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Adaptive leadership begins in medical school
Agreement: I Agree Body: Dear Editor Ramalingam rightly frames measles resurgence as a symptom of systemic inequity rather than a mere vaccination shortfall (1). His five-point call for adaptive leadership—local intelligence, child-centred access, trust-building, routine system strengthening, and accountability—is compelling. Yet the analysis, like most commentary in this space, locates the problem almost entirely within healthcare delivery and public health governance. I would argue that a critical upstream failure is being overlooked: the medical profession itself has not been trained to see these outbreaks coming, or to regard preventing them as core professional work. For two decades, medical schools in high-income countries taught measles elimination as a permanent achievement. Students learned to recognise Koplik spots in photographs but not to trace a case of measles pneumonia backwards through its structural antecedents—missed vaccination visits, permissive exemption policies, algorithm-amplified disinformation, and the silence of trusted institutions. Surveys of medical students confirm that many feel insufficiently prepared to discuss vaccines with patients, let alone to see themselves as agents of vaccination systems (2, 3). The result is a generation of clinicians who can diagnose the rash but do not see averting the outbreak as part of their role. Ramalingam’s framework would be strengthened by a sixth action: reforming medical education to treat vaccines not merely as immunological products but as social technologies whose effectiveness depends on trust, infrastructure, and political stewardship. Concretely, this means building “counterfactual literacy” into training—requiring students to map every vaccine-preventable admission to the broken causal chain that produced it—and embedding longitudinal community placements where trainees work alongside public health teams, school nurses, and community leaders to design and evaluate real-world immunisation outreach. When the Birmingham outbreak demonstrated that 78% of 406 confirmed measles cases occurred in the city’s most deprived areas, and that the risk of infection in black children aged 12–18 was an estimated 28.5 times that of white children of the same age, the structural determinants at work were not hidden (4). Nationally, vaccination inequalities widened across England between 2019 and 2023, with the number of measles-susceptible children by age 5 increasing up to 20-fold in the most deprived areas (5). When Enfield’s two-dose MMR coverage sits at 63.4%—barely above Afghanistan’s—the question is no longer technical; it is whether medical professionalism now includes advocating for the social conditions under which vaccines can do their work. Equipping future doctors with that understanding is not peripheral to Ramalingam’s vision of adaptive leadership—it is its prerequisite. References 1. Ramalingam B. Measles: children and vulnerable communities face disproportionate harms. BMJ 2026;392:s499. 2. Sojati J, Murali A, Rapsinski G, Williams JV. Do not throw away your shot: pilot study in improving medical school curricula through focused vaccine education. AJPM Focus 2024;3(2):100178. 3. Kuppalli K. Medical schools must update approach to vaccine-preventable diseases. STAT News. 12 January 2026. https://www.statnews.com/2026/01/12/medical-school-vaccine-preventable-d... 4. Jary H, Pullen A, Howett D, et al. Sociodemographic inequalities in the epidemiology and vaccine uptake within a large outbreak of measles in Birmingham, England, 2023 to 2024. Euro Surveill 2025;30(16):2400652. 5. Flatt A, Vivancos R, French N, et al. Inequalities in uptake of childhood vaccination in England, 2019–23: longitudinal study. BMJ 2024;387:e079550. No competing Interests: Yes The following competing Interests: Electronic Publication Date: Friday, April 17, 2026 - 15:15 AI use: No, I have not used AI Highwire Comment Subject: Measles: children and vulnerable communities face disproportionate harms Workflow State: Released Full Title: Adaptive leadership begins in medical school Highwire Comment Response to: Measles: children and vulnerable communities face disproportionate harms Check this box if you would like your letter to appear anonymously:: Last Name: Yang First name and middle initial: Y. Tony Email: ytyang@gwu.edu Address: 1919 Pennsylvania Ave. NW. Suite 500. Washington DC 20006 Occupation: Endowed Professor of Health Policy Affiliation: The George Washington University BMJ: Additional Article Info: Rapid response Twitter: @GwPolicy
2026-04-17 15:19:44

Back in city for ‘Moonrise’
MELBOURNE indie folk outfit Pierce Brothers have returned from a European tour and are now taking their fourth studio album, ‘Moonrise’, on the road across Australia. The duo debuted at number one on the ARIA Australian albums chart with 'Moonrise' in December and recently performed at the Port Fairy Folk Festival as part of the opening leg of their national tour. Ahead of their Cairns show at the Tanks Arts Centre, Patrick Pierce said the band was looking forward to returning to a venue they held in high regard. "We've played that venue once before and it is honestly one of my favourite venues in Australia," he said. "It's just such a nice room. The PA is great. Everything about it is just absolutely fantastic." Mr Pierce said the Cairns show held personal significance and was part of a broader effort to reconnect with audiences in the region. "We're very excited to get back to Cairns again, because I got married up that way," he said. "It's a market that we just don't really get to as much as we'd like, so every time an opportunity comes along, we just jump at it." The band's latest album was recorded and produced in their home studio, following what Mr Pierce described as a difficult period. "We had a bunch of family deaths and just a lot of heartache," he said. "Having a tough year with a lot of heartache is good when you're a songwriter, I guess, so we were able to sort of deal with life a little bit." The Pierce Brothers' live performances remain a key part of their appeal, with Mr Pierce noting the difference between their recordings and stage presence. "A lot of people say to me, 'I heard your stuff and it was good, but then I saw it live and now I get it'," he said. "It's a lot of energy, a lot of jumping around and it's quite a show." The upcoming show at the Tanks Arts Centre is scheduled for Saturday, 18 April 2026, with doors opening at 6.30pm and the performance starting at 7.15pm. The event is expected to run for two hours and 45 minutes. Supporting the headline act will be Tessa Devine. Tickets are expected to sell quickly, with audiences encouraged to secure entry early. The Australian tour marks the band's return home following international success and continues their rollout of Moonrise to local audiences, with Cairns shaping as a key stop on the run.
2026-04-11 22:00:00

Is XRP Safer Than Bitcoin? This Analyst Explains The Real Quantum Risk For Holders
Experts say XRP’s design leaves a smaller share of its supply exposed to a potential quantum attack than Bitcoin. An Armor Against Quantum Attacks? Following the recent spike of the crypto quantum-panic or “quantum FUD” (fear, uncertainty and doubt) after Google’s “doomsday” whitepaper, many crypto developers are analysts have taken into the job of running tests to make sure their coins are safe. Others are already writing up safety post-quantum protocols and proofs. Vet, XRP Ledger dUNL validator and long‐time XRPL contributor, shared on a post on the social network X the belief that XRP’s underlying architecture is more favorably positioned against a possible quantum threat than Bitcoin’s. Quick XRP acc quantum vulnerability check. ~300,000 accounts on XRP holding 2.4B XRP never transacted, thus public key unknown and quantum safe. while only 2 accounts with larger holdings of 21M XRP are dormant (inactive over 5 years) and have their public key exposed. Dormant... — Vet (@Vet_X0) April 7, 2026 In short: it’s because of how keys and accounts are handled on XRPL. Related Reading: Bitcoin Stress Cycle Is Ending — But Traders May Hate What Comes Nex XRP’s Quantum Armor Explained The core risk that quantum computers pose and that has a lot of people on crypto very concerned is that, in theory, a future quantum computer could derive the private key that gets revealed once a wallet sends a transaction, thus making possible to drain all the wallet’s funds. However, Vet’s “quick XRP acc quantum vulnerability check” revealed that roughly 300,000 XRP accounts holding about 2.4 billion XRP have never sent funds, so their public keys are unexposed and “quantum‐safe by default. According to the XRPL validator, there are only two long‐dormant XRP whale accounts, together holding around 21 million XRP, whose public key is currently exposed. The holdings of these accounts represent just about 0.03% of the circulating supply, a rounding error next to the network’s total float (circulating supply is around 61 billion XRP as of early April 2026, according to Coinglass data). XRP most important markers, including the circulating supply of 61.40B. Source: Coinglass. XRPL’s account‐based model allows signing key rotation without moving funds, and escrow/timelock tools can keep tokens locked behind conditions, giving holders more options to harden security ahead of any quantum breakthrough. On the flip side, in Bitcoin the early P2PK outputs and exposed public keys leave an estimated 11%–37% of BTC potentially vulnerable in a future quantum scenario. This includes Satoshi‐era coins that can’t just rotate keys. Therefore, despite Ripple and Bitcoin’s approach to quantum resistance being very similar, their stances on dormant whale wallets diverges, simply because almost none exist on XRP. Related Reading: Can’t Move Your Crypto?— Traders Trapped In South Korean Exchanges What This Means For XRP Traders Vet closes the post with calming words directed to XRP holders: Important – your XRP is safe, there are no known quantum computers able to threaten public blockchains. By that time the industry figured a path out. The immediate takeaway for XRP holders is that on‐chain data and XRPL’s toolset point to a relatively contained attack surface, especially for active users who can rotate keys ahead of time. The quantum debate is turning into a new risk‐pricing vector between Bitcoin and high‐cap altcoins. If that narrative sticks, any progress on XRPL’s fully quantum‐resistant testnets or mainnet upgrades could become a fresh catalyst in the next security‐driven rotation. At the moment of writing, XRP trades for around $1,300 on the daily chart. Source: XRPUSD on Tradingview. Cover image from Perplexity. XRPUSD chart from Tradingview.
2026-04-10 11:08:06

Ethereum Price Charges Higher, $2,150 Resistance Under Threat
Ethereum price managed to stay above $2,020 and recovered losses. ETH is now rising and might attempt a move above the $2,150 resistance. Ethereum started a decent upward move above the $2,065 zone. The price is trading above $2,080 and the 100-hourly Simple Moving Average. There was a break above a key bearish trend line with resistance at $2,065 on the hourly chart of ETH/USD (data feed via Kraken). The pair could start a fresh decline if it stays below the $2,150 resistance. Ethereum Price Aims Higher Ethereum price remained stable above $2,020 and started a decent upward move, beating Bitcoin. ETH price climbed above the $2,050 and $2,065 resistance levels. There was a break above a key bearish trend line with resistance at $2,065 on the hourly chart of ETH/USD. The bulls pumped the price above the 50% Fib retracement level of the downward move from the $2,168 swing high to the $2,017 low. Ethereum price is now trading above $2,080 and the 100-hourly Simple Moving Average. If the bulls remain in action above $2,065, the price could attempt another increase. Immediate resistance is seen near the $2,140 level or the 83.2% Fib retracement level of the downward move from the $2,168 swing high to the $2,017 low. The first key resistance is near the $2,150 level. The next major resistance is near the $2,180 level. A clear move above the $2,180 resistance might send the price toward the $2,220 resistance. An upside break above the $2,220 region might call for more gains in the coming days. In the stated case, Ether could rise toward the $2,350 resistance zone or even $2,380 in the near term. Another Decline In ETH? If Ethereum fails to clear the $2,150 resistance, it could start a fresh decline. Initial support on the downside is near the $2,080 level. The first major support sits near the $2,065 zone. A clear move below the $2,065 support might push the price toward the $2,020 support. Any more losses might send the price toward the $1,980 region. The main support could be $1,965. Technical Indicators Hourly MACD – The MACD for ETH/USD is gaining momentum in the bullish zone. Hourly RSI – The RSI for ETH/USD is now above the 50 zone. Major Support Level – $2,065 Major Resistance Level – $2,150
2026-04-06 04:08:01

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