Leishmaniasis is a neglected parasitic tropical disease with numerous clinical manifestations. One of the causative agents of cutaneous leishmaniasis (CL) is Leishmania tropica (L. tropica) known for causing ulcerative lesions on the skin. The adverse effects of the recommended available drugs, such as amphotericin B and pentavalent antimonial, and the emergence of drug resistance in parasites, mean the search for new safe and effective anti-leishmanial agents is crucial. Miltefosine (MIL) was the first recommended oral medication, but its use is now limited because of the rapid emergence of resistance. Pharmaceutical cocrystallization is an effective method to improve the physicochemical and biological properties of active pharmaceutical ingredients (APIs). Herein, we describe the cocrystallization of coumarin-3-carb­oxy­lic acid (CU, 1a; 2-oxobenzo­pyrane-3-carb­oxy­lic acid, C10H6O4) with five coformers [2-amino-3-bromo­pyridine (1b), 2-amino-5-(tri­fluoro­methyl)-pyridine (1c), 2-amino-6-methyl­pyridine (1d), p-amino­benzoic acid (1e) and amitrole (1f)] in a 1:1 stoichiometric ratio via the neat grinding method. The cocrystals 2–6 obtained were characterized via single-crystal X-ray diffraction, powder X-ray diffraction, differential scanning calorimetry and thermogravimetric analysis, as well as Fourier transform infrared spectroscopy. Non-covalent interactions, such as van der Waals, hydrogen bonding, C—H⋯π and π⋯π interactions contribute significantly towards the packing of a crystal structure and alter the physicochemical and biological activity of CU. In this research, newly synthesized cocrystals were evaluated for their anti-leishmanial activity against the MIL-resistant L. tropica and cytotoxicity against the 3T3 (normal fibroblast) cell line. Among the non-cytotoxic cocrystals synthesized (2–6), CU:1b (2, IC50 = 61.83 ± 0.59 µM), CU:1c (3, 125.7 ± 1.15 µM) and CU:1d (4, 48.71 ± 0.75 µM) appeared to be potent anti-leishmanial agents and showed several-fold more anti-leishmanial potential than the tested standard drug (MIL, IC50 = 169.55 ± 0.078 µM). The results indicate that cocrystals 2–4 are promising anti-leishmanial agents which require further exploration.

Platinum(II) complexes of square-planar geometry are interesting from a crystal engineering viewpoint because they exhibit strong luminescence based on the self-assembly of molecular units. The luminescence color changes in response to gentle stimuli, such as vapor exposure or weak mechanical forces. Both the molecular and the crystal designs for soft crystals are critical to effectively generate the chromic luminescence phenomenon of Pt(II) complexes. In this topical review, strategies for fabricating chromic luminescent Pt(II) complexes are described from a crystal design perspective, focusing on the structural regulation of Pt(II) complexes that exhibit assembly-induced luminescence via metal–metal interactions and structural control of anionic Pt(II) complexes using cations. The research progress on the evolution of various chromic luminescence properties of Pt(II) complexes, including the studies conducted by our group, are presented here along with the latest research outcomes, and an overview of the frontiers and future potential of this research field is provided.

Owing to their exceptional properties, hard materials such as advanced ceramics, metals and composites have enormous economic and societal value, with applications across numerous industries. Understanding their microstructural characteristics is crucial for enhancing their performance, materials development and unleashing their potential for future innovative applications. However, their microstructures are unambiguously hierarchical and typically span several length scales, from sub-ångstrom to micrometres, posing demanding challenges for their characterization, especially for in situ characterization which is critical to understanding the kinetic processes controlling microstructure formation. This review provides a comprehensive description of the rapidly developing technique of ultra-small angle X-ray scattering (USAXS), a nondestructive method for probing the nano-to-micrometre scale features of hard materials. USAXS and its complementary techniques, when developed for and applied to hard materials, offer valuable insights into their porosity, grain size, phase composition and inhomogeneities. We discuss the fundamental principles, instrumentation, advantages, challenges and global status of USAXS for hard materials. Using selected examples, we demonstrate the potential of this technique for unveiling the microstructural characteristics of hard materials and its relevance to advanced materials development and manufacturing process optimization. We also provide our perspective on the opportunities and challenges for the continued development of USAXS, including multimodal characterization, coherent scattering, time-resolved studies, machine learning and autonomous experiments. Our goal is to stimulate further implementation and exploration of USAXS techniques and inspire their broader adoption across various domains of hard materials science, thereby driving the field toward discoveries and further developments.

Biological materials have outstanding properties. With ease, challenging mechanical, optical or electrical properties are realised from comparatively `humble' building blocks. The key strategy to realise these properties is through extensive hierarchical structuring of the material from the millimetre to the nanometre scale in 3D. Though hierarchical structuring in biological materials has long been recognized, the 3D characterization of such structures remains a challenge. To understand the behaviour of materials, multimodal and multi-scale characterization approaches are needed. In this review, we outline current X-ray analysis approaches using the structures of bone and shells as examples. We show how recent advances have aided our understanding of hierarchical structures and their functions, and how these could be exploited for future research directions. We also discuss current roadblocks including radiation damage, data quantity and sample preparation, as well as strategies to address them.

MltG, a membrane-bound lytic transglycosyl­ase, has roles in terminating glycan polymerization in peptidoglycan and incorporating glycan chains into the cell wall, making it significant in bacterial cell-wall biosynthesis and remodeling. This study provides the first reported MltG structure from Mycobacterium abscessus (maMltG), a superbug that has high antibiotic resistance. Our structural and biochemical analyses revealed that MltG has a flexible peptidoglycan-binding domain and exists as a monomer in solution. Further, the putative active site of maMltG was disclosed using structural analysis and sequence comparison. Overall, this study contributes to our understanding of the transglycosyl­ation reaction of the MltG family, aiding the design of next-generation antibiotics targeting M. abscessus.

The accuracy of the information in the Protein Data Bank (PDB) is of great importance for the myriad downstream applications that make use of protein structural information. Despite best efforts, the occasional introduction of errors is inevitable, especially where the experimental data are of limited resolution. A novel protein structure validation approach based on spotting inconsistencies between the residue contacts and distances observed in a structural model and those computationally predicted by methods such as AlphaFold2 has previously been established. It is particularly well suited to the detection of register errors. Importantly, this new approach is orthogonal to traditional methods based on stereochemistry or map–model agreement, and is resolution independent. Here, thousands of likely register errors are identified by scanning 3–5 Å resolution structures in the PDB. Unlike most methods, the application of this approach yields suggested corrections to the register of affected regions, which it is shown, even by limited implementation, lead to improved refinement statistics in the vast majority of cases. A few limitations and confounding factors such as fold-switching proteins are characterized, but this approach is expected to have broad application in spotting potential issues in current accessions and, through its implementation and distribution in CCP4, helping to ensure the accuracy of future depositions.

The interaction of intense synchrotron radiation with molecular crystals frequently modifies the crystal structure by breaking bonds, producing fragments and, hence, inducing disorder. Here, a second-rank tensor of radiation-induced lattice strain is proposed to characterize the structural susceptibility to radiation. Quantitative estimates are derived using a linear response approximation from experimental data collected on three materials Hg(NO3)2(PPh3)2, Hg(CN)2(PPh3)2 and BiPh3 [PPh3 = triphenylphosphine, P(C6H5)3; Ph = phenyl, C6H5], and are compared with the corresponding thermal expansivities. The associated eigenvalues and eigenvectors show that the two tensors are not the same and therefore probe truly different structural responses. The tensor of radiative expansion serves as a measure of the susceptibility of crystal structures to radiation damage.

The NaZr2P3O12 family of materials have shown low and tailorable thermal expansion properties. In this study, SrZr4P6O24 (SrO·4ZrO2·3P2O5), CaZr4P6O24 (CaO·4ZrO2·3P2O5), MgZr4P6O24 (MgO·4ZrO2·3P2O5), NaTi2P3O12 [½(Na2O·4TiO2·3P2O5)], NaZr2P3O12 [½(Na2O·4ZrO2·3P2O5)], and related solid solutions were synthesized using the organic–inorganic steric entrapment method. The samples were characterized by in-situ high-temperature X-ray diffraction from 25 to 1500°C at the Advanced Photon Source and National Synchrotron Light Source II. The average linear thermal expansion of SrZr4P6O24 and CaZr4P6O24 was between −1 × 10−6 per °C and 6 × 10−6 per °C from 25 to 1500°C. The crystal structures of the high-temperature polymorphs of CaZr4P6O24 and SrZr4P6O24 with R3c symmetry were solved by Fourier difference mapping and Rietveld refinement. This polymorph is present above ∼1250°C. This work measured thermal expansion coefficients to 1500°C for all samples and investigated the differences in thermal expansion mechanisms between polymorphs and between compositions.

The structures of three multicomponent crystals formed with imidazole-based drugs, namely metronidazole, ketoconazole and miconazole, in conjunction with tri­thio­cyanuric acid are characterized. Each of the obtained adducts represents a different category of crystalline molecular forms: a cocrystal, a salt and a cocrystal of salt. The structural analysis revealed that in all cases, the N—H⋯N hydrogen bond is responsible for the formation of acid–base pairs, regardless of whether proton transfer occurs or not, and these molecular pairs are combined to form unique supramolecular motifs by centrosymmetric N—H⋯S interactions between acid molecules. The complex intermolecular forces acting in characteristic patterns are discussed from the geometric and energetic perspectives, involving Hirshfeld surface analysis, pairwise energy estimation, and natural bond orbital calculations.

In recent years, there is a significant interest from the crystallographic and materials science communities to have access to raw diffraction data. The effort in archiving raw data for access by the user community is spearheaded by the International Union of Crystallography (IUCr) Committee on Data. In materials science, where powder diffraction is extensively used, the challenge in archiving raw data is different to that from single crystal data, owing to the very nature of the contributions involved. Powder diffraction (X-ray or neutron) data consist of contributions from the material under study as well as instrument specific parameters. Having raw powder diffraction data can be essential in cases of analysing materials with poor crystallinity, disorder, micro structure (size/strain) etc. Here, the initiative and progress made by the International Centre for Diffraction Data (ICDDR) in archiving powder X-ray diffraction raw data in the Powder Diffraction FileTM (PDFR) database is outlined. The upcoming 2025 release of the PDF-5+ database will have more than 20 800 raw powder diffraction patterns that are available for reference.

JUAMI, the joint undertaking for an African materials institute, is a project to build collaborations and materials research capabilities between PhD researchers in Africa, the United States, and the world. Focusing on research-active universities in the East African countries of Kenya, Ethiopia, Tanzania and Uganda, the effort has run a series of schools focused on materials for sustainable energy and materials for sustainable development. These bring together early-career researchers from Africa, the US, and beyond, for two weeks in a close-knit environment. The program includes lectures on cutting-edge research from internationally renowned speakers, highly interactive tutorial lectures on the science behind the research, also from internationally known researchers, and hands-on practicals and team-building exercises that culminate in group proposals from self-formed student teams. The schools have benefited more than 300 early-career students and led to proposals that have received funding and have led to research collaborations and educational non-profits. JUAMI continues and has an ongoing community of alumni who share resources and expertise, and is open to like-minded people who want to join and develop contacts and collaborations internationally.

This work describes the X-ray structure of orange–red crystals of 2-meth­oxy-5-nitro­aniline, C7H8N2O3. The compound displays concentration-dependent UV-Vis spectra, which is attributed to dipole-induced aggregation, and light absorption arising from an inter­molecular charge-transfer process that decreases in energy as the degree of aggregation increases. The crystals display π-stacking where the dipole moments align anti­parallel. Stacked mol­ecules inter­act with the next stack via hydrogen bonds, which is a state of maximum aggregation. Light absorption by charge transfer can be compared to colored inorganic semiconductors such as orange–red CdS, with a band gap of 2.0–2.5 eV.

Two different multi-component crystals consisting of papaverine [1-(3,4-di­meth­oxy­benz­yl)-6,7-di­meth­oxy­iso­quinoline, C20H21NO4] and fumaric acid [C4H4O4] were obtained. Single-crystal X-ray structure analysis revealed that one, C20H21NO4·1.5C4H4O4 (I), is a salt co-crystal composed of salt-forming and non-salt-forming mol­ecules, and the other, C20H21NO4·0.5C4H4O4 (II), is a salt–co-crystal inter­mediate (i.e., in an inter­mediate state between a salt and a co-crystal). In this study, one state (crystal structure at 100 K) within the salt–co-crystal continuum is defined as the ‘inter­mediate’.

In crystallographic texture analysis, ensuring that sample directions are preserved from experiment to the resulting orientation distribution is crucial to obtain physical meaning from diffraction data. This work details a procedure to ensure instrument and sample coordinates are consistent when analyzing diffraction data with a Rietveld refinement using the texture analysis software MAUD. A quartz crystal is measured on the HIPPO diffractometer at Los Alamos National Laboratory for this purpose. The methods described here can be applied to any diffraction instrument measuring orientation distributions in polycrystalline materials.

The growing pressure on school curricula has meant crystals and the science of crystallography have been cut from or made optional for many educational programs. This omission is a serious disservice to the history and understanding of modern sciences, given that crystallography underpins many of the greatest advancements in science over the past century, is a critical component of many modern research papers and patents, and has 29 Nobel Prizes awarded in the field. This contribution describes a simple activity to target classroom and public engagement with crystallography, using marshmallows or equivalent sweets/candy to represent atoms and cocktail sticks to represent bonds, together with examples of how crystals are studied and how they are useful. Though it has a simple basis, this activity can be extended in numerous ways to reflect the aims of the demonstrator, and a few of these are described.

In cellulo crystallization is a rare event in nature. Recent advances that have made use of heterologous overexpression can promote the intracellular formation of protein crystals, but new tools are required to detect and characterize these targets in the complex cell environment. The present work makes use of Mask R-CNN, a convolutional neural network (CNN)-based instance segmentation method, for the identification of either single or multi-shaped crystals growing in living insect cells, using conventional bright field images. The algorithm can be rapidly adapted to recognize different targets, with the aim of extracting relevant information to support a semi-automated screening pipeline, in order to aid the development of the intracellular protein crystallization approach.

A systematic procedure is introduced for modeling charge-neutral non-polar surfaces of ionic minerals containing polyatomic anions. By integrating distance- and charge-based clustering to identify chemical species within the mineral bulk, our pipeline, PolyCleaver, renders a variety of theoretically viable surface terminations. As a demonstrative example, this approach was applied to forsterite (Mg2SiO4), unveiling a rich interface landscape based on interactions with formaldehyde, a relevant multifaceted molecule, and more particularly in prebiotic chemistry. This high-throughput method, going beyond techniques traditionally applied in the modeling of minerals, offers new insights into the potential catalytic properties of diverse surfaces, enabling a broader exploration of synthetic pathways in complex mineral systems.

X-ray crystallography is an established tool to probe the structure of macromolecules with atomic resolution. Compared with alternative techniques such as single-particle cryo-electron microscopy and micro-electron diffraction, X-ray crystallography is uniquely suited to room-temperature studies and for obtaining a detailed picture of macromolecules subjected to an external electric field (EEF). The impact of an EEF on proteins has been extensively explored through single-crystal X-ray crystallography, which works well with larger high-quality protein crystals. This article introduces a novel design for a 3D-printed in situ crystallization plate that serves a dual purpose: fostering crystal growth and allowing the concurrent examination of the effects of an EEF on crystals of varying sizes. The plate's compatibility with established X-ray crystallography techniques is evaluated.

From the historical roots of metalworking to the forefront of modern nanotechnology, functional materials have played a pivotal role in transforming societies, and their influence is poised to persist into the future. Encompassing a wide array of solid-state materials, spanning semiconductors to polymers, molecular crystals to nanoparticles, functional materials find application in critical sectors such as electronics, computers, information, communication, bio­technology, aerospace, defense, environment, energy, medicine and consumer products. This feature article delves into diverse instances of functional materials, exploring their structures, their properties and the underlying mechanisms that contribute to their outstanding performance across fields like batteries, photovoltaics, magnetics and heterogeneous catalysts. The field of structural sciences serves as the cornerstone for unraveling the intricate relationship between structure, dynamics and function. Acting as a bridge, it connects the fundamental understanding of materials to their practical applications.

The influence of various combinations of residual stress, composition and grain interaction gradients in polycrystalline materials with cubic symmetry on energy-dispersive X-ray stress analysis is theoretically investigated. For the evaluation of the simulated sin2ψ distributions, two different strategies are compared with regard to their suitability for separating the individual gradients. It is shown that the separation of depth gradients of the strain-free lattice parameter a0(z) from residual stress gradients σ(z) is only possible if the data analysis is carried out in section planes parallel to the surface. The impact of a surface layer z* that is characterized by a direction-dependent grain interaction model in contrast to the volume of the material is quantified by comparing a ferritic and an austenitic steel, which feature different elastic anisotropy. It is shown to be of minor influence on the resulting residual stress depth profiles if the data evaluation is restricted to reflections hkl with orientation factors Γhkl close to the model-independent orientation Γ*. Finally, a method is proposed that allows the thickness of the anisotropic surface layer z* to be estimated on the basis of an optimization procedure.

Using the well known Rn ratio method, a protocol has been elaborated for determining the lattice direction for the 15 most common cubic zone axis spot patterns. The method makes use of the lengths of the three shortest reciprocal-lattice vectors in each pattern and the angles between them. No prior pattern calibration is required for the method to work, as the Rn ratio method is based entirely on geometric relationships. In the first step the pattern is assigned to one of three possible pattern types according to the angles that are measured between the three reciprocal-lattice vectors. The lattice direction [uvw] and possible Bravais type(s) and Laue indices of the corresponding reflections can then be determined by using lookup tables. In addition to determining the lattice direction, this simple geometric analysis allows one to distinguish between the P, I and F Bravais lattices for spot patterns aligned along [013], [112], [114] and [233]. Moreover, the F lattice can always be uniquely identified from the [011] and [123] patterns.

Small-angle X-ray tensor tomography and the related wide-angle X-ray tensor tomography are X-ray imaging techniques that tomographically reconstruct the anisotropic scattering density of extended samples. In previous studies, these methods have been used to image samples where the scattering density depends slowly on the direction of scattering, typically modeling the directionality, i.e. the texture, with a spherical harmonics expansion up until order ℓ = 8 or lower. This study investigates the performance of several established algorithms from small-angle X-ray tensor tomography on samples with a faster variation as a function of scattering direction and compares their expected and achieved performance. The various algorithms are tested using wide-angle scattering data from an as-drawn steel wire with known texture to establish the viability of the tensor tomography approach for such samples and to compare the performance of existing algorithms.

Structural modelling of operando pair distribution function (PDF) data of complex functional materials can be highly challenging. To aid the understanding of complex operando PDF data, this article demonstrates a toolbox for PDF analysis. The tools include denoising using principal component analysis together with the structureMining, similarityMapping and nmfMapping apps available through the online service `PDF in the cloud' (PDFitc, https://pdfitc.org/). The toolbox is used for both ex situ and operando PDF data for 3 nm TiO2-bronze nanocrystals, which function as the active electrode material in a Li-ion battery. The tools enable structural modelling of the ex situ and operando PDF data, revealing two pristine TiO2 phases (bronze and anatase) and two lithiated LixTiO2 phases (lithiated versions of bronze and anatase), and the phase evolution during galvanostatic cycling is characterized.

Understanding the structure–property relationship in electrocatalysts under working conditions is crucial for the rational design of novel and improved catalytic materials. This paper presents the Aarhus University reactor for electrochemical studies using X-rays (AUREX) operando electrocatalytic flow cell, designed as an easy-to-use versatile setup with a minimal background contribution and a uniform flow field to limit concentration polarization and handle gas formation. The cell has been employed to measure operando total scattering, diffraction and absorption spectroscopy as well as simultaneous combinations thereof on a commercial silver electrocatalyst for proof of concept. This combination of operando techniques allows for monitoring of the short-, medium- and long-range structure under working conditions, including an applied potential, liquid electrolyte and local reaction environment. The structural transformations of the Ag electrocatalyst are monitored with non-negative matrix factorization, linear combination analysis, the Pearson correlation coefficient matrix, and refinements in both real and reciprocal space. Upon application of an oxidative potential in an Ar-saturated aqueous 0.1 M KHCO3/K2CO3 electrolyte, the face-centered cubic (f.c.c.) Ag gradually transforms first to a trigonal Ag2CO3 phase, followed by the formation of a monoclinic Ag2CO3 phase. A reducing potential immediately reverts the structure to the Ag (f.c.c.) phase. Following the electrochemical-reaction-induced phase transitions is of fundamental interest and necessary for understanding and improving the stability of electrocatalysts, and the operando cell proves a versatile setup for probing this. In addition, it is demonstrated that, when studying electrochemical reactions, a high energy or short exposure time is needed to circumvent beam-induced effects.

Here, a morphologically based approach is used for the in situ characterization of 3D growth rates of facetted crystals from the solution phase. Crystal images of single crystals of the β-form of l-glutamic acid are captured in situ during their growth at a relative supersaturation of 1.05 using transmission optical microscopy. The crystal growth rates estimated for both the {101} capping and {021} prismatic faces through image processing are consistent with those determined using reflection light mode [Jiang, Ma, Hazlehurst, Ilett, Jackson, Hogg & Roberts (2024). Cryst. Growth Des. 24, 3277–3288]. The growth rate in the {010} face is, for the first time, estimated from the shadow widths of the {021} prismatic faces and found to be typically about half that of the {021} prismatic faces. Analysis of the 3D shape during growth reveals that the initial needle-like crystal morphology develops during the growth process to become more tabular, associated with the Zingg factor evolving from 2.9 to 1.7 (>1). The change in relative solution supersaturation during the growth process is estimated from calculations of the crystal volume, offering an alternative approach to determine this dynamically from visual observations.

The general equation of the δ direct methods is established and applied in its difference form to the definition of one of the two residuals that constitute the SMAR phasing algorithm. These two residuals use the absolute value of ρ and/or the zero conversion of negative Fourier ripples (≥50% of the unit-cell volume). Alternatively, when solved for ρ, the general equation provides a simple derivation of the already known δM tangent formula.

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What an animal eats is a fundamental aspect of its biology, but surprisingly, the evolution of diet had not been studied across the animal kingdom until now. Scientists at the University of Arizona report several unexpected findings from taking a deep dive into the evolutionary history of more than one million animal species and going back 800 million years, when the first animals appeared on our planet. The study revealed several surprising key insights: Many species living today that are carnivorous, meaning they eat other animals, can trace this diet back to a common ancestor more than 800 million years ago; A plant-based, or herbivorous, diet is not the evolutionary driver for new species that it was believed to be; Closely related animals tend to share the same dietary category -- plant-eating, meat-eating, or both. This finding implies that switching between dietary lifestyles is not something that happens easily and often over the course of evolution.

Image credit: Daniel Stolte/UANews

Many hospitals around the country, including Medstar Washington Hospital in Washington DC., have started sharing their prices online in compliance with a recent federal rule.; Credit: DANIEL SLIM/AFP via Getty Images

A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use.

Long hidden, such price variations are supposed to be available in stark black and white under a Trump administration price transparency rule that took effect at the start of this year. It requires hospitals to post a range of actual prices — everything from the rates they offer cash-paying customers to costs negotiated with insurers.

Many have complied.

But some hospitals bury the data deep on their websites or have not included all the categories of prices required, according to industry analysts. A sizable minority of hospitals have not disclosed the information at all.

While imperfect and potentially of limited use right now to the average consumer, the disclosures that are available illustrate the huge differences in prices — nationally, regionally and within the same hospital. But they're challenging for consumers and employers to use, giving a boost to a cottage industry that analyzes the data.

While it's still an unanswered question whether price transparency will lead to overall lower prices, KHN took a dive into the initial trove of data to see what it reveals. Here are five takeaways from the newly public data and tips for how you might be able to use it to your benefit

1) As expected, prices are all over the map

The idea behind the requirement to release prices is that the transparency may prompt consumers to shop around, weighing cost and quality. Perhaps they could save a few hundred dollars by getting their surgery or imaging test across town instead of at the nearby clinic or hospital.

Under the Trump-era rule, hospitals must post what they accept from all insurers for thousands of line items, including each drug, procedure or treatment they provide. In addition, hospitals must present this in a format easily readable by computers and include a consumer-friendly separate listing of 300 "shoppable" services, bundling the full price a hospital accepts for a given treatment, such as having a baby or getting a hip replacement.

The negotiated rates now being posted publicly often show an individual hospital accepting a wide range of prices for the same service, depending on the insurer, often based on how much negotiating power each has in a market.

In some cases, the cash-only price is less than what insurers pay. And prices may vary widely within the same city or region.

In Virginia, for example, the average price of a diagnostic colonoscopy is $2,763, but the range across the state is from $208 to $10,563, according to a database aggregated by San Diego-based Turquoise Health, one of the new firms looking to market the data to businesses, while offering some information free of charge to patients.

2) Patients can look up the information, but it's incomplete

Patients can try to find the price information themselves by searching hospital websites, but even locating the correct tab on a hospital's website is tricky.

Typically, consumers don't comparison-shop, preferring to choose convenience or the provider their doctor recommends. A recent Peterson-KFF Health System Tracker brief, for instance, found that 85% of adults said they had not researched online the price of a hospital treatment.

And hospitals say the transparency push alone won't help consumers much, because each patient's situation is different and may vary from the average— and individual deductibles and insurance plans complicate matters.

But if you do want to try, here's one tip: "You can Google the hospital name and the words 'price transparency' and see where that takes you," says Caitlin Sheetz, director and head of analytics at the consulting firm ADVI Health in the Washington, D.C., metro area.

Typing in "MedStar Health hospital transparency," for example, likely points to the MedStar Washington Hospital Center's "price transparency disclosure" page, with a link to its full list of prices, as well as its separate list of 300 shoppable services.

By clicking on the list of shoppable services, consumers can download an Excel file. Searching it for "colonoscopy" pulls up several variations of the procedure, along with prices for different insurers, such as Aetna and Cigna, but a "not available" designation for the cash-only price. The file explains that MedStar does not have a standard cash price but makes determinations case by case.

Performing the same Google search for the nearby Inova health system results in less useful information.

Inova's website links to a long list of thousands of charges, which are not the discounts negotiated by insurers, and the list is not easily searchable. The website advises those who are not Inova patients or who would like to create their own estimate to log into the hospitals' "My Chart" system, but a search on that for "colonoscopy" failed to produce any data.

3) Third-party firms are trying to make searching prices simpler – and cash in

Because of the difficulty of navigating these websites — or locating the negotiated prices once there — some consumers may turn to sites like Turquoise. Another such firm is Health Cost Labs, which will have pricing information for 2,300 hospitals in its database when it goes live July 1.

Doing a similar search for "colonoscopy" on Turquoise shows the prices at MedStar by insurer, but the process is still complicated. First, a consumer must select the "health system" button from the website's menu of options, click on "surgical procedures," then click again on "digestive" to get to it.

There is no similar information for Inova because the hospital has not yet made its data accessible in a computer-friendly format, said Chris Severn, CEO of Turquoise.

Inova spokesperson Tracy Connell said in a written statement that the health system will create personalized estimates for patients and is "currently working to post information on negotiated prices and discounts on services."

Firms like Turquoise and Health Cost Labs aim to sell the data gathered from hospitals nationally to insurers, employers and others. In turn, those groups may use it in negotiations with hospitals over future prices. While that may drive down prices in areas with a lot of competition, it might do the opposite where there are few hospitals to choose from, or in situations where a hospital raises its prices to match competitors.

4) Consumers could use this data to negotiate, especially if they're paying cash

For consumers who go the distance and can find price data from their hospitals, it may prove helpful in certain situations:

• Patients who are paying cash or who have unmet deductibles may want to compare prices among hospitals to see if driving farther could save them money.
• Uninsured patients could ask the hospital for the cash price or attempt to negotiate for the lowest amount the facility accepts from insurers.
• Insured patients who get a bill for out-of-network care may find the information helpful because it could empower them to negotiate a discount off the hospitals' gross charges for that care.

While there's no guarantee of success, "if you are uninsured or out of network, you could point to some of those prices and say, 'That's what I want,'" says Barak Richman, a contract law expert and professor of law at Duke University School of Law.

But the data may not help insured patients who notice their prices are higher than those negotiated by other insurers.

In those cases, legal experts say the insured patients are unlikely to get a bill changed because they have a contract with that insurer, which has negotiated the price with their contracted hospitals.

"Legally, a contract is a contract," says Mark Hall, a health law professor at Wake Forest University.

Richman agrees.

"You can't say, 'Well, you charged that person less,'" he notes, but neither can they say they'll charge you more.

Getting the data, however, relies on the hospital having posted it.

5) Hospitals still aren't really on board

When it comes to compliance, "we're seeing the range of the spectrum," says Jeffrey Leibach, a partner at the consulting firm Guidehouse, which found earlier this year that about 60% of 1,000 hospitals surveyed had posted at least some data, but 30% had reported nothing at all.

Many in the hospital industry have long fought transparency efforts, even filing a lawsuit seeking to block the new rule. The suit was dismissed by a federal judge last year.

They argue the rule is unclear and overly burdensome. Additionally, hospitals haven't wanted their prices exposed, knowing that competitors might then adjust theirs, or health plans could demand lower rates. Conversely, lower-cost hospitals might decide to raise prices to match competitors.

The rule stems from requirements in the Affordable Care Act. The Obama administration required hospitals to post their chargemaster rates, which are less useful because they are generally inflated, hospital-set amounts that are almost never what is actually paid.

Insurers and hospitals are also bracing for next year when even more data is set to come online. Insurers will be required to post negotiated prices for medical care across a broader range of facilities, including clinics and doctors' offices.

In May, the Centers for Medicare & Medicaid Services sent letters to some of the hospitals that have not complied, giving them 90 days to do so or potentially face penalties, including a $300-a-day fine.

"A lot of members say until hospitals are fully compliant, our ability to use the data is limited," says Shawn Gremminger, director of health policy at the Purchaser Business Group on Health, a coalition of large employers.

His group and others have called for increasing the penalty for noncomplying hospitals from $300 a day to $300 a bed per day, so "the fine would be bigger as the hospital gets bigger," Gremminger says. "That's the kind of thing they take seriously."

Already, though, employers or insurers are eyeing the hospital data as leverage in negotiations, says Severn, Turquoise's CEO. Conversely, some employers may use it to fire their insurers if the rates they're paying are substantially more than those agreed to by other carriers.

"It will piss off anyone who is overpaying for health care, which happens for various reasons," he says.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation).

This content is from Southern California Public Radio. View the original story at SCPR.org.

A passenger wearing a protective face covering to combat the spread of the coronavirus, checks her phone while travelling on a bus along Oxford Street in central London on July 5, 2021.; Credit: DANIEL LEAL-OLIVAS/AFP via Getty Images

In our continuing series looking at the latest medical research and news on COVID-19, Larry Mantle speaks with Professor Kristen Choi of UCLA. 

Topics today include:

• Biden to announce new efforts on vaccination campaign as Delta variant spreads

• Hospitalization rates getting worse for black residents of L.A. County 

• Which parts of the U.S. could be breeding grounds for variants?

• New Israeli data about effectiveness of Pfizer against Delta variant

• England to lift mask restrictions

• Cases on rise in immigration detention centers in the U.S. 

• Bay area zoo is vaccinating big cats and some other animals 

Guest:

Kristen R. Choi, professor of nursing and public health at UCLA; registered nurse practicing at Gateways Hospital, based in Echo Park

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Dr. Jill Baron, Director of the Powell Center, will present a webinar on how to develop a strong proposal for Working Group on November 19th, 2024, at 11am MT/1pm ET.

President Biden listens as Florida Governor Ron DeSantis speaks about the collapse of the 12-story Champlain Towers South condo building in Surfside, Florida.; Credit: Saul Loeb/AFP via Getty Images

President Biden landed in Florida on Thursday to visit privately with families whose loved ones were in the 12-story Champlain Towers South condo when it collapsed.

Biden also met with first responders to thank them for their rescue work. Search and rescue efforts paused on Thursday because of structural concerns. So far, 145 people are still unaccounted for while 18 people have been confirmed dead.

During a briefing with local and state officials, Biden said the federal government would pick up 100% of the costs associated with the response to the building collapse. I think I have the power and will know shortly to be able to pick up 100% of the costs of the county and the state. I'm quite sure I can do that," Biden said.

Biden sat beside Florida's Republican Governor Ron DeSantis, who thanked the president for his support, saying "we've had no bureaucracy" from the Federal Emergency Management Agency.

"You recognize in each individual unit, there's an amazing story, and lives have been shattered irrevocably, as a result of this," DeSantis said. "We have families with kids missing. And we even have young newlyweds who hadn't even been married a year who were in the tower when it collapsed," he said.

"What we just need now is we need a little bit of luck. We need a little bit of prayers. And you know, we would like to be able to, you know, to see some miracles happen," DeSantis said.

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Stillwater Critical Minerals Corp. (PGE:TSX.V; PGEZF:OTCQB; J0G:FSE) has announced new assay results from its ongoing resource expansion drilling at the Stillwater West PGE-Ni-Cu-Co + Au project. Read more for detailed insights into the high-grade rhodium intercepts and resource expansion potential.

This Buy-rated Canadian explorer-developer is working to achieve first mover status in this emerging clean energy space. Find out what all it has done and is doing.

This Buy-rated Canadian explorer-developer is working to achieve first mover status in this emerging clean energy space. Find out what all it has done and is doing.

The pandemic has once again felled Burning Man. Some burners still plan to gather for informal events on the dusty Black Rock Desert Playa this summer.; Credit: Bernard Friel/Education Images/Universal Images Group via Getty Images

And so it goes: Burning Man 2021 is canceled. It's the second year in a row, the popular arts festival won't be held in Nevada's Black Rock Desert due to the pandemic.

"We have decided to set our sights on Black Rock City 2022," event officials announced in a blog post on Tuesday. In a frequently-asked-questions section, organizers added: "We've heard from many who don't feel ready to come to Black Rock City. While we're confident in our ability to get a permit and to safeguard public health, we know that co-creating Black Rock City in 2021 would put tremendous strain on our community while we are still ironing out uncertainty."

Many would-be attendees praised the decision in comments on the Burning Man website and on social media as a safe one; others are anxiously anticipating a bigger and better 2022 Burn.

But the cancellation has put many people in the event's host community at ease.

Wary of a trend of rising coronavirus cases in some parts of the region, Washoe County's district health officer Kevin Dick said "the right call was made," in order to lower the risk of spreading infection.

"The event draws thousands of people from all over the world," Dick said in an email. "We are seeing large outbreaks of COVID-19 occurring in a number of countries, areas where very contagious COVID-19 variants of concern are prevalent and where low rates of vaccination are occurring."

The head of a local Paiute tribe is also feeling less burdened knowing there won't be the annual pilgrimage. The main highway to get to the Black Rock Desert playa, which normally draws tens of thousands of people to the summer event, cuts through tribal lands.

"For us it is a sigh of relief," said Janet Davis, chairwoman of the Pyramid Lake Paiute Tribe.

Although the event — which brings in about $63 million to the state annually — gives the tribal community a welcome financial boost, Davis said.

"We don't know who's vaccinated and who's not," she said. "We've been trying to keep our reservation safe and that happening was too soon for us to open."

As with last year, the organization will offer virtual programming during Burn Week, from Aug. 29 through Sept. 7, an experience they say drew 165,000 participants in 2020.

In response to a request for more details on the reasons for the cancellation, Burning Man organizers declined to comment further. Earlier this month, though, CEO Marian Goodell said the organization was "weighing the gravity" of implementing a vaccination requirement that she said challenged "radical inclusion," one of the group's 10 principles.

Still, for many burners, the news won't extinguish their plans to trek to the desert in droves. Just like last year, revelers are preparing to hold unofficial gatherings on public land in place of the annual event.

Last summer, those events — the so-called "rogue" and "free" burns or, unmistakably, "Not Burning Man" — drew an estimated 3,000 people to Black Rock Desert during the time Burning Man is normally held, according to the Bureau of Land Management, the federal agency that approves the organization's permits each year.

Kevin Jervis, one such attendee who now lives in Gerlach — a tiny desert town near the event site — welcomed this year's cancellation.

He called it "more of a relief than anything. ... A lot of us liked it better the way it happened last year."

During the informal festivities, Jervis spent a few days between the playa and its outskirts. He said he and his fellow burners felt like it represented the festival's freewheeling roots.

"I've had friends that have been going since '94 and they said it was a lot more like it used to be. We didn't have to go by regulations," he said. "We could have guns, dogs ... it was a lot freer."

Even before the pandemic, burners increasingly saw an annual gathering under siege.

Event-goers who adhere to Burning Man's counterculture beginnings say the festival's explosion in popularity in the past decade has welcomed a host of bad actors who trash the desert and surrounding communities and disregard the event's founding principles, including "decommodification" and the eco-friendly philosophy of "leave no trace."

Some of those perceived threats come from festival officials themselves, he said. A ticket to the main event alone cost over $400 in 2019 — a financial hurdle critics say goes against another tenet long espoused, that "everyone is invited."

"People that have never been before came out last year because they either couldn't get a ticket other years or they were just kind of curious. Or they didn't have the money to go to the actual Burn," said Jervis.

As for the Pyramid Lake Paiute community, with the reservation largely closed during that period last year, Davis said, "we really didn't see the impact" from a public health standpoint.

"You're not talking about 65 — 75,000 people." While there was more traffic, she said, "they moseyed on through and moseyed on out."

In the years leading up to the pandemic, BLM had been cracking down on the event's growth. Were the festival to return this year, Burning Man organizers said they would have had to meet a population cap of 69,000, down from its 80,000 limit for previous events.

Jervis says he won't miss what he describes as organizers' leniency toward "elites" who set up VIP areas at their camps and hire out to construct their art creations instead of making their own.

"A lot of people have gotten sick of what Burning Man's kind of become," he said.

Even if this year was a go, he said, burners would still be setting up their own Burning Man-adjacent happenings.

Following the announcement of the event's cancellation, people are taking to Facebook groups to reminisce about last year's unsanctioned burns and discuss preparations for their own this summer.

"So it seems that as of today there isn't going to be an official [Burning Man Ceremony] this year," James Zapata wrote. "So who's joining me in the dust?"

This content is from Southern California Public Radio. View the original story at SCPR.org.

An American flag flies from a crane on July 4th next to the Champlain Towers South condo building, where scores of victims remain missing more than a week after it partially collapsed.; Credit: Lynne Sladky/AP

Preparations continue in Surfside, Fla. for the demolition of a portion of the Champlain Towers South still standing after much of the building collapsed in the early morning hours on June 24.

Miami-Dade County Mayor Daniella Levine Cava told reporters on Sunday that bringing down the remainder of the collapsed condominium in a controlled fashion is crucial to the safety of search and rescue teams.

Those teams have paused their work so demolition can take place. Levine Cava said officials are still unsure of a specific time that the demolition will occur.

"Our top priority is that the building can come down as soon as possible — no matter what time that occurs — and safely as possible," Levine Cava said at a morning news conference.

The number of confirmed dead from the collapse remains at 24. The number of people unaccounted for remains at 121.

Preparations for the demolition come as Tropical Storm Elsa is tracking towards southern Florida. The storm is expected to hit the area Monday and Tuesday.

The instability of the building could be made worse by the storm, which is expected to bring strong winds and rain at the beginning of the week. Mayor Levine Cava said that as soon as the demolition has occurred, search and rescue efforts are expected to resume.

Ahead of Elsa's arrival in Florida, Gov. Ron DeSantis issued a state of emergency Saturday for 15 counties, including Miami-Dade.

On Sunday, he expressed optimism that the Surfside area may be spared from the worst of the storm.

"We could see some gusts, but it has tracked west over the last day and a half — more so than the initial forecast," he said. "So, we'll just keep watching that."

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Crews searching the building collapse site in Surfside, Fla., have discovered four more victims since Monday, bringing the death toll to 32. Authorities have identified 26 of the bodies.

Another 113 people were unaccounted for, though local officials said they had only been able to confirm that about 70 of those people were in the building at the time of the collapse nearly two weeks ago.

Detectives are continuing to follow up on reports submitted about possible victims in the partial collapse, but in some cases they have been unable to reach those who submitted the tips in the first place.

"People call anonymously. People call and don't leave return phone numbers. People call with partial information, not enough to really secure whether that person may or may not have been in the building," Miami-Dade County Mayor Daniella Levine Cava told reporters on Tuesday.

Some of the reports of possible victims are also incomplete, she said, including a name but no apartment number or no date of birth.

Levine Cava urged people who are missing loved ones to communicate with local authorities. She said there may also be victims of the collapse who have not been reported missing.

The rescue effort stopped briefly overnight due to lightning from a passing storm. Surfside Mayor Charles Burkett said high winds were hampering the cranes moving heavy debris from the collapse site.

Lt. Gov. Jeanette Nuñez said Florida has declared a state of emergency ahead of Tropical Storm Elsa, which is expected to reach hurricane strength before making landfall Wednesday morning on the state's west coast.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Three area mayors and several other local officials recently participated in Mayors for Meals in Catawba County. This event was sponsored by Catawba County Social Services� Senior Nutrition Programs, which operates Meals on Wheels, Seniors Morning Out and other senior nutrition programs serving more than 1,000 people.

Catawba County�s Meals on Wheels program has nominated Winnie Hovey for the award and is asking the public to vote for Hovey in the contest. The contest is featured on Facebook, and the top vote-getter will be named the winner.

Winnie Hovey has won the American Volunteer contest sponsored by the Meals on Wheels Association of America. Hovey is a 92-year-old Hickory resident who has been volunteering with the local Meals on Wheels organization for approximately 30 years

Catawba County 4-H Club members are collecting dry dog and cat food for the pets of Catawba County Meals on Wheels recipients.

Bacteria that resist antibiotics can be passed from food animals to humans, but not enough is known to determine the public health risks posed by such transmission, says a new report by a committee of the National Research Council.

Marijuanas active components are potentially effective in treating pain, nausea, the anorexia of AIDS wasting, and other symptoms, and should be tested rigorously in clinical trials.

A limited body of evidence suggests an association between military service and later development of amyotrophic lateral sclerosis (ALS), a rare but fatal neurodegenerative disorder, says a new report from the Institute of Medicine.

Recipients of the 10th annual Communication Awards were announced today by the National Academy of Sciences, National Academy of Engineering, and Institute of Medicine.

During the National Academy of Medicine (NAM) Annual Meeting, Leonard Rubenstein, Director of the Program on Human Rights, Health and Conflict (Center for Public Health and Human Rights) at Johns Hopkins Bloomberg School of Public Health, and Dr. Denis Mukwege, founder and medical director of Panzi Hospital in the DRC, spoke to NAM members about attacks against healthcare professionals globally and the importance of supporting the work of medical professionals in conflict zones.

While scientists have made remarkable advancements in astronomy and astrophysics since the beginning of this decade – notably the first detection of gravitational waves and the discovery of distant Earth-like planets – unforeseen constraints have slowed progress toward reaching some of the priorities and goals outlined in the Academies’ 2010 decadal survey of these disciplines, says a new report from the National Academies of Sciences, Engineering, and Medicine.