Exercise is generally good for you, but a new high-quality clinical trial finds that it's so good, it can even knock back colon cancer—and, in fact, rival some chemotherapy treatments.

The finding comes from a phase 3, randomized clinical trial led by researchers in Canada, who studied nearly 900 people who had undergone surgery and chemotherapy for colon cancer. After those treatments, patients were evenly split into groups that either bulked up their regular exercise routines in a three-year program that included coaching and supervision or were simply given health education. The researchers found that the exercise group had a 28 percent lower risk of their colon cancer recurring, new cancers developing, or dying over eight years compared with the health education group.

The benefits of exercise, published in the New England Journal of Medicine, became visible after just one year and increased over time, the researchers found. The rate of people who survived for five years and remained cancer-free was 80.3 percent among the exercise group. That's a 6.4 percentage-point survival boost over the education group, which had a 73.9 percent cancer-free survival rate. The overall survival rate (with or without cancer) during the study's eight-year follow-up was 90.3 percent in the exercise group compared with 83.2 percent in the education group—a 7.1 percentage point difference. Exercise reduced the relative risk of death by 37 percent (41 people died in the exercise group compared with 66 in the education group).

"The magnitude of benefit from exercise ... was similar to that of many currently approved standard drug treatments," the researchers noted.

However, the exercise routines that achieved those substantial benefits weren't heavy-duty. Participants were coached to perform any recreational aerobic exercise they enjoyed, including brisk walking. Adding 45- to 60-minute brisk walks three or four times a week, or three or four jogs lasting 25 to 30 minutes, was enough for many of the participants to improve their odds.

Overall, the goal was to get the exercise group over 20 MET hours per week. METs are Metabolic Equivalents of Task, which represent the amount of energy your body is burning up compared to when you're at rest, sitting quietly. Brisk walking is about four METs, the researchers estimated, and jogging is around 10 METs. To get to 20 MET hours a week, a participant would have to do five hours of brisk walking a week (e.g., five hour-long walks a week) or jog for two hours a week (e.g., four 30-minute jogs per week).

“Quite impressive”

The exercise group, which had supervised exercise for the first six months of the three-year intervention, reported more exercise over the study. At the end, the exercise group was averaging over 20 MET hours per week, while the education group's average was around 15 MET hours per week. The exercise group also scored better at cardiorespiratory fitness and physical functioning.

Still, with the health education, the control group also saw a boost to their exercise during the trial, with their average starting around 10 MET hours per week. These findings "raise the possibility of an even more powerful effect of exercise on cancer outcomes as compared with a completely sedentary control group," the researchers note.

For now, it's not entirely clear how exercise keeps cancers at bay, but it squares with numerous other observational studies that have linked exercise to better outcomes in cancer patients. Researchers have several hypotheses, including that exercise might cause "increased fluid shear stress, enhanced immune surveillance, reduced inflammation, improved insulin sensitivity, and altered microenvironment of major sites of metastases," the authors note.

In the study, exercise seemed to keep local and distant colon cancer from recurring, as well as prevent new cancers, including breast, prostate, and colorectal cancers.

Outside experts hailed the study's findings. "This indicates that exercise has a similarly strong effect as previously shown for chemotherapy, which is really quite impressive," Marco Gerlinger, a gastrointestinal cancer expert at Queen Mary University of London, said in a statement. "One of the commonest questions from patients is what they can do to reduce the risk that their cancer comes back. Oncologists can now make a very clear evidence-based recommendation."

"Having worked in bowel cancer research for 30 years, this is an exciting breakthrough in the step-wise improvement in cure rates," David Sebag-Montefiore, a clinical oncologist at the University of Leeds, said. "The great appeal of a structured moderate intensity exercise is that it offers the benefits without the downside of the well-known side effects of our other treatments."

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With the federal hiring freeze lifting in mid-July, the Trump administration has rolled out a controversial federal hiring plan that critics warn will politicize and likely slow down the process rather than increase government efficiency.

De-emphasizing degree requirements and banning DEI initiatives—as well as any census tracking of gender, race, ethnicity, or religion to assess the composition of government—the plan requires every new hire to submit essays explaining which executive orders or policy initiatives they will help advance.

These essays must be limited to 200 words and cannot be generated by a chatbot, the guidance noted. While some applicants may point to policies enacted by prior presidents under their guidance, the president appears to be seeking to ensure that only Trump supporters are hired and that anyone who becomes disillusioned with Trump is weeded out over time. In addition to asking for a show of loyalty during the interview process, all federal workers will also be continuously vetted and must agree to submit to "checks for post-appointment conduct that may impact their continued trustworthiness," the guidance noted, referencing required patriotism repeatedly.

According to the Office of Personnel Management (OPM), the official plan is to hire only workers "dedicated to serving the American people effectively and faithfully." It also requires essays on applicants' commitment to upholding the Constitution, furthering government efficiency, and maintaining a strong work ethic.

Although the elimination of DEI initiatives is clearly a core Trump objective, the plan is "a hodgepodge of bipartisan reforms developed under both Trump and former President Biden to accelerate and improve the hiring process, alongside plans to eradicate longstanding efforts to make the federal workforce more reflective of the American populace," the government news site Government Executive (GovExec) reported.

The administration says the plan will "drastically" speed up hiring while cutting costs. The plan said that efficiencies would be created by cutting down resumes to a maximum of two pages (cutting review time) while creating a pool of resumes that can be returned to so that new jobs won't even need to be announced. Even hiring for jobs requiring top secret clearances will be expedited, the plan said.

Critics highlight pain points of hiring plan

A federal HR official speaking anonymously told GovExec that "this plan will make life harder for hiring managers and applicants alike." That official noted that Trump's plan to pivot away from using self-assessments—where applicants can explain their relevant skills—removes a shortcut for HR workers who will now need to devote time to independently assess every candidate.

Using various Trump-approved technical and alternative assessments would require candidates to participate in live exercises, evaluate work-related scenarios, submit a work sample, solve problems related to skill competencies, or submit additional writing samples that would need to be reviewed. The amount of manual labor involved in the new policies, the HR official warned, is "insane."

"Everything in it will make it more difficult to hire, not less," the HR official said. "How the f--- do you define if someone is patriotic?"

Jenny Mattingley, a vice president of government affairs at the Partnership for Public Service, told Politico that she agreed that requiring a loyalty test would make federal recruiting harder.

"Many federal employees are air traffic controllers, national park rangers, food safety inspectors, and firefighters who carry out the missions of agencies that are authorized by Congress," Mattingley said. "These public servants, who deliver services directly to the public, should not be forced to answer politicized questions that fail to evaluate the skills they need to do their jobs effectively."

Don Kettl, a professor emeritus of public policy at the University of Maryland, told GovExec that the decision to stop collecting census data on government workers could also present setbacks for hiring managers.

"I’m concerned about it, not because it would make it harder to pursue DEI goals as a matter of policy but that in general, it’s important not to throw out information about what it is that you’re doing," Kettl said. "It would be important to know whether or not you’re hiring 90 percent men for certain occupations... You don’t want to blind yourself to the implications of what you’re doing."

So far, Trump has prioritized slashing the government workforce through the Department of Government Efficiency (DOGE), with The New York Times estimating in March that 59,000 workers were fired and 76,000 accepted buyouts. Axios noted that 150,000 additional cuts are planned, and DOGE recently supercharged the mass-layoff software that could make it easier to pursue further cuts.

Once the hiring freeze lifts on July 15, the White House has specified that it will allow agencies to hire "no more than one employee for every four employees that depart from federal service (with appropriate immigration, law enforcement, and public safety exceptions."

Among those to be recruited, the federal hiring plan noted, are HR professionals who will align with Trump's plan to end DEI initiatives and prioritize hiring "American patriots."

"There is an urgent need to upgrade the skills and capabilities of Federal HR professionals to implement President Trump’s long-overdue plans to reform the Federal workforce," the hiring plan said, confirming that "OPM will take a greater role in overseeing" and training the HR workforce.

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College students who have reportedly grown too dependent on ChatGPT are starting to face consequences after graduating and joining the workforce for placing too much trust in chatbots.

Last month, a recent law school graduate lost his job after using ChatGPT to help draft a court filing that ended up being riddled with errors.

The consequences arrived after a court in Utah ordered sanctions after the filing included the first fake citation ever discovered in the state hallucinated by artificial intelligence.

Also problematic, the Utah court found that the filing included "multiple" mis-cited cases, in addition to "at least one case that does not appear to exist in any legal database (and could only be found in ChatGPT."

Douglas Durbano, a lawyer involved in the filing, and Richard Bednar, the attorney who signed and submitted the filing, should have verified the accuracy before any court time was wasted assessing the fake citation, Judge Mark Kouris wrote in his opinion.

"We emphasize that every attorney has an ongoing duty to review and ensure the accuracy of their court filings," Kouris wrote, noting that the lawyers "fell short of their gatekeeping responsibilities as members of the Utah State Bar when they submitted a petition that contained fake precedent generated by ChatGPT."

The fake citation may have been easily caught if a proper review process was in place. When Ars prompted ChatGPT to summarize the fake case, "Royer v. Nelson, 2007 UT App 74, 156 P.3d 789," the chatbot provided no details other than claiming that "this case involves a dispute between two individuals, Royer and Nelson, in the Utah Court of Appeals," which raises red flags.

Apologizing and promising to "make amends," the law firm told the court that the law school grad was working as an unlicensed law clerk and had not notified anyone of his ChatGPT use. At the time, the law firm had no AI policy that might have prevented the fake legal precedent from being included in the filing. But after the discovery, the lawyers reassured the court that a new policy had been established, and Bednar's lawyer, Matthew C. Barneck, told ABC4 that the law clerk was fired, despite the lack of a "formal or informal" policy discouraging the improper AI use.

Fake citations can cause significant harms, Kouris noted, including spiking costs to opposing attorneys and the court, as well as depriving clients of the best defense possible. But Kouris pointed out that other lawyers who have been caught using AI to cite fake legal precedent in court have wasted even more resources by misleading the court and denying the AI use or claiming fake citations were simply made in error.

Unlike those lawyers, Bednar and Durbano accepted responsibility, Kouris said, so while sanctions were "warranted," he remained "mindful" that the lawyers had moved to resolve the error quickly. Ultimately, Bednar was ordered to pay the opposition's attorneys' fees, as well as donate $1,000 to "And Justice for All," a legal aid group providing low-cost services to the state's most vulnerable citizens.

A spokesperson for "And Justice for All" told Ars that "a donation like this directly helps vulnerable individuals who would otherwise be unable to access legal help" and confirmed that the group endorses responsible AI use.

"Non-profits, including legal non-profits, are incorporating AI in their services to better serve those who need it most," the spokesperson said. "However, every attorney has a legal and professional responsibility to ensure that court pleadings accurately cite real, applicable case law, not fake AI-generated ones. Like any new technology, users have a responsibility to use it ethically and responsibly. The integrity of the justice system is vital for the vulnerable populations we serve, and we are confident that the courts will continue to safeguard fairness and accuracy as new tools are introduced."

College students rely too much on ChatGPT

Barneck told ABC4 that it's common for law clerks to be unlicensed, but little explanation was given for why an unlicensed clerk's filing wouldn't be reviewed.

Kouris warned that "the legal profession must be cautious of AI due to its tendency to hallucinate information," and likely the growing pains of adjusting to the increasingly common use of AI in the courtroom will also include law firms educating recent college graduates on AI's well-known flaws.

And it seems law firms may have their work cut out for them there.

College teachers recently told 404 Media that their students put too much trust in AI. According to one, Kate Conroy, even the "smartest kids insist that ChatGPT is good 'when used correctly,'" but they "can’t answer the question [when asked] 'How does one use it correctly then?'"

"My kids don’t think anymore," Conroy said. "They try to show me 'information' ChatGPT gave them. I ask them, 'How do you know this is true?' They move their phone closer to me for emphasis, exclaiming, 'Look, it says it right here!' They cannot understand what I am asking them. It breaks my heart for them and honestly it makes it hard to continue teaching."

Ars could not immediately reach Bednar or comment.

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On May 23, President Trump issued an executive order entitled "Restoring Gold Standard Science." And, in news that may surprise our readers, it sounds remarkably good, focusing on issues like reproducibility and conflicts of interest. While there were a few things that could be phrased better, when it comes to basic scientific practices, the language was remarkably reasonable.

So, why didn't we report on what appeared to be a rare bit of good news? I'd considered doing so, but the situation is complicated by the fact that the order is structured in a way that makes it very sensitive to who's responsible for implementing it, a situation that's subtle enough that I couldn't figure out how to handle it well. Fortunately, I only had to wait a week for a member of the Trump administration to show just how dangerous it could be and highlight its biggest problem.

On Sunday, Food and Drug Administration Commissioner Marty Makary appeared on one of the weekend news programs, where he was asked about the decision to limit pregnant people's access to the COVID-19 vaccines. The host mentioned that aggregation of studies involving a total of over 1.8 million women had shown the vaccine was safe and effective.

Makary dismissed all that data because it wasn't "gold standard science," perfectly illustrating how the phrase can be used as a tool to mislead the public.

Setting standards

The executive order defines gold standard science in various ways that have already been discussed and promoted by the scientific community itself, including groups like the open science movement. It mentions things such as reproducibility and the use of hypotheses you can show are wrong, the open communication of results and uncertainties, and a focus on collaborative work. It also includes a few obvious rules, such as forbidding federal employees from engaging in research misconduct.

Overall, when it comes to scientific practice, the elements of gold standard science appear to range from obvious and innocuous to highly positive.

But even the principles themselves are open enough to interpretation that their implementation will matter. It's more than slightly ironic to call for more reproducibility at a time when budgets for even original research are being slashed severely, meaning that any money that goes to reproducing prior results will need to be met using a vanishing research budget. And, in the first Trump administration, "transparency" was used as a way to avoid using unpublished company data as part of considerations regarding whether the company's products needed to be regulated.

The executive order also calls for agencies to form policies that "provide for consideration of different or dissenting viewpoints" and "protect employees from efforts to prevent or deter consideration of alternative scientific opinions." Which again, don't sound problematic but are coming from an administration filled with people like Robert F. Kennedy Jr., who wouldn't accept scientific evidence unless it were delivered in the corpse of a bear. It's notable that many non-scientific arguments about topics ranging from climate change to pandemic responses have been presented as simply "alternative scientific opinions." So this is definitely subject to potential abuse as well.

Finally, there's the enforcement of these rules—and thus final say on what actually constitutes gold standard science—which involves each agency naming a single political appointee to make the decisions. There's the potential for honest misunderstandings; how could any one individual understand everything going on at a place like the National Science Foundation, which funds everything from evolutionary biology to high-energy physics? But there's also the potential for abuse along the lines of what we've seen in authoritarian governments. That potential has already been widely recognized. And this weekend, we got a clear example of what it might look like in practice.

Concrete fears

Makary appeared on the news program Face the Nation over the weekend and showed exactly how this emphasis on gold standard science can be abused. The host, Margaret Brennan, challenged Makary on his recent participation in an announcement that would make it harder to get COVID vaccines during pregnancy, even though he had earlier helped pen an editorial that placed pregnant people in a high-risk category. Brennan also highlighted a meta-analysis of 67 different studies of COVID vaccines given during pregnancy. Collectively, these studies included over 1.8 million women, a large enough population to enable even rare side effects to emerge from the statistical murk.

"COVID-19 vaccines are effective in preventing SARS-CoV-2 infection and related complications in pregnant women," the authors of the meta-analysis conclude. "Unvaccinated pregnant women are more likely to experience hypertensive disorders and caesarean sections, and their neonates are more likely to be admitted to a neonatal unit."

That seems pretty clear. But Makary dismisses all of that data with a single short sentence: "There's no randomized control trial, that's the gold standard."

In this, Makary is following a strategy adopted earlier by congressional Republicans, who desired to conclude that SARS-CoV-2 had been the product of a lab leak. So, they switched standards of evidence as needed, tightening the rules to exclude inconvenient information, while accepting studies without relevant empirical data in others. That congressional report now serves as the primary source for the Trump administration's covid.gov website, in case there was any doubt that this strategy is appreciated by the people running the government.

The reality of science is that there are different qualities of evidence; some approaches produce data that can speak more definitively than others. When scientists talk about things like the weight of the evidence, they take these uncertainties into account. A sufficiently large and diverse collection of uncertain evidence can often outweigh a single result that appears definitive. In fact, the executive order at issue prominently describes how important it is to communicate scientific uncertainties clearly, one of its positive aspects.

Makary is not at all interested in discussing uncertainties. Instead, he's using uncertainty as a tool, one that allows him to dismiss any evidence that runs against his preferred narrative. And there's no reason to think that he'll be the last member of this administration to use "gold standard science" in this way.

The only favors Makary is doing for the public is making it easier to see how the fine-sounding principles of gold standard science can so easily be abused.

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The Centers for Disease Control and Prevention on Thursday updated its immunization schedules for children and adults to partially reflect the abrupt changes announced by health secretary and anti-vaccine advocate Robert F. Kennedy Jr. earlier this week.

In a 58-second video posted on social media Tuesday, May 27, Kennedy said he was unilaterally revoking the CDC's recommendations that healthy children and pregnant people get COVID-19 vaccines.

"I couldn’t be more pleased to announce that, as of today, the COVID vaccine for healthy children and healthy pregnant women has been removed from the CDC recommended immunization schedule," Kennedy said in the video.

The health agency's immunization schedules were not, in fact, updated at the time of the announcement, though. The Washington Post subsequently reported that the CDC was blindsided by the announcement. Five hours went by after the video was posted before CDC officials said they received a one-page "secretarial directive" about the changes, which was signed by Kennedy and puzzlingly dated May 19, according to the Post.

Late Thursday, the CDC updated the immunization schedules. Contradicting what Kennedy said in the video, the CDC did not remove its recommendation for COVID-19 vaccines for healthy children in the child and adolescent immunization schedule. Instead, it added a stipulation that if a child's doctor agrees with the vaccination and parents "desire for their child to be vaccinated," healthy children can get vaccinated.

In practice, it is unclear how this change will affect access to the vaccines. Health insurers are required to cover vaccines on the CDC schedules. But, it's yet to be seen if children will only be able to get vaccinated at their doctor's office (rather than a pharmacy or vaccine clinic) or if additional consent forms would be required, etc. Uncertainty about the changes and requirements alone may lead to fewer children getting vaccinated.

In the adult immunization schedule, when viewed "by medical condition or other indication" (table 2), the COVID-19 vaccination recommendation for pregnancy is now shaded gray, meaning "no guidance/not applicable." Hovering a cursor over the box brings up the recommendation to "Delay vaccination until after pregnancy if vaccine is indicated." Previously, COVID-19 vaccines were recommended during pregnancy. The change makes it less likely that health insurers will cover the cost of vaccination during pregnancy.

The change is at odds with Trump's Food and Drug Administration, which just last week confirmed that pregnancy puts people at increased risk of severe COVID-19 and, therefore, vaccination is recommended. Medical experts have decried the loss of the recommendation, which is also at odds with clear data showing the risks of COVID-19 during pregnancy and the benefits of vaccination.

The President of the American College of Obstetricians and Gynecologists (ACOG) put out a statement shortly after the Tuesday video saying the organization was "extremely disappointed" with Kennedy's announcement.

"It is very clear that COVID-19 infection during pregnancy can be catastrophic and lead to major disability, and it can cause devastating consequences for families," ACOG President Steven Fleischman said.

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Once hailed as a triumph of public health, water fluoridation is now under intense attack in the US.

Despite decades of data proving its efficacy at protecting teeth from decay—particularly children's teeth—two states have now banned the use of fluoride in public water, and communities around the country have followed suit or are considering doing the same. The current US health secretary, Robert F. Kennedy Jr., who is known for his anti-vaccine advocacy and for peddling conspiracy theories, has pledged to remove fluoride from US water.

Now, a pair of researchers at Harvard—Sung Eun Choi and Lisa Simon—have modeled exactly what will happen in the US if Kennedy follows through on his pledge: The number of cavities and decayed teeth in American children and teens (ages 0–19) will increase by an estimated 7.5 percentage points over the first five years. That means there will be 25.4 million more rotten teeth in the mouths of children and teenagers. The dental bills for the added decay will total at least $9.8 billion in that time. Other costs, such as loss of work among parents, were not included, making the financial estimate conservative. But children will also be more miserable, with an estimated loss of 2.9 million quality-adjusted life years.

After 10 years, the number of additional decayed teeth would be 53.8 million at a cost of $19.4 billion.

The analysis, published Friday in JAMA Health Forum, drew from real-world dental utilization and oral health data from a national health survey. It also modeled tooth decay as a function of age, sex, race, ethnicity, and income. The model was calibrated against real dental decay prevalence. Costs for dental work were based on standard rates from the American Dental Association, insurance claims, and prior analyses.

In all, the increased decay and boosted dental costs would disproportionately affect children who are in low-income families, in rural areas, and/or on public health insurance.

The study's findings are likely unsurprising to those in the public health community, who have consistently supported fluoridation. The practice, however beneficial, has a long history of being under attack. After its introduction in the US in 1945, conspiracy theorists claimed fluoridation was a communist plot and a form of government mind control. More recently, critics have claimed that fluoridation lowers IQ.

The data linking water fluoridation to low IQ is controversial. Many of the studies on the topic are of poor quality and have numerous confounding factors and flawed methods. Many compare IQ levels in communities in China and other countries, where there are areas with water that is naturally high in fluoride—much, much higher than what is intentionally added to US water. Further, a federal meta-analysis—a type of study that aggregates and reanalyzes data from independent studies—has been plagued by criticism for bias, poor statistical methods, and a lack of data transparency.

But despite the controversy, one thing is clear in all the data and debate: Any possible association with low IQ and fluoridation only occurs at excessive levels—levels more than twice the amount used in the US and recommended by the US Centers for Disease Control and Prevention. The CDC recommendation for water fluoridation levels is 0.7 mg/L, while potential harms are not observed until water levels exceed 1.5 mg/L. Some areas in China have natural levels as high as 11.8 mg/L.

The authors of the new study conclude that, at current US levels, the benefits are clear.

"These findings suggest that, despite the potential harms of excessive fluoride exposure, fluoridation at safe levels offers both individual and societal benefits that would be at risk."

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