ignored. "'Traffic cop' would've been a more accurate description of the system than 'concierge,'" he said.)
Whatever the intent, that portal would come to give high-level hawkers of dubious COVID-19 nostrums and tests a direct line to the agency in the coming months, and unleash "a tsunami of randoms" onto the FDA's career staff, according to one senior official with the Department of Health and Human Services familiar with the FDA's efforts. There was President Trump's ex-wife Marla Maples pushing an eight-minute antibody test on behalf of a North Carolina doctor. Jill Kelley, the infamous Tampa socialite best known for a bit part in the sex scandal that felled CIA director General David Petraeus, sought to advance a COVID-19 saliva test. People identifying themselves as friends of current House Republican leader Kevin McCarthy and former Republican Speaker of the House Paul Ryan proposed pet projects. A ventilator company with ties to Ivanka Trump was "willing and WANTS to help produce ventilators for adults ASAP but needs FDA-expedited assistance," according to an email from a White House special assistant. (Through her talent agent, Maples declined to comment. Kelley did not comment on the record. The White House did not comment on Ivanka's possible intercession for a ventilator company.)
In some instances the products with VIP entrée leapfrogged the FDA's jam-packed queue. The geyser of requests, often followed by phone calls directly to career staff, also drained scarce time and attention from more critical reviews. Dr. Peter Lurie, president of the Center for Science in the Public Interest and a former associate FDA commissioner, called the White House's funneling of VIP requests an "outrage" that allowed influencers "people with potentially limited scientific knowledge to distort the priorities of the [FDA's] overworked line staff." He added, "That means some potentially more deserving product is pushed back in the queue because you're forced to deal with the latest whim of someone who has the president's ear."
By early fall the FDA's credibility was in tatters; Hahn had found himself in the White House's crosshairs; and public confidence in the ultimate therapeutic, a COVID-19 vaccine, had cratered. "There is a way to manage that White House," said a former HHS official. "Once Hahn crossed the line and started to be their deliveryman and open the door to their every whim, all bets were off."
In several wide-ranging interviews conducted last week as the Trump administration was coming to its disastrous conclusion, Hahn described his time at the agency as war. There was ceaseless work and a "ton of incoming," including the president's Twitter feed, which only served to make an exhausted staff more anxious. As the FDA sought to preserve public confidence by following a well-honed review system, the administration "equated process with bureaucracy." He also found himself frequently navigating a minefield of politically motivated lies.
"I came from a world of hospital medicine [with] good communication," he said. "It is very unusual in hospital medicine that someone lies, because people die." He added, "What we decided to do as a team was try to ignore the externalities and do the right thing based on science and data."
In many countries people have little guarantee that their medicine is safe and effective. As both China and India plan mass COVID-19 vaccinations, their respective drug regulators have released scant reliable data—or none at all—from Phase III clinical trials. By contrast the FDA required drug companies to monitor clinical trial patients for two months beyond their last injection of COVID vaccine, and its advisory committee has made critical data public.
But even in the best of times, the FDA's status as the world's top drug regulator, vigilant in protecting Americans against snake oil, is buffeted by behind-the-scenes lobbying of well-connected pharmaceutical companies, the demands of Congress for certain approvals, and the chronic underfunding of the short-staffed agency.
In 1960 an astute FDA reviewer named Frances Oldham Kelsey famously refused to approve a sleeping pill being widely used in Europe to treat morning sickness in pregnant women, despite pressure from the drugmaker Richardson-Merrell. That decision largely spared American women from the tragedy of thalidomide, a drug later linked to devastating birth defects, with over 10,000 children worldwide born with flippers in lieu of limbs. That triumph of regulation has been matched by terrible lapses, such as the FDA's move in 2001 to permit opioid makers to market their drugs as safe for long-term use in treating moderate pain, a decision that helped to fuel the opioid epidemic.
Donald Trump listens as Alex Azar speaks to members of the media before boarding Marine One on the South Lawn on May 14, 2020. By Andrew Harrer/Bloomberg/Getty Images.
Facing a once-in-a-century pandemic, a well-run FDA could have guided the private sector early on in developing lifesaving products, made fast but careful approval decisions, and retained its political independence—not linking arms with the president in touting specific products—to preserve a critical firewall between the regulator and the regulated. "The FDA commissioner should be like the head of the CIA," said the senior HHS official. "You stay in the shadows."
But interviews with various insiders and those familiar with the FDA's pandemic response reveal an agency stumbling through the pandemic, buffeted by mercurial demands from the White House, political sabotage from its parent agency, Health and Human Services, and an inexperienced commissioner unsure of whom to trust, and so eager to be liked that it amounted to a "Shakespearean flaw," according to the senior HHS official. The result was a "catastrophic failure of leadership…that has manifested in unforced error after unforced error," that official said. The FDA's actions likely slowed industry testing, sowed public distrust, led to the seesaw approval and revocation of an ineffective remedy, and might have even delayed the approval of a vaccine, in an effort to compensate for the perception that it had been co-opted by Trump.
Morale plunged inside the agency as political appointees filtered in and bullied career staff. On a conference call one of those new arrivals threatened colleagues, "Either you get on Trump time or you get out." Meanwhile, lower-level reviewers were crushed by work. Two staffers have committed suicide in recent months. Dr. Michael Waters, a lead reviewer of COVID-19 diagnostic tests in the FDA's Office of In Vitro Diagnostics and Radiological Health, took his own life in September. His widow, Hang Waters, told Vanity Fair that he was working around the clock and had gone five nights without sleep. She said he told his children that "he had to work harder to save a lot of people, and if you don't work hard, then many people will die."
In a statement an FDA spokesperson said, "From day one of the COVID-19 pandemic, the FDA's flexibility, outreach, and thorough but rapid reviews significantly contributed to a year of unparalleled scientific achievement. The agency's around-the-clock work to ensure the development and availability of COVID-19 tests, treatments, and vaccines has consistently been guided by the best available scientific data and made by career experts with the urgency of the public health emergency in mind."
Hahn said, "I would never sacrifice public health in order to be liked."
On December 17, 2019, not long after the first cases of COVID-19 were detected in Wuhan, China, Hahn took up his post at the FDA's White Oak campus in Silver Spring, Maryland, to lead the $5.9 billion agency and its 17,000-plus employees. His lack of experience in the nation's capital would soon earn him a derisive nickname among some of the agency's political appointees: Mr. Smith Goes to Washington.
While navigating the West Wing on one front, Mr. Smith would soon be battling hostilities on another. Azar, the secretary of health and human services and Hahn's boss, was laser-focused on winning Trump's support and not being overshadowed. One senior HHS official described Azar as possessing a "triple black belt" in bureaucratic infighting. Inside the administration some officials had also given Azar his own nickname: Purple Rage, a nod to the violet hue he seemed to turn when he was pissed off.
Looming in the background for both Hahn and Azar was President Trump's first FDA commissioner, Scott Gottlieb, a savvy political operator with almost half a million Twitter followers, so ready for a TV camera that he would sometimes arrive at the agency's headquarters wearing translucent powder. (Gottlieb declined to comment on that characterization.)
Eager to put a stop to any similar showboating, Azar attempted to keep Hahn on a very short leash, said one former White House official, restricting his tweets and communications, and even blocking him from reaching out to the White House directly. (An HHS spokesperson called this "unequivocally false.")
Azar had another way to tether Hahn, according to agency insiders: insisting that Hahn retain as chief of staff Keagan Lenihan, a former McKesson lobbyist who had helped Azar in his own Senate nomination and had served as his counselor at HHS. Though Lenihan had extensive Capitol Hill experience, she had no significant public health or science background, unlike the FDA's previous chiefs of staff. "She ended up being a spy," said one senior HHS official. "At the end of the day, she was working for Azar." (Lenihan declined to comment.)
As Hahn spent his first month getting basic briefings on how the FDA worked—a kind of color-by-numbers guide to the agency—SARS-CoV-2 was spreading silently and mercilessly. By January 29, Azar had been tapped by the White House to lead the administration's coronavirus task force. He delegated day-to-day authority to his chief of staff, Brian Harrison, a former Labradoodle breeder from Dallas. Hahn was excluded from the initial task force, an absence that bewildered the public health community, since his agency was the front line for approving any COVID-19 treatment. (An HHS spokesperson said, "The White House determined who was on the task force, not Secretary Azar nor Brian Harrison.")
By February 5, Hahn had formed an executive committee within the FDA to respond to the growing pandemic. But inside the White House, concern was mounting that Hahn had not yet alerted the private sector—including drug, diagnostic test, and mask makers—to the critical need for its submissions. As Hahn and his team scrambled to compile a list of key CEOs for him to contact, Azar, learning of the effort, moved to stop him, Vanity Fair has learned, despite the evident need for an all-hands-on-deck response.
On February 10, Hahn's chief of staff, Lenihan, relayed this news in an email to FDA senior officials, writing, "HHS is not going to let us be proactive on the comms for CEO touches, only reactive. With that in mind, is it worth reconsidering the effort going in to this?" Remarkably, Hahn accepted the edict to essentially lead from behind.
That same day a dangerous slowdown became a full-blown catastrophe. The FDA learned that 10 laboratories that had attempted to use the first diagnostic testing kit for COVID-19 designed by the Centers for Disease Control and Prevention were reporting failures. The CDC, so certain that it could design a world-class diagnostic test, chose not to use a more basic and effective one already created by the World Health Organization. Meanwhile, laboratory contamination had marred its own test.
In short, Azar had put the brakes on a critical process—the FDA notifying private partners of the need to roll out tests—even as a second agency under his control was bungling its own testing rollout, said the senior HHS official, adding, "Hahn was a "deer in headlights." According to the FDA's public calendar, Hahn did not formally speak with an industry trade group about diagnostic testing until March 17, five weeks later. (An HHS spokesperson said, "There is not a shred of truth to this," adding that Azar "immediately prioritized the development of diagnostics, therapeutics, and vaccines.")
As the evident absence of tests cascaded into a full-blown crisis, the White House ran through possible spin with FDA officials. It came up with a potential one on March 6, when a communications official with the Office of Management and Budget, within the White House, sent talking points to an FDA lawyer, asking, "Is Obama to blame for testing kit delays?" The answer they arrived at was: "partially."
Meanwhile, the administration was vetting Hahn's predecessor Gottlieb to come on as a senior adviser to the White House, to serve as a possible coordinator of the coronavirus task force. (Dr. Deborah Birx ultimately took that role.) Within the FDA's leadership there was palpable fear that his stint as commissioner would end almost before it began. "Scott would be empowered to run the FDA, sitting at 1600 Pennsylvania Avenue," said a senior HHS official.
As confidence in Hahn cratered, Joe Grogan, then Trump's domestic policy adviser, instituted a daily 7:30 a.m. phone call with the FDA director, seven days a week, to spoon-feed him directives and move the FDA onto a war footing. (Hahn said he found the calls "very helpful.... They wanted to make sure we were on track, given that I was new to government.") Inside the agency, as errors accumulated, political pressure intensified, and Hahn failed to shield career staff from crackpot VIP demands, the agency's senior leadership splintered into warring fiefdoms. The vibe, as one senior HHS official put it, was Mogadishu 1993.
On March 17, two days before Trump first announced hydroxychloroquine from the White House, a strange request landed in the inboxes of senior health officials at three agencies. Sent by FDA attorney Stacy Amin, the subject line read: "WH request on Rx Drugs." The email contained no small ask: that the federal government should try to supersede state laws regulating how prescription drugs are delivered. "They want us to issue an order telling states not to require signature upon delivery of prescription drugs and to use that order to preempt conflicting state law," Amin wrote.
Even stranger was the source of the appeal: "The request is coming from Ivanka," Amin wrote. The email went on to say that several officials were "still socializing it in the WH but asked us to start working on it."
The request, said a White House official, was not related to the delivery of hydroxychloroquine, but rather to COVID-19 safety: "During a time when most were afraid to leave their homes or couldn't risk driving to pharmacies to pick up their essential drugs, Ivanka suggested the concept of contactless deliveries for needed prescriptions." Though the idea did not get traction, it's clear that intervening at the FDA in the midst of a pandemic had become an all-first-family affair.
The same day that Ivanka's request hit health officials' email boxes, the president had spoken with Safra Catz, the CEO of the computer software company Oracle, according to a person familiar with the discussions. She and Oracle's billionaire cofounder Larry Ellison were deep in discussion with the West Wing about designing a database that could accompany the malaria drug's launch. As proposed, it would have allowed doctors seeing COVID patients to automatically prescribe the drug, by choosing it from an order set available to the physicians, and the federal government would cover the costs, Vanity Fair has learned. (An Oracle spokesperson said that in the early days of the pandemic, the database it had donated "served to provide medical communities a secure way to collect, store, and manage data on the virus spread and patient symptoms and responses to treatments.")
As word of the hydroxychloroquine-promoting database spread among federal health officials, the plan sparked alarm. U.S. law prohibits drugmakers from marketing their products beyond approved uses. (Doctors can use their discretion to prescribe drugs to their patients for so-called off-label use) On March 21, Dr. Janet Woodcock, the longtime leader of the FDA's Center for Drug Evaluation and Research, warned her colleagues by email: "We must be really carefully [sic] not to be seen as endorsing an off-label use. We prosecute companies for this."
Inside the agency a debate was raging as to how, or even whether, to approve hydroxychloroquine as a COVID-19 treatment, given the sparse data and the drug's known risks of sparking irregular heart rhythms, one senior agency official recalled. But the pressure for approval was intense. "The president was killing people over this," said the official. "His minions believed that we were withholding something precious."
On March 27, the FDA issued an emergency use authorization for hydroxychloroquine as a COVID-19 treatment, but with an important restriction: It could only be used in hospitalized patients or in a controlled clinical trial. Nonetheless, Trump's top health officials, including Hahn, got behind a plan for much broader use: to "flood Ny and NJ with treatment courses," according to an email sent by Brett Giroir, assistant secretary for health in the Department of Health and Human Services. The emails indicate that Hahn had also greenlighted mass distribution of hydroxychloroquine to drugstores. (In a statement Giroir said, "Health care providers may prescribe a drug for an off-label use when they judge that it is medically appropriate for their patient, and [that is] why I supported these drugs going to out-patient pharmacies.")
The following day, as Vanity Fair previously reported, Hahn even reached out directly to an obscure family physician, Dr. Vladimir Zelenko, in Monroe, New York, who'd become a West Wing darling for his claims that he'd had great success treating his COVID patients with the malaria drug. Hahn asked the doctor via text how he, the commissioner, could be of help.
(Hahn said that the White House had asked him to reach out to Zelenko.)
Even as data rolled in from clinical trials around the world, showing that the malaria drug worsened outcomes for COVID patients and increased their risk of cardiac events, hydroxychloroquine remained an article of faith in the West Wing, championed not just by the president but by his combative trade adviser Peter Navarro, whose office authored a 24-page treatise titled (all caps theirs) "HYDROXYCHLOROQUINE VERSUS THE CHINA VIRUS AND THE HIGH COSTS OF HYDROXY HYSTERIA."
On June 15, the FDA followed the emerging data and revoked its emergency use authorization for hydroxychloroquine. Furious, Navarro emailed Hahn: "The latest proposed action is OUTRAGEOUS." At a subsequent White House task force meeting, Navarro was so threatening to Hahn, accusing his agency of being "fucking Deep State," that the vice president's chief of staff, Marc Short, stepped in to protect Hahn and separate the men, according to someone familiar with the exchange. Neither Short nor Navarro responded to messages seeking comment.
Meanwhile, the flood of proposed cure-alls kept coming, in part because of Trump's own drive to market a miracle. "The president is prone to magical thinking about science and therapeutics and wants to believe in the cure," said a former HHS official. "It's not that hard to sell him a story about a technological innovation."
One such story involved a product called oleandrin, which was the extract of a poisonous shrub. On March 21, six skeptical FDA officials exchanged emails about a company, Phoenix Biotechnology, that was lobbying to have oleandrin approved as a COVID-19 treatment. Mike Lindell, a former crack cocaine addict turned direct-to-consumer pillow mogul and devoted Trump donor, was on the company's board. (In the weeks following the January 6 Capitol riot, Lindell was photographed entering the West Wing with a document that seemed to propose that the president institute martial law.) "I think the only reason this is being passed around is because at some point it was forwarded by Congressman (chief of staff now?) Mark Meadows," the FDA's deputy director in the division of antivirals wrote to colleagues. "Also forwarded through Debbie Birx's assistant. So apparently there is some connections at that level. But in my opinion, this sounds really sketchy. I doubt there is scientific merit."
The next day one of those officials forwarded the request to a new group inside the FDA, writing, "I am reluctant to bother you with this, but the company (which claims to have a drug that was used to successfully treat a child in Mexico) has made a number of political contacts and suggests that the President of Mexico may contact our President about the drug."
Four months later in July, as the oleandrin pitch bumped through the FDA's review, the voluble director of Phoenix Biotechnology, Andrew Whitney, was ushered into the Oval Office by the secretary of housing and urban development, Dr. Ben Carson, accompanied by Lindell. They were there to discuss promising results from laboratory tests at the University of Texas. Whitney said, "It is President Trump's job to find a solution to the problems the country is beset by…. It's their job to leave no stone unturned. Secretary Carson did that. He looked at the data; he spoke to the professionals. That's how we wound up in front of the president."
Shortly after that Oval Office meeting, the FDA sent an inspector to a Houston, Texas, company called HealthQuilt, whose president, Dr. Kimberly Dunn, had used oleander extract supplied by Phoenix Biotechnology on 81 patients. There, the inspector made an alarming discovery. The patients—drawn from a nursing home and a meatpacking plant where the doctor saw patients—had not properly consented to the treatment under FDA regulations. Nor had HealthQuilt obtained permission for the study from the FDA. The lapses, captured in an FDA inspection record called a 483, raised the specter of human-subject violations, said one FDA official familiar with the case. (Dunn defended her study, telling Vanity Fair that she had every "T crossed and I dotted. From a medical standpoint we went beyond the standard of care." In a statement to Vanity Fair, Phoenix Biotechnology's president and acting CEO, Lou Kost Jr., said that the company had not been aware of the details of the FDA's findings at HealthQuilt.)
Compared to strict FDA standards, this was Trump-style science, from a president who'd even floated the idea of ingesting household disinfectant to fight COVID-19. "There's a process for everything to be evaluated fairly," said one former FDA official. "People around Hahn had to spend time responding to a lot of crazy ideas that were not going through a very robust process of evaluation." (An FDA spokesperson said the agency has "strongly advised against using any product containing oleandrin…and warned [Phoenix Biotechnology] to cease the sale of this unapproved new drug claiming to mitigate, prevent, treat, diagnose, or cure serious and/or life-threatening conditions such as COVID-19.")
On the morning of July 28, John "Wolf" Wagner, the FDA's associate commissioner of external affairs, stumbled out of the agency's suite at HHS headquarters, weaved down the hallway, and collapsed in cardiac arrest. Dr. Anand Shah, the FDA deputy commissioner for medical and scientific affairs and a radiation oncologist, came to his aid before an ambulance arrived, according to several people familiar with the event. (Shah declined to comment.) Wagner's collapse in late July seemed a fitting portent of what was about to befall the agency. Within weeks the FDA would undergo its worst public relations crisis in a generation.
Wagner had arrived at the agency a month earlier to run communications as part of an escalating White House effort to control COVID-19 messaging in the nation's public health agencies. He had little background in science or public health. Nor did the man to whom he now reported, Michael R. Caputo, who in April became assistant secretary of public affairs in the Department of Health and Human Services. The two men had previously worked together on Trump's 2016 campaign, Wagner said. (Caputo took a leave from his post in November, after claiming in an unhinged Facebook rant that left-wing scientist hit squads were in training to assassinate him.)
On August 17, roughly two weeks after Wagner's heart attack, Emily Miller, also installed by the White House, would arrive at the FDA to run the Office of Media Affairs. She had previously worked as a correspondent at a far-right news network, One America News. And she had authored a book, Emily Gets Her Gun: But Obama Wants to Take Yours. On starting the job, one official recounted, Wagner told Miller, "I'll take care of the Deep State, and you focus on fighting the media." (Wagner denied making this statement.)
The far-right duo of Wagner and Miller was a poor fit for a science-based agency already struggling to communicate during a deadly pandemic. "Wolf had no understanding of simple health care issues," said one HHS official. Miller was "flippant, disorganized" that official said, and interacted with colleagues on a "high school level."
On Sunday, August 23, Hahn joined President Trump and Azar in a White House press conference to announce an emergency use authorization for convalescent plasma to treat COVID-19. After Trump touted the "historic breakthrough," first Azar and then Hahn stated that the treatment, which infused a portion of blood from previously infected patients, had been shown to reduce mortality by 35%. Hahn then doubled down on that: "What that means is—and if the data continue to pan out—100 people who are sick with COVID-19, 35 would have been saved because of the administration of plasma."
The remarks, wildly incorrect, stunned even some FDA officials. He had made a hash of the available data, which researchers at the Mayo Clinic in Rochester, Minnesota, had picked out retrospectively, without a randomized clinical trial. He had confused a relative reduction in death with an absolute increase in survival, making the plasma treatment sound like nothing short of a miracle. The agency had done extensive work to clamp down on fraudulent COVID-19 treatment claims throughout the pandemic. And there was its own commissioner appearing to spew some. "I had to leave the room," said one staffer who had been watching the televised press conference from home.
Outrage in the medical community was almost instantaneous. Hahn's statements were "statistical malpractice," said Dr. Eric Topol, a prominent cardiologist who directs the Scripps Research Translational Institute in La Jolla, California. "You can't make assertions about survival to the public based on retrospective data dredging." Topol and others called for Hahn to retract the statement or resign. It was "do or die" for Hahn, said a senior HHS official. "This was a nationally embarrassing moment."
In full damage control mode, Hahn publicly apologized for his misstatements the next day, drawing the fury of the White House. "They were very upset and angry with me," Hahn confirmed. "Apologizing is seen in some quarters as weakness. In medicine it's seen as a strength. In my opinion that's what leaders do."
The press circled: Where had the 35% number originated, and was this more Trumpian snake oil, to which Hahn had loaned the agency's credibility? Within a week Hahn had relieved Wagner and Miller of their responsibilities, making it appear that Hahn was reclaiming his agency from West Wing infiltration. But that was only partly true. Miller and Wagner, though evidently unqualified, were nonetheless scapegoated, according to several people familiar with the events. "He threw Miller under the bus," one senior HHS official told Vanity Fair. Hahn said of the staff shake-up, "Once we discovered that it wasn't the right fit, my obligation was to make those changes." But he added that he continues to view Miller as "really good at what she does."
In fact the 35% number had been supplied to Hahn by Dr. Peter Marks, the agency's director of the Center for Biologics Evaluation and Research, who was also overseeing the approval of a COVID-19 vaccine, according to records reviewed by Vanity Fair.
The issue of approving convalescent plasma had already sparked so much conflict between the FDA and the National Institutes of Health, whose director, Dr. Francis Collins, felt the data was inadequate, that a Mayo clinic researcher described it as a "range war" in an email to Marks. Jared Kushner's allies, including his former college roommate Adam Boehler, who had been assisting with the pandemic response, had been railing for the FDA to announce the approval, which could then be timed with the upcoming Republican National Convention on August 24.
Into this cauldron walked Emily Miller. She arrived at the FDA on August 17 to find her boss, Wagner, still recovering from his heart attack. Three days later she still had no laptop or office phone, internal records indicate. On the morning of August 22, the president was publicly blasting the FDA. "The deep state, or whoever, over at the FDA is making it very difficult for drug companies to get people in order to test the vaccines and therapeutics," the president tweeted. "Obviously, they are hoping to delay the answer until after November 3rd."
That afternoon, from his Colorado vacation home, Hahn called the president to say the approval was in the works. "'He said he's proud of me,'" Hahn reported back to one FDA official, who observed that Hahn seemed "desperate for the president's approval."
With a White House press conference being planned for the following day, Marks sent Hahn several emails that evening that mentioned a 35% improvement in survival and enthusiastically endorsed the authorization. But Marks did not spell out that the 35% number was a relative and comparative number, in a subset of a subset of patients, and not an absolute improvement. Nor did Hahn ask.
On Sunday, Hahn landed at Dulles Airport several hours before the press conference, without a suit in hand or clear talking points. On a preparatory conference call of close to a dozen FDA officials, while he was still at the airport, Hahn asked Marks, according to a participant, "Peter, did you just say one third more people are not dying?" Marks responded, "Yeah, one third."
Marks referred questions to the FDA press office, which stated, "We decline to comment on internal deliberative discussions."
The disaster that ensued at the White House press conference was bad enough. But the announcement was widely viewed as the prelude to a far more consequential one: the upcoming COVID-19 vaccine. Would the FDA capitulate to President Trump and approve a vaccine before the presidential election, possibly before it was proven safe?
Fighting for his reputation, Hahn reached out to one of his most ardent critics. Just after 6 a.m. on September 3, he cold-called Eric Topol, described the pressure he was under, and admitted that he was facing an "existential crisis." (Hahn denied using those words.)
Some four months earlier, on April 29, Marks had headed to the White House to pitch his idea for what would become, arguably, the Trump administration's only pandemic success: the breakneck development of a COVID-19 vaccine. Though Trump shunted responsibility for diagnostic testing and shortages of protective equipment to the states, with dire consequences, he embraced the moonshot vaccine effort. As drug companies raced through clinical trials, delivering that win would all come down to the FDA's say-so.
Marks, a brilliant though prickly hematologist-oncologist, had envisioned a sweeping partnership between the federal government and private drug companies to develop a number of vaccine candidates simultaneously. A longtime Star Trek fan, he had dubbed the concept Operation Warp Speed. Inside the White House that early spring day, as the administration's top health officials, including Hahn, crowded into a secure room, Marks sat against the wall until someone gave him their chair. As he briefed the group, Deborah Birx aggressively questioned him, not seeming to understand that he was an FDA official outlining an idea, rather than an operational director unprepared to implement a plan.
As Hahn remained silent, Seema Verma, administrator of the Centers for Medicare & Medicaid Services, came to Marks's defense, saying, "Deb, you're out of line. Leave him alone." Hahn, who still did not join her in defending Marks, leaned over to Verma and said approvingly, "You're a really good egg."
Even Azar chimed in, asking Hahn, "Aren't you going to stick up for your guy?" (Birx did not respond to a request for comment.)
Though Marks emerged shaken from the meeting, his idea was a go. Operation Warp Speed soon got underway, a vast—and secretive—$15 billion program run jointly by the departments of Defense and Health and Human Services, with a management structure that seemed intended to deliver political, and not just pharmaceutical, wins. Jared Kushner and his pandemic wingman Adam Boehler were among the five members of a coordinating committee that oversaw the sprawling effort.
Even with Trump intent on a pre-election vaccine approval, Hahn continued his trips to the White House, as dazzled as a "kid in the candy store," said a senior HHS official.
At the time the FDA was weighing a plan to preliminarily authorize a COVID vaccine for high-risk groups, such as nursing home residents, before the completion of Phase III clinical trials, Vanity Fair has learned. Using a staged approach, the FDA could have balanced risk against benefit: a less-than-thoroughly vetted vaccine, but one more likely than not to protect the most vulnerable Americans. Then, as more data came in, the FDA could have expanded its authorization to include younger, healthier Americans. But the plan had a paradoxical liability: It might meet Trump's desired timeline, thereby spooking a public already skeptical about the FDA's independence. (Though an FDA spokesperson denied that a "staged" approach was ever considered, the agency had initially conveyed to drug companies that it could consider authorization based on interim data, a source familiar with the discussions said.)
As it happened, the convalescent plasma disaster derailed any such plan. On August 31, in an open letter to Hahn in the journal Medscape, where he served as editor in chief, Topol called Hahn "subservient to President Trump's whims" and wrote, "Tell us…that you will not, under any condition, authorize a SARS-CoV-2 vaccine approval before the full Phase 3 completion and read-out of a program. Otherwise, you need to resign."
Meanwhile, the crisis was widening inside the FDA. On September 10, the agency's eight top career officials, who directed its scientific centers, published an op-ed in USA Today, attempting to reclaim their independence and reaffirm that science guided their decisions. "If the agency's credibility is lost because of real or perceived interference," they wrote, "people will not rely on the agency's safety warnings."
Though Hahn said the officials gave him a heads-up and had his blessing, the piece was a "fuck-you" to the commissioner, said a source familiar with its publication. The FDA was officially at war with itself.
Hahn was forced to take a side. He ultimately joined with the agency's career officials in their call to fully vet a vaccine, regardless of the political fallout. On September 21, the FDA sent the White House's Office of Management and Budget new vaccine guidance, calling for drug developers to monitor patients enrolled in their clinical trials for roughly two months after their last shot. It would push any vaccine approval beyond the November election.
Inside the White House, Azar worked to have Hahn fired, repeatedly bringing his case to Trump and Meadows, according to several officials aware of Azar's campaign. An HHS spokesperson said, "We do not comment on personnel matters in the press." As Hahn told Vanity Fair, "I certainly don't think I'm well liked now."
Hahn moved his staff out of HHS headquarters and returned to the FDA's White Oak campus. "'We're leaving HHS. They're all evil,'" an official recounted him saying. As the Office of Management and Budget sat on the FDA's new guidance, refusing to approve it, the FDA defied the White House. On October 22, it released the guidance, inside a briefing document for an upcoming public vaccine-advisory committee meeting.
Though Hahn had been "subjugated to Trump," said someone in frequent contact with the commissioner, "he became block and tackle for this to be done right." Within hours the White House folded and approved the FDA's new guidance, but not before Trump took a shot at his newly disobedient FDA commissioner. "New FDA Rules make it more difficult for them to speed up vaccines for approval before Election Day," he tweeted that day. "Just another political hit job! @SteveFDA."
On December 8, the White House staged a vaccine summit, to give the president a much-needed victory lap after he'd lost the election and Britain's drug regulator had beaten the FDA in approving Pfizer's COVID-19 vaccine. Hahn was invited and expected to come. But he sidestepped the invitation, sending Keagan Lenihan, his chief of staff, instead. The summit's organizers were livid at Hahn's absence, one HHS official said. But it appeared that the commissioner had finally learned his lesson: He could either stand next to Trump or stand with his agency.
Additional reporting by Amy Martyn and Stan Friedman
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Katherine Eban
Katherine Eban is a contributing editor at Vanity Fair, covering medical and scientific mayhem. An award-winning investigative journalist, she is the best-selling author of Bottle of Lies: The Inside Story of the Generic Drug Boom. You can follow her on Twitter.
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Exclusive: Inside the S--tshow That Was the Trump-Biden Transition
New revelations about how one Trump staffer helped preserve the transfer of power—from the forthcoming book on the Biden White House, The Fight of His Life.
By Chris Whipple
COVID-19 Origins: Investigating a "Complex and Grave Situation" Inside a Wuhan Lab
The Wuhan Institute of Virology, the cutting-edge biotech facility at the center of swirling suspicions about the pandemic's onset, was far more troubled than previously known, explosive documents unearthed by a Senate research team reveal. Following the trail of evidence, Vanity Fair and ProPublica provide the clearest picture yet of a laboratory institute in crisis.
"This Shouldn't Happen": Inside the Virus-Hunting Nonprofit at the Center of the Lab-Leak Controversy
Chasing scientific renown, grant dollars, and approval from Dr. Anthony Fauci, Peter Daszak transformed the environmental nonprofit EcoHealth Alliance into a government-funded sponsor of risky, cutting-edge virus research in both the U.S. and Wuhan, China. Drawing on more than 100,000 leaked documents, a V.F. investigation shows how an organization dedicated to preventing the next pandemic found itself suspected of helping start one.
Report: Trump Is Blowing a Gasket Over His Joke of a Social Media Network
Truth Social has been a complete disaster and the ex-president seems to know it.


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Free Kindle books & bargains for Wednesday, July 1, 2015
by Steve Weber on July 1, 2015
Bite & Release
Women's Fiction > Romance
Author: Cory Cyr
Ryan Chase left Fairbanks, Alaska, when she was 21 years old to pursue her dream of becoming an actress. Somewhere along the way her dreams of stardom crashed and burned, along with her life.
Thirteen years later she is forced to return to Fairbanks because her unforgiving and emotionally-distant father has suddenly died. Ryan seizes the opportunity to not only escape her abusive husband but to be able to attend her best friend's wedding. What could go wrong? It's only Fairbanks, Alaska…
While wishing she was anywhere but her father's funeral and wake, Ryan is struck senseless by a stunning, drop-dead gorgeous man. Her thoughts turn carnal and she desperately wants to know him in every way—and position—possible. There's only one problem…
The Jack Hammer
Thrillers > Espionage
Author: Derek Ciccone
It was the height of the Cold War and America was in need of a distraction. And it came in the form of Jack Myles, who burst on the scene hitting home runs with such repetitive force that he became known as the Jack Hammer.
27 years after Myles' tragic death, Anna Stepania walks into the office of PI Tim O'Connell, and makes the crazy claim that Jack Myles is her father … and that he's still alive. A search takes them from New York to Russia to Sedona, Arizona, all leading to a deadly showdown between the Jack Hammer and the family he left behind.
Truths and Roses: A Second Chance Novel – Book One
Author: Inglath Cooper
First love. Second chances. Secrets with the power to change lives.
When Will Kincaid's professional football career comes to an abrupt end in a single night, he's left to figure out what he's going to do with the rest of his life. He heads home to the small Virginia town where he grew up and crosses paths with Hannah Jacobs, the only girl in high school who had ever rejected him. It's Hannah who once made him question the choices he had made, and it's Hannah who's making him question them all over again. But with the weight of a secret he's managed to hide from the world his entire adult life hanging over him, he can't afford to question his choices.
Hannah Jacobs had once made the choice to deny her feelings for Will Kincaid, at the time finding it the only possible option for a young girl intent on burying a nightmare she only wanted to forget. The life she's made for herself as a librarian in Lake Perdue is a quiet one, and she's hardly prepared for the day when Will rams his fancy Ferrari into her dependable old clunker.
OUTLAW REVENGE (Back Down Devil MC series Book 1)
Fiction > Coming of Age
Author: London Casey, Karolyn James
Emily didn't want to go watch a bunch of bikers fight each other, and by the time the fight is over, her best friend is shot dead and Emily finds herself clutching the leather cut of a sexy guy named Gaige as she's on the back of his motorcycle, escaping gunfire.
As Vice President of Back Down Devil MC, Gaige Gaen's world is consumed by the club, the life, and finding a way to make it all work. The last thing he needs on his plate – or in his bed – is a woman like Emily. He can't stop looking at her, and he definitely can't stop touching her. He promises to avenge the death of Emily's best friend, Rachel, but then the situation takes a turn for the worse when Rachel's father – a rich man hell bent on revenge – shows up and wants answers that the MC doesn't have.
Emily is in fear of returning to a past she had escaped. She and Gaige can't seem to stop their feelings for each other, and as her dangerous past digs its way into the present, Gaige and Back Down Devil are now in the line of fire.
Ireland: For Travelers!: The Tourist Guide To Make The Most Out Of Your Trip To Ireland
Travel > Europe > Ireland
Author: Allison Keys R
Ireland might not be the place that you see on the world's leading media houses everyday but it definitely has more to offer than you have ever thought of.
If you are planning to visit Ireland, this book will give you all the information you need to ensure that you make the most from your visit to Ireland.
With "Ireland: For Travelers! The Tourist Guide To Make The Most Out Of Your Trip To Ireland – Discover Where To Go, Eat, Sleep & Party", you can be sure that each moment will be an experience that you will cherish forever.
A brief introduction on the different regions in Ireland and a sneak peek of what each region has to offer
A short description of accommodation in Ireland plus a few hotels to help you have a good stay
Top experiences you cannot afford to miss during your travel to Ireland
Evernote for Your Productivity – The Beginner's Guide to Getting Things Done
Skills > Time Management
Author: Allan Green
Ever thought of just extracting all your thoughts and storing them somewhere safe? Evernote presents a way to do just that. Now you can transfer all the things that you need to remember, store, or save for the future to one platform.
In this powerful and comprehensive guide you will find the solutions on how to make yourself more productive and pro-active!
Evernote comes to the rescue.
Are you ready to redesign your life with Evernote? Fasten Your Belts!
The Color Purple Collection: The Color Purple, The Temple of My Familiar, and Possessing the Secret of Joy
Literary Fiction > Classics
Author: Alice Walker
Three powerful novels by Alice Walker, beginning with her masterpiece The Color Purple, and following characters as they are drawn into critical confrontations with history.
The Color Purple is Walker's stunning, Pulitzer Prize–winning novel of courage in the face of oppression. Celie grows up in rural Georgia, navigating a childhood of ceaseless abuse. Not only is she poor and despised by the society around her, she's badly treated by her family.
In The Temple of My Familiar, Celie and Shug from The Color Purple follow the lives of a brilliant cast of characters, all dealing in some way with the legacy of the African experience in America. From recent African immigrants, to a woman who grew up in the mixed-race rainforest communities of South America, to Celie's own granddaughter living in modern-day San Francisco, all must come to understand the brutal stories of their ancestors to come to terms with their own troubled lives.
Possessing the Secret of Joy portrays Tashi's tribe, the Olinka, where young girls undergo circumcision as an initiation into the community. Tashi manages to avoid this fate at first, but when pressed by tribal leaders, she submits. Years later, married and living in America as Evelyn Johnson, Tashi's inner pain emerges. As she questions why such a terrifying, disfiguring sacrifice was required, she sorts through the many levels of subjugation with which she's been burdened over the years.
Don Juan (Xist Classics)
Literature & Fiction > Classics > Romance
Author: Lord Byron
Don Juan is an epic poem by Lord Byron about a womanizing Spaniard who is sent away for dishonoring his family. His adventures lead him through slave markets and royal courts until he grows into a man who can be admired.
The book is based on the legend of Don Juan, which Byron reverses, portraying Juan not as a womanizer but someone easily seduced by women. It is a variation on the epic form. Unlike the more tortured early romantic works by Byron, exemplified by Childe Harold's Pilgrimage, Don Juan has a more humorous, satirical bent. Modern critics generally consider it to be Byron's masterpiece.
The Granny Square Book
Crafts & Hobbies > Needlecrafts & Textile Crafts
Author: Margaret Hubert
Granny squares are to crochet what pieced squares are to quilting. They originated with pioneer women using up precious scraps of yarn to make blankets for their families, and over the years, many recognized, named patterns have been handed down from one generation to the next. Beyond this treasury of 75 different granny square motifs, Margaret Hubert shows the evolution of the granny square, how it can be used and interpreted in different ways with different yarns, and how today's crocheter can design her own projects using the granny squares of her choice with the yarn choices of today.
Just as Margaret learned from her grandmother and mother and then passed the skill down to her daughter and granddaughter, each generation finds new uses and artistic ways to interpret granny squares.
Roanoke: Solving the Mystery of the Lost Colony
History > United States > Colonial Period
Author: Lee Miller
November 1587. A report reaches London that Sir Walter Raleigh's expedition, which left England months before to land the first English settlers in America, has foundered. On Roanoke Island, off the coast of North Carolina, a tragedy is unfolding. Something has gone very wrong, and the colony—115 men, women, and children, among them the first English child born in the New World, Virginia Dare—is in trouble. But there will be no rescue. Before help can reach them, all will vanish with barely a trace.The Lost Colony is America's oldest unsolved mystery. In this remarkable example of historical detective work, Lee Miller goes back to the original evidence and offers a fresh solution to the enduring legend.
Thrillers > Psychological
Author: Andrew E. Kaufman
The psychologist with a troubled past…
Dr. Christopher Kellan spends his days at Loveland Psychiatric Hospital, overseeing a unit known as Alpha Twelve, home to the most deranged and psychotic killers imaginable. His newest patient, Donny Ray Smith, is accused of murdering ten young girls and making their bodies disappear. But during his first encounter with Donny, Christopher finds something else unsettling: the man looks familiar.
The killer with a secret…
Donny Ray knows things about Christopher—things he couldn't have possibly learned at Loveland. As the psychologist delves deeper into the mysterious patient's case, Christopher's life whirls out of control.
Romance > Contemporary
Author: Brenda Rothert
Palmer Sinclair was on the edge of happily ever after when she broke off her engagement to Brady Grant. The end of their relationship marked the beginning of a painful solitary journey for her. Though she makes places beautiful with her work as an interior designer, the rest of her life is anything but beautiful – it's slowly pulling her under.
Brady, a contractor, is swiftly building his business into an empire. Work is a faithful companion that never lets him down like Palmer did. When he sees women now, it's on his terms. And his terms are simple: just sex. He won't let a woman break him again.
Palmer is barely holding it together when she and Brady are unexpectedly paired on a project after a year apart. The pull between them is stronger than ever, but the fallout from their reconnection leaves them both wondering if maybe some things are better left unsaid.
Shambling Towards Hiroshima
Science Fiction > Alternative History
Author: James Morrow
It is the early summer of 1945, and war reigns in the Pacific Rim with no end in sight. Back in the States, Hollywood B-movie star Syms Thorley lives in a very different world, starring as the Frankenstein-like Corpuscula and Kha-Ton-Ra, the living mummy. But the U.S. Navy has a new role waiting for Thorley, the role of a lifetime that he could never have imagined.
The top secret Knickerbocker Project is putting the finishing touches on the ultimate biological weapon: a breed of gigantic, fire-breathing, mutant iguanas engineered to stomp and burn cities on the Japanese mainland. The Navy calls upon Thorley to don a rubber suit and become the merciless Gorgantis and to star in a live drama that simulates the destruction of a miniature Japanese metropolis. If the demonstration succeeds, the Japanese will surrender, and many thousands of lives will be spared; if it fails, the horrible mutant lizards will be unleashed.
An Illustrated Book of Bad Arguments
Philosophy > Logic & Language
Author: Ali Almossawi, Alejandro Giraldo
Have you read (or stumbled into) one too many irrational online debates? Ali Almossawi certainly had, so he wrote An Illustrated Book of Bad Arguments! This handy guide is here to bring the internet age a much-needed dose of old-school logic (really old-school, a la Aristotle).
Here are cogent explanations of the straw man fallacy, the slippery slope argument, the ad hominemattack, and other common attempts at reasoning that actually fall short—plus a beautifully drawn menagerie of animals who (adorably) commit every logical faux pas. Rabbit thinks a strange light in the sky must be a UFO because no one can prove otherwise (the appeal to ignorance). And Lion doesn't believe that gas emissions harm the planet because, if that were true, he wouldn't like the result (theargument from consequences).
Once you learn to recognize these abuses of reason, they start to crop up everywhere from congressional debate to YouTube comments—which makes this geek-chic book a must for anyone in the habit of holding opinions.
Merriam-Webster's School Dictionary
Reference > Dictionaries
Author: Merriam-Webster
A dictionary written especially for students grades 9–11, ages 14 and up. Fully updated with more than 100,000 definitions. More than 28,000 usage examples. Nearly 1,000 illustrations.
More than 500 synonym paragraphs and 200 word history paragraphs clarify meaning.
Author: Nora Roberts
For more than three hundred years, Bluff House has sat above Whiskey Beach, guarding its shore—and its secrets. But to Eli Landon, it's home.
A Boston lawyer, Eli has weathered an intense year of public scrutiny and police investigations after being accused of—but never arrested for—the murder of his soon-to-be ex-wife.
He finds sanctuary at Bluff House, even though his beloved grandmother is in Boston recuperating from a nasty fall. Abra Walsh is always there, though. Whiskey Beach's resident housekeeper, yoga instructor, jewelry maker and massage therapist, Abra is a woman of many talents—including helping Eli take control of his life and clear his name. But as they become entangled in each other, they find themselves caught in a net that stretches back for centuries—one that has ensnared a man intent on reaping the rewards of destroying Eli Landon once and for all.
Agenda 21 (Agenda 21 Series)
Fiction > Political
Author: Glenn Beck, Harriet Parke
Just a generation ago, this place was called America. Now, after the worldwide implementation of a UN-led program called Agenda 21, it's simply known as "the Republic." There is no president. No Congress. No Supreme Court. No freedom.
There are only the Authorities.
Citizens have two primary goals in the new Republic: to create clean energy and to create new human life. Those who cannot do either are of no use to society. This bleak and barren existence is all that eighteen-year-old Emmeline has ever known. She dutifully walks her energy board daily and accepts all male pairings assigned to her by the Authorities. Like most citizens, she keeps her head down and her eyes closed.
Until the day they come for her mother.
All New Square Foot Gardening, Second Edition: The Revolutionary Way to Grow More In Less Space
Gardening & Landscape Design > By Technique > Urban
Author: Mel Bartholomew
Rapidly increasing in popularity, square foot gardening is the most practical, foolproof way to grow a home garden. That explains why author and gardening innovator Mel Bartholomew has sold more than two million books describing how to become a successful DIY square foot gardener. Now, with the publication of All New Square Foot Gardening, Second Edition, the essential guide to his unique step-by-step method has become even better. Mel developed his techniques back in the early 1980s and has been teaching them throughout the world ever since. In the process, he has made improvements and refinements and continually adapted his practices to keep pace with modern times. In this new volume, Bartholomew furthers his discussion on one of the most popular gardening trends today: vertical gardening.
If I Were You (Inside Out Series Book 1)
Author: Lisa Renee Jones
One day I was a high school teacher on summer break, leading a relatively uneventful but happy life. Or so I told myself. Later, I'd question that, as I would question pretty much everything I knew about me, my relationships, and my desires. It all began when my neighbor thrust a key to a storage unit at me. She'd bought it to make extra money after watching some storage auction show. Now she was on her way to the airport to elope with a man she barely knew, and she needed me to clear out the unit before the lease expired.
Soon, I was standing inside a small room that held the intimate details of another woman's life, feeling uncomfortable, as if I was invading her privacy. Why had she let these items so neatly packed, possessions that she clearly cared about deeply, be lost at an auction? Driven to find out by some unnamed force, I began to dig, to discover this woman's life, and yes, read her journals–dark, erotic journals that I had no business reading.
Author: Abigail Strom
The last thing Jenna Landry wants is to fall in love. The former rock musician is getting ready to start a new job and a new life in LA, and she's only back in her hometown for the summer. Nothing could tempt her to stay any longer than that…not even the sexy doctor next door.
Michael Stone has a reputation for being as cold as ice. So what is it about his free-spirited neighbor that sets him on fire? The straitlaced MD has his hands full with his career and his teenage daughter, and even if he were looking for a relationship, he knows Jenna is all wrong for him.
So why does being with her feel so right?
Witches on Parole (WitchLight Trilogy: Book 1)
Fantasy > Sword & Sorcery
Author: Debora Geary
World-famous (and now retired) photographer Jenvieve Adams has a debt to repay—and a soft spot for witches who have lost their way. Or so she thinks, until they actually show up.
Join some of the cast of characters from the very successful A Modern Witch series as they take on a new kind of journey as guides for WitchLight. What happens when an obsessive psychologist and a wordsmithing delinquent get dropped into Witch Central?
Note: Witches on Parole is a spin-off trilogy, set in the world of the A Modern Witch series.
The King's Curse (Cousins War Series Book 6)
Author: Philippa Gregory
Regarded as yet another threat to the volatile King Henry VII's claim to the throne, Margaret Pole, cousin to Elizabeth of York (known as the White Princess) and daughter of George, Duke of Clarence, is married off to a steady and kind Lancaster supporter—Sir Richard Pole. For his loyalty, Sir Richard is entrusted with the governorship of Wales, but Margaret's contented daily life is changed forever with the arrival of Arthur, the young Prince of Wales, and his beautiful bride, Katherine of Aragon. Margaret soon becomes a trusted advisor and friend to the honeymooning couple, hiding her own royal connections in service to the Tudors.
After the sudden death of Prince Arthur, Katherine leaves for London a widow, and fulfills her deathbed promise to her husband by marrying his brother, Henry VIII.
Mystery > Hard-Boiled
Author: Aric Davis
Nickel is a survivor. He has to be. For as long as he can remember, his life has hinged on the flip of a coin. Or, rather, the scribble of a social worker's pen. He's been through the system, even had a good dad for a few years, until he was gone, too. But Nickel remembers everything he taught him, and since the day he escaped from foster-care hell, he's put that knowledge to good use. Just twelve years old, he makes a steady living by selling marijuana to high schoolers, blackmailing pedophiles he ferrets out online, and working as a private investigator. When a beautiful girl named Arrow hires him to find her little sister Shelby, Nickel figures at best the kid's a runaway; at worst, some perv's gotten a hold of her. He scours the internet and the streets of Arrow's suburban neighborhood, and what he finds there is as ugly a truth as he's ever seen.
Who In Hell Is Wanda Fuca? (A Leo Waterman Mystery)
Mystery > Private Investigators
Author: G.M. Ford
When an old gangster friend of Leo's father makes a request he "can't refuse," Leo and his band of drunks, delve into the world of environmental politics in search of Caroline Nobel, a spoiled brat, without the sense God gave a gopher. With the help of "the Boys" — a group of aging winos who are his modern day "Baker Street Irregulars" — Leo fights Native American tribal politics, industrial pollution, and psychotic grannies to fulfill his obligation to a friend.
Someone Else's Love Story: A Novel (P.S.)
Author: Joshilyn Jackson
Someone Else's Love Story is beloved and highly acclaimed New York Timesbestselling author Joshilyn Jackson's funny, charming, and poignant novel about science and miracles, secrets and truths, faith and forgiveness; about falling in love, and learning that things aren't always what they seem—or what we hope they will be.
Shandi Pierce is juggling finishing college, raising her delightful three-year-old genius son Nathan, aka Natty Bumppo, and keeping the peace between her eternally warring, long-divorced parents. She's got enough complications without getting caught in the middle of a stick-up and falling in love with William Ashe, who willingly steps between the robber and her son.
Shandi doesn't know that her blond god Thor has his own complications.
The Pawn (The Bowers Files Book #1)
Author: Steven James
Special Agent Patrick Bowers never met a killer he couldn't catch. Until now.
Called to North Carolina to consult on the case of an area serial killer, Bowers finds himself caught in a deadly game of cat and mouse. Cunning and lethal, the killer is always one step ahead of the law, and he's about to strike again. It will take all of Bowers's instincts and training to stop the man who calls himself the Illusionist.
Thrilling, chilling, and impossible to put down, The Pawn will hold you in its iron grip until the very last page.
Sweet Nothings (A Sugar Springs Novel)
Women's Fiction > Domestic Life
Author: Kim Law
Joanie Bigbee, cupcake baker extraordinaire, likes to keep her options open—and she's good at it. She's started and sold some 30 businesses in her postage stamp-sized Tennessee town, and at the moment she can be found in a short skirt and go-go boots, selling cupcakes out of the back of a converted Volkswagen van. What she moves on to next is anybody's guess. She knows better than to be tied down. In any way. She's watched every woman in her family fall head-over-heels, only to find themselves wondering how to pick up the pieces when love is lost.
When Nick Dalton shows up at the groovy cupcakery, all Joanie wants is a taste; a fling with no strings suits her just fine. But for Nick, a bite is not enough; he wants the whole cake: a big house, a family, true love. But love only makes you stupid, right? Joanie has to decide whether to follow where her free-spirit leads…or hold on to the sweetest thing she's ever known.
Every Witch Way But Wicked (Wicked Witches of the Midwest Book 2)
Author: Amanda M. Lee
Where there's a witch, there's a way! Where there's a whole family of them, there's trouble. Bay Winchester, editor of Hemlock Cove's small weekly newspaper, thinks her small hamlet's upcoming murder mystery weekend is going to be all about fun, food and frolicking. Instead, when another dead body is discovered in Hemlock Cove, things turn into murder, mayhem and migraines (the latter is mostly thanks to her family, of course).
The body belongs to the town drunk – and no one can figure out who would want to kill him, or why. Bay's investigation is stymied by her new boss, Brian Kelly, and her old flirtation, FBI agent Landon Michaels, both of whom seem to have more than interviews on their mind.
For Love or Legacy (Book 2)
Author: Ruth Cardello
Nicole Corisi will lose her inheritance if she doesn't find a way around the terms of her father's will, but she will have to partner up with her estranged brother's rival to do it. As pretense becomes painfully real, Nicole will have to choose between Stephan and the family he is driven to destroy.
Stephan Andrade has been planning his revenge ever since Dominic Corisi unscrupulously took over his father's company. With Corisi Enterprises gambling its reputation on the success of a new software network for China, Stephan finally has his chance to take back his legacy. Dominic's younger sister, Nicole, asks Stephan for his help and provides him with an opportunity to exact his revenge on a personal level.
It all goes smoothly until he falls in love.
… See the rest of today's Editor's Picks here on page 2Page 2

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Non Practice Areas
Independent contractors are not treated the same as employees. Independent contractors often receive no overtime pay; enjoy few, if any, protections under federal and state law against unlawful discrimination, harassment, and retaliation; and commonly are ineligible to participate in valuable company-sponsored benefit programs, such as group health insurance, stock ownership, 401(k), or other fringe benefits.
Whether a worker is an independent contractor or a traditional employee continues to be a source a great confusion for Texas employers. Often, the inquiry is fact-intensive. The Texas Labor Board (now known as the Texas Workforce Commission), Internal Revenue Service (IRS), U.S. Department of Labor (DOL), and U.S. Equal Employment Opportunity Commission (EEOC) apply varying standards to determine whether an individual is an employee or independent contractor.
Merely because an employer and a worker agree to an independent contractor relationship does not mean an independent contractor relationship is created. Rather, courts and federal and state administrative agencies look to the employer's right to control the manner and mode of the individual's work and the economic realities of the relationship.
The consequences for an employer's misclassification of an employee's status can be potentially disastrous, including penalties owed to the IRS and TWC for unpaid employment taxes, liability for back wages, and liquidated damages for unpaid overtime, and liability for medical expenses which should have been covered under an employer's group health plan.
Contact a Dallas Employment Lawyer
Dallas employment lawyer Barry Hersh dedicates a significant part of his practice to resolving Texas wage and compensation disputes, including independent contractor misclassification matters. If you would like to schedule a consultation with Barry or you believe that you have been misclassified as an independent contractor, complete the law firm's online inquiry form.
Looking for representation or advice? Submit your information here. The law firm schedules consultations and determines whether it can help you based, initially, on the information you submit online.
There's no need to call. Submitting your information online gets us your information more quickly.
Lawyer Barry Hersh
12377 Merit Dr #880
Barry S. Hersh is Certified in Labor and Employment Law by the Texas Board of Legal Specialization.
All other attorneys not board certified.
Barry S. Hersh is the attorney responsible for this website.
Principal place of business: Dallas, Texas.
We serve the following localities: Collin County including Allen, Frisco, McKinney, and Plano; Dallas County including Addison, Carrollton, Dallas, Garland, Grand Prairie, Irving, Mesquite, and Richardson; Denton County including Denton, Lewisville, and The Colony; Ellis County including Waxahachie; Kaufman County including Kaufman; Rockwall County including Rockwall; and Tarrant County including Arlington, Euless, and Fort Worth.
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Copyright © 2022, Hersh Law Firm, PC.


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NSW to beef up protections for travellers following cancellation chaos
By Carrie Fellner
For our free coronavirus pandemic coverage, learn more here.
NSW will move ahead of other states to improve protections for the millions of Australians who will embrace travel again in 2022, as pressure mounts on the federal government to pursue wider reforms to restore consumer confidence battered by the COVID-19 pandemic.
The Herald can reveal that Better Regulation Minister Kevin Anderson will introduce a new minimum information standard for terms and conditions, to help customers better understand cancellation policies before putting down a deposit.
Holiday fun on the Great Barrier Reef amid calls for stronger national consumer protections. Credit:Istock
"These changes mean that customers will be fully informed before they commit to a purchase helping them avoid an unexpected shock if they have to cancel or defer," Mr Anderson said.
"NSW will be the first jurisdiction in Australia to take this important step."
But as Australians rush to book overseas getaways with their newfound freedom, the Queensland government and consumer advocates are leading calls for wider-ranging national reforms.
The pandemic sparked cancellation chaos as Australians struggled to obtain refunds and has raised broader concerns about a gradual erosion of consumer protections for travellers.
Three former travel agents said it was routine in the industry to add significant mark-ups to bookings which were not disclosed to customers.
Less than one in five Australians received a full refund on trips cancelled because of COVID-19, and in most cases it took between three and six months to receive refunds, according to a survey by Choice magazine.
Concerns have recently been raised around a lack of transparency around agents' mark-ups, excessive cancellation fees and protections for customers when travel agencies collapse.
Choice has also called for a mandatory industry code and an industry ombudsman to handle complaints.
The travel industry has strenuously rejected suggestions such wide-ranging reform is needed.
The Australian Federation of Travel Agents (AFTA) stressed that agents had secured $8 billion in refunds and travel credits from suppliers to be passed back to Australian consumers.
Three former travel agents have told the Herald it was routine in the industry to add significant mark-ups to bookings which were not disclosed to customers.
They did not wish to be identified as they are still working with or connected to the industry.
Mark-ups are a process where an agent manually increases the cost of a flight, tour or hotel booking to increase their commission. One former agent said mark-ups were "very encouraged" by superiors.
"I didn't like doing it," she said. "I was in the minority."
The woman also had concerns about excessive cancellation fees. She was uncomfortable to see a customer charged a cancellation and rebooking fee after their trip was disrupted by a hurricane, even though the airline had waived the fees.
The woman said of a colleague: "She was profiting in people getting caught up in hurricanes".
Another industry source said agents would trade mark-up strategies and had responses ready if customers complained.
"The way I was trained, I said if you can find a better price, I'll beat it," the man said. "That circumvents the mark-up conversation."
A third agent said she was paid a salary instead of the commission-based model, which meant you "didn't have to rip someone off to benefit yourself".
"For such a great industry, it feels like it's gone backwards," she said.
She questioned why agents did not have to be licensed, given the sums of money involved in transactions.
Consumer Advocate Adam Glezer said the pandemic had exposed a series of systemic issues plaguing the industry.
Consumer advocate Adam Glezer. Credit:Eddie Jim
He argued customers should be given a guaranteed refund where travel was cancelled for reasons outside their control, and an itemised fee schedule, disclosing any mark-ups.
"We are calling for full transparency from travel agents," he said.
He said trust accounts could better protect consumers in the event a travel agent became insolvent.
"Real estate agents and lawyers need to be licensed and use trust accounts. Why don't travel agents?"
Mr Glezer said many good agents had been trying hard to help consumers during challenging times. "However there have also been a lot really letting the team down. What we are trying to do is get consistency across the board."
AFTA chief executive Dean Long said the majority of problems with refunds had been caused by the withholding of funds by the suppliers, rather than agents.
"Those customers who have gone through that process have been overwhelmingly satisfied," he said.
He said there was no proof of excessive cancellation fees charged by agents or widespread use of mark-ups, rejecting the need for trust accounts, fee schedules or a licensing scheme.
"No one has been able to demonstrate there's been any breakdown in industry practice that requires changes," he said.
"We've got an industry code and the overwhelming part of industry is part of that."
Mr Long welcomed the reforms regarding terms and conditions in NSW, saying customers needed "absolute clarity".
An ACCC spokesperson said it was aware of the call for national reforms but said it was "ultimately a question for government".
Queensland Attorney-General Shannon Fentiman said the matters were discussed at a recent joint meeting of Australia's consumer affairs ministers.
"It was agreed that this issue needs to be progressed," Ms Fentiman said.
"I have written to the Commonwealth urging them to take urgent action to provide better protections under Australian Consumer Law.″
Assistant Treasurer Michael Sukkar, who oversees consumer law in Australia, said: "If a consumer is having difficulty understanding their rights or dealing with a business, they should speak with their state or territory consumer affairs regulator or the ACCC.
"The ACCC is engaging with travel businesses in relation to their approach to travel cancellations in response to COVID-19."
Fascinating answers to perplexing questions delivered to your inbox every week. Sign up to get our new Explainer newsletter here.
Shannon Fentiman
Michael Sukkar
Carrie Fellner is an investigative reporter for The Sydney Morning Herald.Connect via Twitter or email.


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About the site | Read our blog
SciCombinator
Discover the most talked about and latest scientific content & concepts.
Concept: Tooth enamel
Sugar Industry Influence on the Scientific Agenda of the National Institute of Dental Research's 1971 National Caries Program: A Historical Analysis of Internal Documents
Published almost 5 years ago
In 1966, the National Institute of Dental Research (NIDR) began planning a targeted research program to identify interventions for widespread application to eradicate dental caries (tooth decay) within a decade. In 1971, the NIDR launched the National Caries Program (NCP). The objective of this paper is to explore the sugar industry's interaction with the NIDR to alter the research priorities of the NIDR NCP.
Concepts: Lactic acid, Teeth, Dental caries, Tooth enamel, Sucrose, Oral hygiene, Dental restoration, Dental drill
Beeswax as dental filling on a neolithic human tooth.
Evidence of prehistoric dentistry has been limited to a few cases, the most ancient dating back to the Neolithic. Here we report a 6500-year-old human mandible from Slovenia whose left canine crown bears the traces of a filling with beeswax. The use of different analytical techniques, including synchrotron radiation computed micro-tomography (micro-CT), Accelerator Mass Spectrometry (AMS) radiocarbon dating, Infrared (IR) Spectroscopy and Scanning Electron Microscopy (SEM), has shown that the exposed area of dentine resulting from occlusal wear and the upper part of a vertical crack affecting enamel and dentin tissues were filled with beeswax shortly before or after the individual's death. If the filling was done when the person was still alive, the intervention was likely aimed to relieve tooth sensitivity derived from either exposed dentine and/or the pain resulting from chewing on a cracked tooth: this would provide the earliest known direct evidence of therapeutic-palliative dental filling.
Concepts: Electron, Spectroscopy, Mass spectrometry, Teeth, Dental caries, Scanning electron microscope, Tooth enamel, Dentin
Atomic-scale compositional mapping reveals Mg-rich amorphous calcium phosphate in human dental enamel
Science advances
Human dental enamel, the hardest tissue in the body, plays a vital role in protecting teeth from wear as a result of daily grinding and chewing as well as from chemical attack. It is well established that the mechanical strength and fatigue resistance of dental enamel are derived from its hierarchical structure, which consists of periodically arranged bundles of hydroxyapatite (HAP) nanowires. However, we do not yet have a full understanding of the in vivo HAP crystallization process that leads to this structure. Mg(2+) ions, which are present in many biological systems, regulate HAP crystallization by stabilizing its precursor, amorphous calcium phosphate (ACP), but their atomic-scale distribution within HAP is unknown. We use atom probe tomography to provide the first direct observations of an intergranular Mg-rich ACP phase between the HAP nanowires in mature human dental enamel. We also observe Mg-rich elongated precipitates and pockets of organic material among the HAP nanowires. These observations support the postclassical theory of amelogenesis (that is, enamel formation) and suggest that decay occurs via dissolution of the intergranular phase. This information is also useful for the development of more accurate models to describe the mechanical behavior of teeth.
Concepts: Hierarchy, Solubility, Philosophy of science, Teeth, Crystallization, Tooth enamel, Nucleation, Remineralisation of teeth
Earliest evidence of dental caries manipulation in the Late Upper Palaeolithic
Prehistoric dental treatments were extremely rare, and the few documented cases are known from the Neolithic, when the adoption of early farming culture caused an increase of carious lesions. Here we report the earliest evidence of dental caries intervention on a Late Upper Palaeolithic modern human specimen (Villabruna) from a burial in Northern Italy. Using Scanning Electron Microscopy we show the presence of striations deriving from the manipulation of a large occlusal carious cavity of the lower right third molar. The striations have a "V"-shaped transverse section and several parallel micro-scratches at their base, as typically displayed by cutmarks on teeth. Based on in vitro experimental replication and a complete functional reconstruction of the Villabruna dental arches, we confirm that the identified striations and the associated extensive enamel chipping on the mesial wall of the cavity were produced ante-mortem by pointed flint tools during scratching and levering activities. The Villabruna specimen is therefore the oldest known evidence of dental caries intervention, suggesting at least some knowledge of disease treatment well before the Neolithic. This study suggests that primitive forms of carious treatment in human evolution entail an adaptation of the well-known toothpicking for levering and scratching rather than drilling practices.
Concepts: Human, Teeth, Dental caries, Scanning electron microscope, Tooth enamel, Paleolithic, Stone Age, Prehistory
The diet of the first Europeans from Atapuerca
Hominin dietary specialization is crucial to understanding the evolutionary changes of craniofacial biomechanics and the interaction of food processing methods' effects on teeth. However, the diet-related dental wear processes of the earliest European hominins remain unknown because most of the academic attention has focused on Neandertals. Non-occlusal dental microwear provides direct evidence of the effect of chewed food particles on tooth enamel surfaces and reflects dietary signals over time. Here, we report for the first time the direct effect of dietary abrasiveness as evidenced by the buccal microwear patterns on the teeth of the Sima del Elefante-TE9 and Gran Dolina-TD6 Atapuerca hominins (1.2-0.8 million years ago - Myr) as compared with other Lower and Middle Pleistocene populations. A unique buccal microwear pattern that is found in Homo antecessor (0.96-0.8 Myr), a well-known cannibal species, indicates dietary practices that are consistent with the consumption of hard and brittle foods. Our findings confirm that the oldest European inhabitants ingested more mechanically-demanding diets than later populations because they were confronted with harsh, fluctuating environmental conditions. Furthermore, the influence of grit-laden food suggests that a high-quality meat diet from butchering processes could have fueled evolutionary changes in brain size.
Concepts: Human, Nutrition, Food, Teeth, Food processing, Tooth enamel, Human evolution, Pleistocene
Effects of plain packaging, warning labels, and taxes on young people's predicted sugar-sweetened beverage preferences: an experimental study
The international journal of behavioral nutrition and physical activity
Consumption of sugar-sweetened beverages (SSBs) is associated with increased risk of obesity, diabetes, heart disease and dental caries. Our aim was to assess the effects of plain packaging, warning labels, and a 20 % tax on predicted SSB preferences, beliefs and purchase probabilities amongst young people.
Concepts: Hypertension, Risk, Lactic acid, Dental caries, Tooth enamel, Sucrose, Drink, Tax
The use of custom-milled zirconia teeth to address tooth abrasion in complete dentures: a clinical report
Journal of prosthodontics : official journal of the American College of Prosthodontists
Published about 7 years ago
A patient exhibited severe abrasion of resin posterior denture teeth including perforation of the denture base. New dentures were provided to explore the application of zirconia teeth for complete dentures. [Correction added to online publication 07 November 2012: "Zirconium" corrected to "Zirconia".] Traditional denture procedures were combined with fixed prosthodontic CAD/CAM procedures to fabricate custom-designed four-tooth posterior segments in hollow crown form to reduce weight and with a retentive form for interlocking to the denture base. The new dentures were successful in reducing wear of the denture teeth over the short-term follow-up period.
Concepts: Nitrogen, Teeth, Tooth enamel, Dentures, Zirconium dioxide, Prosthodontology, Prosthodontics
Self-Assembly of Filamentous Amelogenin Requires Calcium and Phosphate: From Dimers via Nanoribbons to Fibrils.
Enamel matrix self-assembly has long been suggested as the driving force behind aligned nanofibrous hydroxyapatite formation. We tested if amelogenin, the main enamel matrix protein, can self-assemble into ribbon-like structures in physiologic solutions. Ribbons 17 nm wide were observed to grow several micrometers in length, requiring calcium, phosphate, and pH 4.0-6.0. The pH range suggests that the formation of ion bridges through protonated histidine residues is essential to self-assembly, supported by a statistical analysis of 212 phosphate-binding proteins predicting 12 phosphate-binding histidines. Thermophoretic analysis verified the importance of calcium and phosphate in self-assembly. X-ray scattering characterized amelogenin dimers with dimensions fitting the cross-section of the amelogenin ribbon, leading to the hypothesis that antiparallel dimers are the building blocks of the ribbons. Over 5-7 days, ribbons self-organized into bundles composed of aligned ribbons mimicking the structure of enamel crystallites in enamel rods. These observations confirm reports of filamentous organic components in developing enamel and provide a new model for matrix-templated enamel mineralization.
Concepts: DNA, Scientific method, Protein, Histidine, Observation, Hypothesis, Amorphous calcium phosphate, Tooth enamel
Salivary proteins as a biomarker for dental caries-A systematic review.
AIM: To develop a systematic review based on the relation between salivary proteins and dental caries by comparing subjects with and without caries experience and to evaluate whether salivary proteins can be considered biomarkers for dental caries or not. METHODS: An electronic search was performed in the PubMed Medline, Ovid Medline, ISI Web of Science, Medline, Cochrane Library, Lilacs, Scielo, BBO, Paho and Wholis databases applying the following MeSH terms: "dental caries" OR "tooth demineralization" OR "dental caries susceptibility" OR "dental enamel solubility" AND "salivary proteins and peptides" OR "saliva" AND "proteins". To be eligible for the systematic review, the observational controlled studies had to have groups with and without caries experience. Studies with high risk of bias were excluded. RESULTS: From a total of 188 identified studies, only seven were included in this systematic review. Four studies were classified as "low risk of bias" and three as "moderate risk of bias". Three studies reported a relation between salivary proteins and dental caries. CONCLUSION: There was not sufficient evidence to establish salivary proteins as a biomarker for this disease although three of the seven studies showed a relation between salivary proteins and dental caries in terms of protein phenotypes, total protein concentration and protein molecular weight.
Concepts: Saliva, Enzyme, MEDLINE, Teeth, Tooth development, Dental caries, Tooth enamel, Medical Subject Headings
A historical case of amelogenesis imperfecta: Giovanna of Austria, Grand Duchess of Tuscany (1547-1578)
European journal of oral sciences
The skeletal remains of Giovanna of Austria (1547-1578), daughter of the Emperor Ferdinand I of Habsburg (1503-1564) and first wife of the Grand Duke of Tuscany, Francesco I (1541-1587), exhumed from the Basilica of San Lorenzo in Florence, were submitted to paleopathological study. Examination of the dentition, which was in a good state of preservation, showed maxillary retrognathism, together with a caries lesion, moderate periodontal disease, malposition of the upper second premolars and tooth wear. Furthermore, several horizontal grooves were observed in both the buccal and the lingual crown surfaces of almost all teeth, especially the anterior ones. The orthopantomogram showed hypomineralized enamel and alveolar bone loss. Two third-molar teeth were investigated using micro-computed tomography (micro-CT) analysis, revealing highly irregular enamel caps with reduced average thickness. The observed features suggest a diagnosis of hypoplastic amelogenesis imperfecta, a developmental condition affecting enamel formation.
Concepts: Teeth, Tooth enamel, Charles V, Holy Roman Emperor, Monarch, House of Habsburg, Habsburg Monarchy, Ferdinand I, Holy Roman Emperor, Francis II, Holy Roman Emperor


2016 is the most significant energy election this century. A President Hillary Clinton or Bernie Sanders would almost certainly commit our country to dismantling the fossil fuel industry. The Republican candidates have barely talked about energy at all, but they are at least open to not only preserving but even liberating fossil fuel, nuclear, and hydroelectric energy.
It is morally irresponsible and practically devastating for the fossil fuel industry to legitimize and compromise with the moral movement against its existence. It should instead make the moral, humanitarian case for fossil fuels–to the public, to its employees, and to politicians.
There are 3 basic steps you can take to move the needle.
Educate your employees. At a time when the existence of your industry is at stake, your employees need to know why what they're doing is so important–and explain it to others. Give them the time, resources, and training to become champions of fossil fuels.
Demand energy freedom from politicians. For all the industry's supposed political influence, the topic of energy freedom has barely come up in the Republican debates or rhetoric. This is the most important energy election this century. Energy freedom needs to be an issue and you have every right to demand that it be an issue for politicians you support.
I have created a number of resources (mostly free, a few low-cost) to make this easy.
America's Energy Opportunity. A petition where you, your employees, and your politicians can demand that politicians commit to energy freedom. It takes 20 seconds, please sign this!
The Moral Case for Fossil Fuels website. At this site we have dozens of free graphs plus a free copy of Chapter 1 of The Moral Case for Fossil Fuels, which will give you a powerful framework for arguing that fossil fuels are a life-enhancing good, not a necessary evil.
My Forbes columns on current topics.
My Twitter feed with quick comments on many hot issues.
"Arguing to 0 vs. Arguing to 100." This lecture will teach you how to get off the defensive when talking about energy.
The moral case in just 17 Minutes.
Can We Rely on Wind and Solar Energy? This 4-minute video contains a clear, concise answer.
The Moral Case for Fossil Fuels, the full book. The most comprehensive and persuasive collections of arguments for the morality of fossil fuels. A mind-changer that will help you, empower employees, and even impact politicians.
How to Talk to Anyone About Energy e-course. This will help you reframe discussions and gives you dozens of proven talking points on the issues you are most likely to encounter. The combination of these two resources can make anyone an effective energy champion.
Please sign and share America's Energy Opportunity!


AWE 365 - A Perfect Offering.
Under the Law, the provision for sin was a yearly sacrifice offered by the Priest for cleansing. And yet the sin was never really done away with but covered with the blood of bulls and rams. Every sacrifice was a reminder of sin, a repetitive display of man's imperfection and yet a shadow of the reality to come. And when that reality came, it came as Christ presenting Himself as an offering, but this time, it was once and for all.
Under the Law, when the people drew near to God in an attempt to worship, their sin was before them, they were not free to love God wholly. The sacrifice of Christ came not only to purify from sin, but also to cleanse from a conscience of guilt.
Christ paid the full price for all our sins at once; past, present, future. He redeemed us back to our original inheritance in the Divine nature. His sacrifice needed no duplicate: He is enough.
Related Post: A Holy Demonstration.
When we see redemption for what it truly is, our hearts begin to see Christ's sufficiency. Then we understand that Christ is enough for us today, tomorrow and forever; we need nothing, no one in addition to Him. He is our perfect offering, our eternal sacrifice.
Our lives are totally transformed when we place Christ at the center and flee all that is not Him.
It is easy to jump on the idea of our eternal perfection in Christ's sacrifice and consider it as all there is to this journey. Truthfully, however, this lasting perfection is for those who are being sanctified; those who are partaking in God.
Too many times, we want just enough of God to get us what we want. God will not have this. He looks for a people He can fully inhabit, a people who want all of Him and who will give Him all of themselves, a people who will be His dream and make Him their dream. Having recognized how we couldn't do this ourselves, He took the first step towards us by giving all of Himself as a one-time offering.
And now He waits for us to meet Him with our reciprocal offering.
Lord, today and forever, I offer myself fully to You, as You did for me.


Subject: LongIsland.com - Your Name sent you Event details of "Three Village Chamber Players Concert: Music from Jane Austen's 'Pride and Prejudice'"
Join us in the Reading Room for a 45 min program of music from the 18th and 19th centuries on period instruments. We will be performing music referenced in Jane Austen's 'Pride and Prejudice', music that the Bennet sisters would have been playing, music from Jane Austen's time period, music from Jane Austen's library, as well as theme music from the movies. The performing instruments will include harpsichord, clavichord, traverso, and violin. To learn more about 3VCP concerts please visit 3vcp.org.