And they were armed with paintbrushes, not hockey sticks.

The Panthers — a few hours before their Winter Classic outdoor game at the Miami Marlins’ ballpark against the New York Rangers — unveiled a couple dozen panther sculptures, all painted in a unique way and now being auctioned off with hopes of raising $1 million for cancer research.

Gretzky commissioned a sculpture that displays some of his stats, Johnson arranged one depicting a scene from Augusta National, Bublé’s is adorned in rhinestone braille, the NBA’s Heat commissioned a pair of sculptures with some of the team’s themes, artist Romero Britto painted one as well and Navratilova didn’t technically paint hers — she dipped tennis balls into paint and then served them into the panther, creating a polka-dotted splash of various colors.

“To be able to have the privilege to reach out and make those contacts and have those folks say, ‘Of course,’ what a gift that was,” Panthers general manager and hockey operations president Bill Zito said. “It’s just so neat.”

About $700,000 has been raised already, Zito said. The idea for the fundraiser — “Panthers on the Prowl,” they call it — is loosely built around Chicago’s “Cows on Parade” art project. Zito and his wife Julie co-chair the Panthers’ project; she is a breast cancer survivor, and Zito has lost a number of relatives to the disease.

“It was my wife Julie’s idea,” Zito said. “And we lived in Chicago during ‘Cows on Parade,’ and then Romero Britto said we should auction them. I can’t take credit for any of it.”

Many of the panthers were on display at LoanDepot Park on Friday, where about 35,000 fans attending the Winter Classic would see them.

“There’s a tear and a smile,” Zito said. “And then you think, you know what, there’s a reason that everybody is engaged. There’s a reason that everybody gave their time and their talent. And it’s because it works and it’s right.”

When Yraida Faneite was on trial for drug-related charges, the judge had to halt proceedings at one point because her period was so heavy that blood was running down her legs.

The same struggle followed her into a federal prison in Florida after she was convicted. For about a decade, officials allowed her only a small ration of menstrual products, and she couldn’t afford extra pads from the commissary. She bartered with other women. On her worst days, she tore up her own T-shirts and used them as makeshift pads.

When she told officers she needed to see a doctor and couldn’t safely continue a mandatory kitchen shift, she said, she was placed in solitary confinement. She eventually found out that her heavy bleeding was caused by cysts.

“I didn’t have enough napkins to use during my period. … No matter what you say, they don’t care,” recalled Faneite, who was released from prison in 2006 and went on to found the prison reentry nonprofit YG Institute.

Her experience echoes what researchers, advocates and formerly incarcerated people describe across prisons and jails nationwide: Even where menstrual products are available, limited supplies, low-quality products, strict disciplinary rules and delays in medical care can result in incarcerated people facing potentially avoidable health issues or disciplinary write-ups.

Access to menstrual products also has been a persistent issue in immigration detention centers, with recent reports and lawsuits alleging that women in some facilities have been unable to obtain or outright denied feminine hygiene products despite federal standards and law requiring sufficient and timely access.

A new report from the Prison Policy Initiative, a research and advocacy organization, says that menstruation is still regularly treated as a disciplinary matter — through contraband rules, work violations and sanitation write-ups — even in prisons and jails that provide free products.

These disciplinary actions can affect everything from parole eligibility to access to programming and services.

Women make up a growing share of the state prison population, which rose about 5% nationwide from 2022 to 2023, according to the latest data from the federal Bureau of Justice Statistics.

In recent years, more states have begun taking steps to improve access to menstrual products in jails and prisons, and to address the overall conditions that shape incarcerated women’s experiences.

The Ohio legislature last month passed legislation to strengthen access to period products for incarcerated people in jails and prisons. The bill is awaiting the governor’s signature. And Wisconsin lawmakers introduced a bill on the issue this month.

At least 24 states and Washington, D.C., require that people in state prisons or local jails have free access to menstrual products, according to the National Conference of State Legislatures. Federal correctional facilities have provided free products since 2017.

More than a dozen states have passed versions of the Dignity of Incarcerated Women Act, which includes provisions to improve basic conditions, such as access to and the quality of period products and pregnancy care.

Still, in most of the country, access depends on a patchwork of laws and corrections department policies. Nearly every state has a rule on the books about providing menstrual products, but the specifics, implementation and enforcement vary widely. Advocates say that leaves many incarcerated people without the consistent access they need.

“In the system that we have where there’s very little oversight, accountability, transparency, you have no easy way of enforcement,” said Miriam Vishniac, the founder and director of the Prison Flow Project, a database tracking access to menstrual products in U.S. jails and prisons.

In Alabama, the state Department of Corrections says it provides menstrual products — pads and tampons — free of charge. People can choose a monthly allotment of 30 pads, 30 tampons or a mix of both. Housing unit staff keep small supplemental supplies on hand and can issue additional products as needed, according to Rand Champion, the agency’s chief of communications.

In Colorado, corrections officials said staff are prohibited from using access to menstrual products as a behavior-management tool, and facilities are required to keep products stocked and available regardless of an individual’s financial status.

Maryland’s policy requires correctional facilities to provide menstrual products at no cost during admission or transfer, on a monthly basis and upon request. The state says it offers tampons, winged pads, and both light- and heavy-flow pads. The products must be provided in quantities appropriate to each person’s health needs. Corrections officials told Stateline there have been no recent challenges with implementation.

In the months after a Maryland law requiring correctional facilities to provide free menstrual products and maintain a sufficient supply took effect in 2018, advocates said women at the Correctional Institution for Women were still paying for tampons and relying on flimsy pads handed out each month. State officials acknowledged the policy was not being implemented consistently systemwide.

Rules and restrictions

The new report from the Prison Policy Initiative outlines several ways that prison and jail rules can indirectly penalize people who menstruate.

Some facilities classify having more pads or tampons than the allowed number as contraband, which can lead to confiscation or formal disciplinary actions. Rules on property and hygiene mean that leaking through uniforms or bedding may be treated as a violation.

Asking for additional menstrual products can sometimes be interpreted as abusing medical rules or “feigning illness.” And trading or sharing products with other incarcerated people may also be prohibited under unauthorized exchange rules, the report said.

“It’s just another reminder that they have no autonomy over themselves, over their bodies, over their lives,” said Alycia Welch, the associate director of the Prison and Jail Innovation Lab at the University of Texas at Austin.

Access is further complicated by shower schedules and clothing allocations, which can make it difficult to change products regularly. Items available for purchase at the commissary — including pads, tampons and pain relief — are often costly.

Transgender men, nonbinary people and older women who menstruate or experience irregular cycles may face additional scrutiny or confusion from staff when requesting menstrual products, creating further barriers, according to prison policy experts.

Disciplinary actions can include fines, loss of commissary privileges, restrictions on phone or visitation access or placement in segregation units.

Many advocates and formerly incarcerated people say that even in facilities that provide free menstrual products, the supplies are often of poor quality, with thin pads and low-absorbency tampons.

“We can’t just stop at creating these rules that mandate that people have access to these products,” Vishniac, of the Prison Flow Project, said. “There needs to be some kind of way of ensuring that it’s actually happening.”

Strengthening access in Ohio

The bill Ohio lawmakers unanimously passed would require that all incarcerated women in state or local correctional facilities have free access to feminine hygiene products. It also would mandate that facilities allow incarcerated women to shower once per day while menstruating.

The bill also would require safe, designated disposal containers for used menstrual products and prohibit denial of products based on race, sex, income, charge, disability or other protected traits and identities.

In 2022, the Ohio Department of Rehabilitation and Correction adopted a new policy requiring state prisons (but not jails) to provide free menstrual products; advocates, however, say there’s no mechanism to hold staff or facilities accountable.

While the bill does not lay out an explicit oversight mechanism, its language would give incarcerated women a clear legal standard they can reference if access is denied, said Kayelin Tiggs, an advocate who helped author the bill’s language. Tiggs created the Ohio Coalition for Menstrual Equity.

“The fact that we were able to pass it here with that anti-discrimination language is a good sign,” Tiggs said. “I feel like we could take this nationally.”

Stateline reporter Amanda Watford can be reached at ahernandez@stateline.org.

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

The new year is a time when many try to start new good habits and commit to improving health and wellness.

But resolutions, lofty as they may be, can turn daunting quickly with all the advice and sometimes contradicting information coming at you from news reports, advertisers, influencers, friends and even politicians.

But they don’t have to be.

This year, The Associated Press got the downlow on all manner of health and wellness claims and fads. The good news is that the experts mostly say to keep it simple.

As 2026 arrives, here’s what you can skip, what you should pay attention to and how to get credible information when you are inevitably faced with more confusing claims next year.

Protein and fiber are important, but you probably don’t need to pay more

When it comes to your diet, experts say most people can skip the upcharge. If you’re eating enough, you’re probably getting enough protein and don’t need products that promise some big boost.

And it’s true that most people could use more fiber in their diets. But, please, ditch the “fiber-maxxing” trend. Instead, eat whole foods such as fruits, vegetables, beans and whole grains.

A good skin care routine is not expensive or complicated

That 20-step skin care routine and $200 serum some TikToker sold you on? Dermatologists say you really don’t need it. Stay away from the beef tallow and slather on a good sunscreen instead (yes, even if you have darker skin ), they say.

And the same rule for simplicity applies to that hourlong “everything shower.” The best showers are simple and short, dermatologists say, no “double cleansing” required.

There are many simple ways to get that workout in

If the gym and all its equipment feel intimidating, you can drop the illusion that a good workout requires either. This year, the comeback of calisthenics put the focus back on no frills, bodyweight workouts you can do in the comfort of home. Research shows calisthenics helps with muscle strength and aerobic conditioning. You may eventually need weightlifting or other equipment, but it is a great place to start to build consistency and confidence.

Be wary of wellness fads and treatments — they are often too good to be true

Even if you imbibe too much this New Year’s Eve, doctors say you can do without “IV therapy” which have vitamins you can get more easily and cheaper in pill form — if you even need more, which is unlikely if you have a balanced diet. You’re pretty much just paying for “expensive urine,” one doctor said.

Same for “wellness” focused products like microbiome testing kits that generate information that doctors can’t actually act on. And if you don’t have diabetes, there’s scant evidence that you need a continuous glucose monitor.

To improve your health, go back to the basics

The idea of a panacea pill, product or routine can be enticing. But science already knows a lot about how to improve mental and physical health, and they are tried and true:

1. Whether you’re in the city or the country — walk more. Research shows walking is great for physical and mental health. It’s so good for you, doctors are literally prescribing time in the outdoors to their patients.

2. Take steps to get certain health metrics under control, like high blood pressure, which often goes undiagnosed and is known to cause a range of health problems down the road. Prioritize getting enough sleep, and make sure your family does too. Don’t just eat right — eat slower.

3. Give your mind some care too. Set better boundaries with your technology and regain and retrain your attention span. Build out your social networks and invest in all forms of love for the people around you.

These lifestyle changes don’t just make you feel better in the moment. Research shows they impact your life for years to come, by lowering the risk of dementia and many other health issues.

Don’t know who to trust? Start with your doctor

It can be tough to know who to listen to about your health, faced with compelling personal stories on social media from people who swear something worked from them, or clever marketing and advertising from companies that scare you or promise an easy fix.

Doubts have been raised this year about established medicine, including the safety of food dyes, fluoride dental treatments,hepatitis B shot for newborns, and hormone therapies for menopause.

While the medical system is not perfect, your doctor remains the best person to talk to about prevention, health concerns and potential treatments.

If you can’t get to a human doctor and turn to Dr. Google instead, be sure to follow these tips and never use it to diagnose yourself. When you do get that doctor’s appointment, you can make the most of it by bringing a list of written questions — and don’t hesitate to ask for any clarification you need.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The complaint, filed Thursday on the employees’ behalf by the Human Rights Campaign, is in response to an August announcement from the Office of Personnel Management that it would no longer cover “chemical and surgical modification of an individual’s sex traits through medical interventions” in health insurance programs for federal employees and U.S. Postal Service workers.

The complaint argues that denying coverage of gender-affirming care is sex-based discrimination and asks the personnel office to rescind the policy.

“This policy is not about cost or care — it is about driving transgender people and people with transgender spouses, children, and dependents out of the federal workforce,” Human Rights Campaign Foundation President Kelley Robinson said in a statement announcing the move.

The complaint, filed with the Equal Employment Opportunity Commission, includes testimonies from four current federal workers at the State Department, Health and Human Services and the Postal Service who would be directly affected by the elimination of coverage.

For instance, the Postal Service employee has a daughter whose doctors recommended that she get puberty blockers and potentially hormone replacement therapy for her diagnosed gender dysphoria, which would not be covered under the new OPM policy, according to the complaint.

The complaint notes that the workers are making the claim on behalf of themselves and a “class of similarly situated federal employees.”

The Trump administration has taken other steps to restrict care for transgender Americans, particularly minors. In December, the U.S. Department of Health and Human Services released proposals that would block gender-affirming care to minors, including a policy that would bar Medicare and Medicaid dollars to hospitals that provide such care to children.

Senior Trump officials, such as Health and Human Services Secretary Robert F. Kennedy Jr., call gender-affirming care “malpractice” for minors. But such restrictions go against recommendations from major medical groups such as the American Medical Association and the American Academy of Pediatrics.

NEW YORK (AP) — Enhanced tax credits that have helped reduce the cost of health insurance for the vast majority of Affordable Care Act enrollees expired overnight, cementing higher health costs for millions of Americans at the start of the new year.

Democrats forced a 43-day government shutdown over the issue. Moderate Republicans called for a solution to save their 2026 political aspirations. President Donald Trump floated a way out, only to back off after conservative backlash.

In the end, no one’s efforts were enough to save the subsidies before their expiration date. A House vote expected in January could offer another chance, but success is far from guaranteed.

The change affects a diverse cross-section of Americans who don’t get their health insurance from an employer and don’t qualify for Medicaid or Medicare — a group that includes many self-employed workers, small business owners, farmers and ranchers.

It comes at the start of a high-stakes midterm election year, with affordability — including the cost of health care — topping the list of voters’ concerns.

“It really bothers me that the middle class has moved from a squeeze to a full suffocation, and they continue to just pile on and leave it up to us,” said 37-year-old single mom Katelin Provost, whose health care costs are set to jump. “I’m incredibly disappointed that there hasn’t been more action.”

Some families grapple with insurance costs that are doubling, tripling or more

The expired subsidies were first given to Affordable Care Act enrollees in 2021 as a temporary measure to help Americans get through the COVID-19 pandemic. Democrats in power at the time extended them, moving the expiration date to the start of 2026.

With the expanded subsidies, some lower-income enrollees received health care with no premiums, and high earners paid no more than 8.5% of their income. Eligibility for middle-class earners was also expanded.

On average, the more than 20 million subsidized enrollees in the Affordable Care Act program are seeing their premium costs rise by 114% in 2026, according to an analysis by the health care research nonprofit KFF.

Those surging prices come alongside an overall increase in health costs in the U.S., which are further driving up out-of-pocket costs in many plans.

Some enrollees, like Salt Lake City freelance filmmaker and adjunct professor Stan Clawson, have absorbed the extra expense. Clawson said he was paying just under $350 a month for his premiums last year, a number that will jump to nearly $500 a month this year. It’s a strain for the 49-year-old but one he’s willing to take on because he needs health insurance as someone who lives with paralysis from a spinal cord injury.

Others, like Provost, are dealing with steeper hikes. The social worker’s monthly premium payment is increasing from $85 a month to nearly $750.

Effects on enrollment remain to be seen

Health analysts have predicted the expiration of the subsidies will drive many of the 24 million total Affordable Care Act enrollees — especially younger and healthier Americans — to forgo health insurance coverage altogether.

Over time, that could make the program more expensive for the older, sicker population that remains.

An analysis conducted last September by the Urban Institute and Commonwealth Fund projected the higher premiums from expiring subsidies would prompt some 4.8 million Americans to drop coverage in 2026.

But with the window to select and change plans still ongoing until Jan. 15 in most states, the final effect on enrollment is yet to be determined.

Provost, the single mother, said she is holding out hope that Congress finds a way to revive the subsidies early in the year — but if not, she’ll drop herself off the insurance and keep it only for her four-year-old daughter. She can’t afford to pay for both of their coverage at the current price.

Months of discussion, but no relief yet

Last year, after Republicans cut more than $1 trillion in federal health care and food assistance with Trump’s big tax and spending cuts bill, Democrats repeatedly called for the subsidies to be extended. But while some Republicans in power acknowledged the issue needed to be addressed, they refused to put it to a vote until late in the year.

In December, the Senate rejected two partisan health care bills — a Democratic pitch to extend the subsidies for three more years and a Republican alternative that would instead provide Americans with health savings accounts.

In the House, four centrist Republicans broke with GOP leadership and joined forces with Democrats to force a vote that could come as soon as January on a three-year extension of the tax credits. But with the Senate already having rejected such a plan, it’s unclear whether it could get enough momentum to pass.

Meanwhile, Americans whose premiums are skyrocketing say lawmakers don’t understand what it’s really like to struggle to get by as health costs ratchet up with no relief.

Many say they want the subsidies restored alongside broader reforms to make health care more affordable for all Americans.

“Both Republicans and Democrats have been saying for years, oh, we need to fix it. Then do it,” said Chad Bruns, a 58-year-old Affordable Care Act enrollee in Wisconsin. “They need to get to the root cause, and no political party ever does that.”

WASHINGTON (AP) — Flu is rising rapidly across the U.S., driven by a new variant of the virus — and cases are expected to keep growing with holiday travel.

That variant, known as “subclade K,” led to early outbreaks in the United Kingdom, Japan and Canada. In the U.S., flu typically begins its winter march in December. On Tuesday, the Centers for Disease Control and Prevention reported high or very high levels of illness in more than half the states.

The CDC estimated there have been at least 7.5 million illnesses, 81,000 hospitalizations and 3,100 deaths from flu so far this season. That includes at least eight child deaths — and is based on data as of Dec. 20, before major holiday gatherings.

Some states are particularly hard-hit. New York’s health department said the week ending Dec. 20 marked the most flu cases the state had recorded in a single week since 2004: 71,000.

It’s far too soon to know if this flu season will be as severe as last winter’s.

But it’s not too late to get a flu shot, which health experts say can still prevent severe illness even if someone gets infected. While this year’s vaccine isn’t a perfect match to the subclade K strain, a preliminary analysis from the U.K. found it offered at least partial protection, lowering people’s risk of hospitalization.

According to the CDC, only about 42% of adults and children have gotten a flu vaccination so far this year.

What is subclade K flu?

The flu virus is a shape-shifter, constantly mutating, and it comes in multiple forms. There are two subtypes of Type A flu, and subclade K is a mutated version of one of them, named H3N2. That H3N2 strain is always harsh, especially for older adults.

Subclade K’s mutations aren’t enough of a change to be considered an entirely new kind of flu.

But they’re different enough to evade some of the protection from this year’s vaccine, said Andrew Pekosz, a virus expert at Johns Hopkins Bloomberg School of Public Health.

Will subclade K make people sicker?

The CDC said it’s too soon to know how severe this season will be.

Flu seasons dominated by any version of H3N2 tend to be bad, with more infections overall and more people becoming seriously ill. But Hopkins’ Pekosz cautioned it will take time to tease apart whether this subclade K version simply spreads more easily or also is more dangerous.

That question aside, the CDC notes there are some prescription medicines to treat flu — usually recommended for people at high risk of complications. But they generally need to be started a day or two after symptoms begin.

Who needs a flu vaccine?

The CDC and major medical societies all recommend a flu vaccine for just about everyone age 6 months and older. Despite lots of recent misinformation and confusion about vaccines, the flu recommendations haven’t changed.

Flu is particularly dangerous for people 65 and older, pregnant women, young children and people of any age who have chronic health problems, including asthma, diabetes, heart disease and weak immune systems.

The vaccines are brewed to protect against three influenza strains. Despite concern over that new H3N2 variant, they appear to be a good match against H1N1 and Type B flu that may also circulate this year, Pekosz said.

There are shots for all ages, as well as the nasal spray FluMist for ages 2 to 49. For the first time this year, some people may be eligible to vaccinate themselves with FluMist at home.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The 4-3 decision said a 1993 state law about sperm donors relinquishing rights was designed to address situations involving the use of assisted reproductive technology, such as in vitro fertilization.

But dissenting justices said the law also applies to other sperm donors and raised the specter that the majority’s decision could lead to children having three parents.

The ruling, in a Hillsborough County case, stemmed from Angel Rivera providing sperm to Ashley Brito and Jennifer Salas, with Brito then using an at-home kit to become pregnant. Brito and Salas subsequently got married, with the child’s birth certificate showing Brito and Salas as the parents.

Brito and Salas raised the child together for a little more than a year before separating, according to Tuesday’s majority opinion written by Justice Jamie Grosshans. After that, Rivera filed a petition in circuit court seeking to be recognized as the child’s legal father.

A circuit judge and the 2nd District Court of Appeal ruled against Rivera, citing the 1993 law about sperm donors relinquishing rights.

Tuesday’s majority opinion stopped short of saying Rivera should have paternal rights because he would need to meet other legal requirements. But it said he didn’t automatically relinquish the rights when he provided the sperm.

“No party disputes that the child in this case was not conceived using ART (assisted reproductive technology), as at-home artificial insemination does not ‘involve the laboratory handling of human eggs or preembryos.’ … Thus, the situation, contemplated by the statutory scheme as a whole, did not occur here. As such, Rivera has not automatically relinquished his paternal rights and obligations to the child at issue, and his legal rights must be determined by other sources of law addressing paternity,” Grosshans wrote, partially quoting a definition in state law.

Grosshans was joined in the opinion by Chief Justice Carlos Muniz and Justices Charles Canady and Jorge Labarga. But Justice John Couriel wrote a dissenting opinion, disputing that the 1993 law only applies to donors when assisted reproductive technology is used.

“To support this reading, the majority observes that the 1993 act aimed to provide a legal framework for such technology,” wrote Couriel, who was joined in the dissent by Justices Renatha Francis and Meredith Sasso. “And no doubt the 1993 act was a response to technological and social developments. But no statutory or historical context supports rewriting the statute as the majority undertakes to do.”

Couriel wrote that “our laws about parentage reflect a consistent legislative design that assigns two, and only two, parents to a minor child.”

“That Salas and Brito have parental rights has never been disputed in this litigation, and there is no indication that either would forfeit those rights,” the dissent said. “But now, the majority authorizes Rivera to become parent number three. This might be good or bad policy by the court’s lights, but it is not our law.”

But Grosshans wrote that arguments about three parents are flawed. The majority opinion said it only addresses a “narrow question” about whether Rivera automatically relinquished his paternal rights.

“We do not address, as the dissent implies, whether Rivera is likely to succeed in establishing any legal rights under the statutes governing paternity, especially given that the child in question was born within an intact marriage,” Grosshans wrote.

Then, when she turned 2, the seizures started. She suddenly began to lose skills. Three months later, Everly needed a feeding tube. Now, at 8, she can only move her eyes, allowing her to communicate via a screen.

Everly, whose family lives in Fort Collins, Colorado, has a rare mutation in a gene called FRRS1L, pronounced “frizzle,” which affects how cells in her brain communicate. Her parents, and other members of the tiny community of children with the condition, have worked with researchers and small-scale manufacturers to develop a treatment that could restore some of her ability to move — but only if they can raise $4 million to develop and test it.

Everly clearly understands what happens around her and loves school, where she learns in a mainstream classroom with support and has several best friends, said Chrissy Green, Everly’s mother. Still, she wants to do things she can’t, such as holding toys on her own or going on the occasional family trip with her brothers, Green said.

“These kids are in there, they want to play like other kids, they just can’t move,” she said.

Green is co-president of the foundation Finding Hope for FRRS1L, which is collecting funds for the next stage of drug development. Children with FRRS1L gene disorder, the foundation’s website says, “are trapped in a body they can’t move, however still retain high cognitive function, understanding, communication and awareness.”

Worldwide, only a few dozen children currently have a diagnosis of the same mutation in FRRS1L, meaning there’s little interest from drug companies. Families are on their own to fund research and, if all goes well, convince the U.S. Food and Drug Administration that the treatment is safe and effective enough to go on the market.

And, even if they succeed with the FDA, they’ll still face a battle with insurance companies that may not want to pay the steep price for a drug to correct a faulty gene. (Even though the families aren’t looking to make a profit, these types of treatments are expensive, and the company under contract to do the manufacturing isn’t doing it for free.)

Gene therapy involves replacing a faulty gene with a healthy one, usually via a harmless virus engineered to insert a specific snippet of genetic code. It has offered a new way to treat infants born without functioning immune systems, who previously relied on bone marrow transplants. Trials have also shown good results with a liver problem causing ammonia to build up in the body, and one form of inherited deafness.

The technology also carries risks. Patients have died after receiving gene therapies, with liver problems emerging as a potential risk.

Normally, drug companies take on the financial risk of turning basic research that’s often publicly funded into treatments, with the hope of eventually making a profit. For gene therapies, that model can break down because of the small number of patients. Green’s FRRS1L foundation knows of about three dozen patients worldwide, though other children with unexplained seizures could have the mutation.

A drug that treats so few patients will never be profitable, so parents are largely on their own in trying to fund research and development, said Neil Hackett, a researcher who has worked with families on gene therapies and advised the FRRS1L foundation. Usually, they can’t do it unless they happen to have one or more business-savvy parents with the time and resources to run a foundation while caring for a child with complex needs, he said.

“They need specific expertise, which is not easy to find, and they need massive amounts of money,” he said.

When they first received Everly’s diagnosis, her doctor told the family to make the most of the time they had left, because medicine couldn’t offer anything to extend her life or reduce her symptoms, Green said. She didn’t initially question that, but focused on loving her daughter and trading tips for daily life with other families via Facebook.

Green connected with a mother in London who had a child the same age as Everly. Viviana Rodriguez was exploring whether researchers had found any evidence to suggest they could repurpose existing drugs to reduce FRRS1L symptoms.

Through a “providential” series of events, one of Rodriguez’s contacts knew a doctor at the University of Texas Southwestern Medical Center who worked on gene therapies. That doctor had read a paper from a German researcher who bred mice with the FRSS1L mutation so he could study it. The German scientist had given the mice a gene therapy as part of his experiments, but his work wasn’t focused on the clinical applications, Green said.

Green and Rodriguez, along with a small group of other parents, formed the foundation to raise $400,000 for the UT Southwestern researchers to breed their own group of FRSS1L mice and give them a gene therapy in a study that was set up to show results. The mice that received the gene therapy had near-normal movement after it took effect, she said.

“We saw major recovery in the animals, so we’re really hopeful for our kids,” she said.

The next step was testing for toxic side effects, then finding a manufacturer who could do the complicated work of inserting the corrected gene into a harmless virus, Green said. If they can raise the necessary money and all goes as expected, children could receive their doses through a clinical trial starting in September, she said.

Many treatments that look promising in mice don’t pan out in humans. Even if they do, foundations must navigate the complex process of getting permission from the FDA to sell the treatment, Hackett said. Then they face the separate battle of convincing insurance companies, or national health systems serving patients in other countries, that they should pay for it, he said.

Theoretically, a foundation could keep a treatment in reserve for patients diagnosed with the FRSS1L mutation in the future, but that likely isn’t feasible, Hackett said.

“At the end, I think you have to turn it over to a commercial entity, and I don’t think anyone knows what that looks like,” he said.

Green is hopeful, however, that the treatment she’s trying to fund will not only help children like Everly, but also ease the path for future gene therapies.

“All the diseases can kind of help each other move forward,” she said.

Antibiotic resistance has become an increasingly fatal problem that South Florida college students are trying to solve.

The Centers for Disease Control and Prevention estimates that in 2019, antimicrobial resistance killed 1.27 million people worldwide and nearly 5 million deaths were associated with infections caused by drug-resistant organisms. Research has shown that this number is projected to increase to 10 million per year by 2050, greatly exceeding deaths from cancer.

In this landscape, a Nova Southeastern University professor and her class of 40 students are conducting research and searching for the next new antibiotic. For students, being part of the Tiny Earth network of student researchers is more than just a course: They become scientists working to address a global challenge while cultivating a sense of belonging in the field of science and within their local communities.

Students test soil from around the NSU campus or their backyards.

“Some students have found bacteria that are producing antibiotic-like compounds,” said Dr. Aarti Raja, the NSU professor teaching the course. “We are working to identify what these bacteria are and the composition of the compounds they are producing.”

The concept of crowdsourcing antibiotic discovery has opened the possibility of finding a solution to this global challenge. Leveraging this model allows entire classes of students — not just one or two students — to engage in research.

“Students often speak about how research plays an important role in their career path and express genuine interest in engaging in the work,” Raja said. “For many students, there is a great thrill in owning a project, being involved in a global effort, and the possibility of discovering something novel.”

NSU in Davie is among 540 institutions, 800 faculty, and 16,000 students worldwide working to find a solution to the antibiotic resistance crisis that affects care in hospitals and the narrowing of medical treatment options. Students work through a semester or beyond on their research.

“I was able to create pamphlets and talk about antibiotic resistance with my family, and help people understand the importance of it and why it should be taken seriously,” said Jennifer Vargas, a junior at NSU in Davie. “I hope the pamphlets I created in English and Spanish will help patients.”

The students will disseminate their research findings to their peers, the university community, and the network of researchers worldwide. Some students will go on to present their work at an international conference of scientists.

In the U.S., the CDC estimates that 2.8 million infections annually are caused by antimicrobial-resistant microorganisms, and 35,000 people die from such infections. Compounding this, the World Health Organization notes that the development and approval of antibiotics have dwindled over the years down to 1.2 agents per year globally.

Along with health concerns, combating antimicrobial resistance, called AMR, has economic impacts, creating high costs for both health systems and national economies overall. For example, it makes a need for more expensive and intensive care for patients, involves prolonged hospital stays, and harms agricultural productivity.

Raja says students often speak about how research plays a vital role in their career path and express a genuine interest in engaging in the work. Many of the students will continue to medical school and face the real-life concerns with antibiotic resistance as physicians treating patients.

“This was my first experience with hands-on research,” said Jaelyn Freeston, an NSU junior. “I am grateful for the opportunity to have contributed to something meaningful and important in the real world.”

This article was contributed as a collaboration between the South Florida Sun Sentinel and the Mako Media Institute at Nova Southeastern University.

Florida Blue and Broward County’s two public health systems, both under the same CEO, still lack a new contract. The months-long impasse between Florida Blue and Broward Health and Memorial Healthcare System has affected as many as 40,000 policyholders who must deal with higher out-of-pocket costs, a disruption in their doctor relationships, and finding ongoing treatment for non-emergency care. Earlier communication from the parties indicated new contracts might be completed by year’s end, but that hasn’t happened.

“We are having ongoing and productive discussions with the leadership teams from Broward Health and Memorial Healthcare System,” Florida Blue spokesperson Jorge Martinez said Tuesday.

In addition, unless Florida Blue reaches an agreement with Cleveland Clinic Weston by March, notices will go out to policyholders informing them that the hospital will be out of network as well, meaning they will not be covered for non-emergency services. For now, Florida Blue members can continue scheduling appointments and receiving care as usual at the Weston hospital.

The inability to negotiate a contract, however, would put Florida Blue policyholders at a significant disadvantage when choosing care. Open enrollment for employer-sponsored health plans has now closed for most companies, forcing them to decide whether to continue with Florida Blue and Blue Cross Blue Shield. Martinez said it’s too soon to know if and how contract disputes affected enrollment choices. Broward’s public health systems have suffered, too, with patients delaying care or finding new providers.

In Palm Beach County, Cigna policyholders received good news Wednesday when an eleventh-hour deal allowed them to stay in network at their major hospitals.

Tenet’s Palm Beach Health Network, which operates six major hospitals, was about to go out-of-network with Cigna on Wednesday. However, a Tenet spokesperson said the parties reached an agreement that will allow 1.3 million Florida Cigna policyholders and 13,000 Palm Beach County residents to be covered at its hospitals. Those hospitals are Delray Medical Center,  Good Samaritan Medical Center in West Palm Beach, Palm Beach Gardens Medical Center, St. Mary’s Medical Center in West Palm Beach, and Palm Beach Children’s Hospital in West Palm Beach. Tenet also operates Florida Coast Medical Center in Port St. Lucie.

Non-renewal of Cigna’s contract would have put the county’s only children’s hospital out of network, just as Joe DiMaggio Children’s Hospital has gone out of network for Florida Blue policyholders in Broward County.

Cigna’s standoff with Tenet’s Palm Beach Health Network was part of a national contract dispute with Tenet Healthcare facilities and services nationwide, which the two health giants resolved on Wednesday.

Patients are increasingly caught in disputes as health insurers and providers disagree on contract terms and the two parties urge each other to stop disrupting medical treatment.

On Wednesday,  Cigna spokesperson Madeline Ziomek said, “An agreement has been reached with Tenet-owned Palm Beach Health Network, their physicians, and ambulatory surgery centers (ASCs) to continue providing in-network health care with no interruption in coverage for our customers. Together we will continue improving the health and vitality of the people we both serve in this community through access to affordable care.”

The heated negotiations between the insurer and healthcare company may represent the trend ahead and the role AI will play.

Tenet had set up a website for patients to demand that Cigna relent and said that Cigna would not guarantee that a physician, not a computer algorithm, makes decisions about patient care.

“Tenet Healthcare has been negotiating in good faith to keep in-network access to hospitals and providers at the Palm Beach Health Network for our patients,” Andrew Lofholm, Communications and Community Relations Manager with Palm Beach Health Network, had said.  “If Cigna ends its contract by December 31, 1.33 million Floridians could lose affordable access to both of the county’s Level I trauma centers and the only children’s hospital in the region. Because Cigna refuses to agree to reasonable terms to guarantee that a doctor, not a computer algorithm or AI, will make meaningful decisions about our patients’ care, families will be faced with paying thousands more or leaving the doctors and hospitals they’ve relied on for years.”

The standoffs over financial terms and reimbursement rates are also infuriating Broward patients, who at one point were told by Memorial and Broward Health they couldn’t make appointments as Florida Blue policyholders, even if they wanted to self-pay. On Tuesday, Broward Health and Memorial said they would accept Florida Blue patients who want to self-pay to continue seeing their doctors.

“We welcome any Florida Blue policyholders to continue their care with Broward Health providers,” said Broward Health Vice President of Communications Jennifer Smith. “Patients would need to self-pay or get a single-case agreement from Florida Blue. ”

The law requires hospitals to provide emergency care to patients regardless of whether they are in network.

“Anyone who arrives at our emergency departments will be treated regardless of their insurance status or ability to pay,” Smith said. “If admission is required, we notify the payor, and they decide whether to authorize admission or start transfer to an in-network hospital. But ultimately, it is the patient’s choice where they are treated.”

South Florida patients are upset that they are caught in the conflict between provider and insurer.

“My husband and I have complex medical histories,” Rev. Corrie Montoya of Davie wrote in a letter to the Sun Sentinel. “We have Blue Cross Blue Shield insurance through my employer. Most of our physicians are with Broward Health. We now must find a new primary care doctor and at least eight new specialists. It’s frustrating to have to start over. I can push through, but what I can’t abide is Florida Blue putting my child and all Broward children at risk.”

The breakdown in contract negotiations between health providers and health insurers put South Florida residents like Bob and Gayle Pifer in the position of losing access to doctors they have come to rely on over many decades.

Bob Pifer has been calling and writing Memorial Healthcare and Florida Blue, seeking answers to whether they can continue to see their doctors, and when the contract dispute will be resolved. The couple live in Pembroke Pines and all hospitals nearby, south of Interstate 595, are operated by Memorial. Both see various specialists at Memorial and Gayle Pifer is undergoing cancer treatment. The Pifers said they have been Blue Cross Blue Shield policyholders for more than 40 years, but can’t afford to keep seeing the same doctors.

“We live eight minutes from Memorial West. If we keep going, we could be stuck for the whole bill,” Bob Pifer told the Sun Sentinel. “In my wife’s case, the last infusion was very expensive.”

Plantation resident Andy Greenfield said he has been getting primary care at Memorial for over 30 years. “Because of this impasse, I will be forced to look elsewhere, even for ongoing conditions that Memorial physicians had treated. I don’t understand how so many hospitals can be out of network simultaneously for residents of Broward County.”

South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.