iiinova — where your digital self keeps evolving

Dr. D Boulware, MD MPH @drboulware.bsky.social · 01/10/2026

NIH Funding rate of Early Stage Investigators (ESI). 2025 was a major drop. 2026 will be worse.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 08/09/2026

Is there anything more gratifying in ID than solving a FUO?

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Dr Rasu Shrestha @rasushrestha.bsky.social · 31/08/2026

⚠️Did you know that COVID is on the rise, again? The summer COVID wave continues and is expected to peak around #LaborDay (September 7) Here are the facts from @drruth.bsky.social drruth.substack.com/p/dr-ruth-re... #medsky #idsky #publichealth

drruth.substack.com

Dr. Ruth Report, 8/30/26

COVID wave increases, new COVID boosters, COVID changes blood stem cells, H5N1 found in fetal bovine serum (FBS), 2 measles deaths in Pennsylvania, and more.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 31/08/2026

There is an updated version 2.0 upcoming. At the @msgerc.bsky.social biennel meeting, there will be further discussion and group input on where to go with the app and revamped website. msgerc.org/2026-biennia...

msgerc.org

2026 Biennial Meeting – MSGERC

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 31/08/2026

BPaLMZ TB meningitis trial continues to enroll, up to n=3. Single arm safety study testing bedaquiline, pretomanid, linezolid, moxifloxacin, and pyrazinamide (BPaLMZ) clinicaltrials.gov/study/NCT072... TB meningitis has a 6-month mortality of ~40%. Can this be improved upon? In mice, yes.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 22/08/2026

Downside, only took 13 months since it was reviewed by a study section in July 2025.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 22/08/2026

Excited to receive our NIH T32 training grant renewal supporting clinical/translational reseach in infectious diseases. T32 enters its 21st year. Of ID graduates, half are in research intensive posts, and one-third of graduating ID fellows obtained a career development award.

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Alasdair Munro @apsmunro.bsky.social · 17/08/2026

My piece on the new White House Executive Order on childhood vaccines The document is based on an inappropriate premise, flies in the face of existing science, and would achieve the opposite of its own stated aims It is a catastrophic failure at vaccine policy

alasdairmunro.substack.com

Executive Vaccine Order: Home run or Own goal?

Is the White House statement a welcome shake up or unnecessary blunder?

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Reposted by Dr. D Boulware, MD MPH

Robert Reich @rbreich.bsky.social · 16/08/2026

In the past, the rich used to pay higher taxes. Now, the government pays the rich interest on a swelling debt, caused largely by lower taxes on the rich. It's a big switcheroo that we need to talk about if we're going to talk about the national debt.

youtu.be

The Secret Way the Rich are Getting Richer

The biggest untold story about how we pay for government involves a big switcheroo by America’s wealthy. Watch.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 17/08/2026

Why is America being intentionally made weak?

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M Meerkat @kackbro.bsky.social · 16/08/2026

This Entire Chump Regime Is Unqualified.......

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Jeremy Berg @jeremymberg.bsky.social · 17/08/2026

This is a must-read for anyone interested in NIH. formernih.substack.com/p/nih-direct... NIH_Leadership™ held a session full of half-truths about the "unified funding strategy" while they and HHS continues to play politics with NIH grants. Chilling, but a call to action! @standupforscience.net

formernih.substack.com

NIH Directors Decide, Except When HHS Says No

A June 2026 Nature report revealed that mandatory reviews by top officials, checking for a list of 235 disfavored terms, have left hundreds of meritorious NIH applications in administrative limbo (Koz...

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Reposted by Dr. D Boulware, MD MPH

Ron Filipkowski @ronfilipkowski.bsky.social · 16/08/2026

For the first time in US history, America betrays South Korea, one of our closest allies for over 75 years. These exercises in various forms have taken place every year since 1974.

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Reposted by Dr. D Boulware, MD MPH

Jack Mirkinson @jackmirkinson.bsky.social · 11/08/2026

Today in @thenation.com: a harrowing piece written from inside the Dilley ICE detention center by Maryam Tahmasebi, a green card holder who's been locked up along with her husband and son for months despite none of them committing any crime. www.thenation.com/article/soci...

thenation.com

One Woman’s Message From the Hell of ICE Detention

My husband, son, and I have been locked up for months—despite being permanent residents with no criminal record. It is an unendurable, unending nightmare.

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Carolyn Barber, MD @cbarbermd.bsky.social · 12/08/2026

SAMUEL ALITO MADE UP TO $2.9M FROM OIL & GAS INTERESTS. Now he’s set to hear a case that could limit climate lawsuits against fossil fuel companies. Mineral rights. Exxon stock. Investments in Chevron, ConocoPhillips & more. He’s recused over financial ties before. NOT THIS TIME. 1/2

theguardian.com

Samuel Alito gained up to $2.9m from oil and gas assets since joining supreme court, analysis shows

Critics argue US high court justice should recuse himself from upcoming fossil fuel firms’ climate accountability case

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BK. Titanji @boghuma.bsky.social · 11/08/2026

I cannot control the vaccine disinformation coming from the White House. But I can control what happens when I walk into a patient’s room, sit down, listen and try to earn their trust. This matters more than ever. There is too much at stake. bktitanji.substack.com/p/that-space...

bktitanji.substack.com

That Space Still Belongs to Us

When vaccine misinformation comes from the highest levels of government, the work of building trust with our patients matters more than ever.

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NIH Vigils @nihvigils.bsky.social · 11/08/2026

Trust isn’t broken by having a mandate. It’s broken when the public is lied to. This happened during Covid, and it’s happening now.

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Ryan Marino, MD @ryanmarino.bsky.social · 07/08/2026

Typhoid Mary only gave 57 people diarrhea and she was imprisoned until she died

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

I am sure there are mean, nasty Canadians somewhere in the world, but I have yet to meet any. I have however met a lot of great ones in the world of ID, such as @drtoddlee.bsky.social and team.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

We could of course could be wrong, in which case the trial may halt quickly.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

We can kill bugs in crypto when there are millions of yeast/mL and immune complications get better. Here in TBM we can barely find any Mtb, often CSF is Xpert neg were LOD is 10 Mtb/mL. Kill those 10 quickly, and all the inflammation should improve (we hypothesize)

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

Not what our data in HIV TBM show: doi.org/10.1093/infd... Baseline hypo inflammatory state is very bad. Go back and look at which subgroup had a trend in favorable response in HARVEST to higher dose RIF, those living with HIV who were ART naive trended towards 8% better survival.

doi.org

Cerebrospinal Fluid Hypo-inflammation Drives Mortality in HIV-Associated Tuberculous Meningitis

In adults with HIV-associated tuberculous meningitis, mortality is driven by insufficient cerebrospinal fluid inflammation, in particular low IFN-γ, rather

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

BPaLMZ is 1000-fold more active in a murine brain TBM model than standard of care (SOC) isoniazid+ rifampin + ethambutol + pyrazinamide. We hypothesize that many of the immune problems and complications are due to poorly active drugs, poorly penetrating into CNS.

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

This is a radical redesign of TB therapy for meningitis after the HARVEST trial showed no benefit of 35 mg/kg rifampicin. www.nejm.org/doi/abs/10.1...

nejm.org

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

Excited to open our next TB meningitis trial testing BPaLMZ combo of: bedaquiline, pretomanid, linezolid, moxifloxacin, & pyrazinamide in a Phase 2a single arm trial (n=40) to assess safety. clinicaltrials.gov/study/NCT072... We are presently self-funding the trial. That can't go on forever.

clinicaltrials.gov

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Elizabeth Jacobs, PhD @elizabethjacobs.bsky.social · 06/08/2026

Arizona’s kindergarten vaccination coverage for MMR continues to plummet. And measles is just the bellwether. As vaccination rates fall, other vaccine-preventable diseases will also emerge. RFK Jr. is the absolute GOAT when it comes to putting kids in harm’s way.

Figure showing that Arizona’s kindergartners dropped below herd immunity threshold for measles vaccination in 2011 and has now fallen below 90%

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 07/08/2026

In calling Canadians nasty, has the President ever met any Canadians?

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 05/08/2026

IDSA has released important guidance for Antimicrobial Resistance. Interesting that the entire Kingdom of Fungi is ommitted from AMR considerations. Does not exist as a problem, per IDSA. www.idsociety.org/practice-gui... @idsainfo.bsky.social

idsociety.org

2026 AMR Guidance

This updated IDSA AMR Guidance document provides treatment suggestions for infections caused by extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E), AmpC β-lactamase–producing Enterobact...

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Christopher Webb @cwebbonline.com · 29/07/2026

Dead or alive, Mitch McConnell is on extended medical leave — on your dime. This is the same Mitch McConnell who voted against: paid family and medical leave for everyone else.

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BK. Titanji @boghuma.bsky.social · 28/07/2026

Very important phase1/2 trial of a 6-valent group B strep vaccine. The vaccine was both safe and immunogenicity in pregnant and non pregnant persons. Sets the stage for ph3 studies. GBS sepsis is a major cause of neonatal sepsis causing 91,000 newborn deaths/yr. www.nature.com/articles/s41...

nature.com

Maternal 6-valent group B Streptococcus vaccine in non-pregnant and pregnant females: a randomized phase 1/2 trial - Nature Medicine

A phase 1/2 study found maternal hexavalent 6 polysaccharide−protein conjugate group B Streptococcus vaccine (GBS6) to be safe and immunogenic and to have induced antibody responses to vaccine serotyp...

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Reposted by Dr. D Boulware, MD MPH

Charles Gaba ✡️ @charlesgaba.com · 27/07/2026

🚨 NEW: Over 48,000 #PENNSYLVANIA residents have lost ACA healthcare coverage so far this year...and the remaining ~430,000 are looking at 17% rate hikes for unsubsidized enrollees next year: acasignups.net/26/07/27/202...

acasignups.net

2027 Rate Changes - Pennsylvania: +17.1% indy mkt; +11% sm. group mkt

Before I begin, it's important to note that ACA exchange enrollment has dropped in Pennsylvania since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year...

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Dr. D Boulware, MD MPH @drboulware.bsky.social · 12/07/2026

Just returned from transcontinental flight = Pulmonary embolism

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Paul Guinnessy @paulguinnessy.bsky.social · 12/07/2026

Pretty classy message by the Norwegian Embassy. #WorldCup

Thank you message from the Norwegians to America for hosting them during the World Cup

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Reposted by Dr. D Boulware, MD MPH

Republicans Against Trumpism @rpsagainsttrump.bsky.social · 10/07/2026

A growing outbreak of the Cyclospora parasite, which causes severe diarrhea, has sickened more than 1,200 people across the U.S. Experts say the true number is much higher. In March 2025, RFK Jr. dissolved the CDC’s Division of Parasitic Diseases and Malaria, which monitored parasitic diseases

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Reposted by Dr. D Boulware, MD MPH

Phil Rocco @philiprocco.bsky.social · 10/07/2026

I don’t think people really understand how bad the OMB proposed rule is going to be for state and local govt. We’re talking about putting a full third of state budgets under the explicit control of Russ Vought. (1/2) www.bondbuyer.com/news/cities-...

bondbuyer.com

Cities, states warn of credit impact from proposed federal grant rule

Discretionary termination of grants allowed under the rule would pose a particular risk, issuer advocates said.

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Jonathan Howard @joho.bsky.social · 10/07/2026

"Kulldorff testified that the plaintiffs paid him $400 an hour and he had already billed for about $33,000 in legal work on the case through late September. He said he also received a $4,000 retainer in the North Carolina case, according to court documents."

reuters.com

Kennedy's new vaccine adviser was expert witness against Merck vaccine

One of the new vaccine advisers picked by U.S. Health Secretary Robert F. Kennedy Jr. has earned thousands of dollars as an expert witness in litigation against Merck’s Gardasil vaccine, court records...

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