An idealistic ophthalmologist, he came up with an ingenious way to treat blindness in far-flung places: by outfitting an airplane with an operating room.David Paton, an idealistic and innovative ophthalmologist who started Project Orbis, converting a United Airlines jet into a flying hospital that took surgeons to developing countries to operate on patients and educate local doctors, died on April 3 at his home in Reno, Nev. He was 94.His death was confirmed by his son, Townley.The son of a prominent New York eye surgeon whose patients included the Shah of Iran and the financier J. Pierpont Morgan’s horse, Dr. Paton (pronounced PAY-ton) was teaching at the Wilmer Eye Institute at Johns Hopkins University in the early 1970s when he became discouraged by increasing cases of preventable blindness in far-flung places.“More eye doctors were needed,” he wrote in his memoir, “Second Sight: Views from an Eye Doctor’s Odyssey” (2011), “but equally important was the need to beef up the existing doctors’ medical education.”But how?He considered shipping trunks of equipment — almost the way a circus would — but that presented logistical challenges. He pondered the possibility of using a medical ship like the one that Project Hope, a humanitarian group, sent around the world. That was too slow for him.“Shortly after the first moon landing in 1969, thinking big was becoming a reality,” Dr. Paton wrote.And then a moonshot idea struck him: “Could an aircraft be the answer? A large enough aircraft could be converted into an operating theater, a teaching classroom and all the necessary facilities.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

On March 11, about 50 judges gathered in Washington for the biannual meeting of the Judicial Conference, which oversees the administration of the federal courts. It was the first time the conference met since President Trump retook the White House.In the midst of discussions of staffing levels and long-range planning, the judges’ conversations were focused, to an unusual degree, on rising threats against judges and their security, said several people who attended the gathering.Behind closed doors at one session, Judge Richard J. Sullivan, the chairman of the conference’s Committee on Judicial Security, raised a scenario that weeks before would have sounded like dystopian fiction, according to three officials familiar with the remarks, who spoke on the condition of anonymity to discuss internal deliberations: What if the White House were to withdraw the protections it provides to judges?The U.S. Marshals Service, which by law oversees security for the judiciary, is part of the Justice Department, which Mr. Trump is directly controlling in a way that no president has since the Watergate scandal.Judge Sullivan noted that Mr. Trump had stripped security protections from Mike Pompeo, his former secretary of state, and John Bolton, his former national security adviser. Could the federal judiciary, also a recent target of Mr. Trump’s ire, be next?Judge Sullivan, who was nominated by President George W. Bush and then elevated to an appellate judgeship by Mr. Trump, referred questions about his closed-door remarks to the Administrative Office of the U.S. Courts, which stated its “complete confidence in those responsible for judicial security.”There is no evidence that Mr. Trump has contemplated revoking security from judges. But Judge Sullivan’s remarks were an extraordinary sign of the extent of judges’ anxiety over the threats facing the federal bench. And they highlight a growing discomfort from judges that their security is handled by an agency that, through the attorney general, ultimately answers to the president, and whose funding, in their view, has not kept pace with rising threats.Mike Pompeo. Mr. Trump’s former secretary of state, in National Harbor, Md., in 2023. A White House spokesman said Mr. Trump’s decision to strip security from former officials had no bearing on his approach to sitting judges.Haiyun Jiang /The New York Times“Cutting all the security from one judge or one courthouse — stuff like that hasn’t happened, and I don’t expect it to,” said Jeremy Fogel, a retired federal judge who directs the Berkeley Judicial Institute at the University of California, Berkeley, and is in frequent contact with current judges. “But, you never know. Because it’s fair to say that limits are being tested everywhere. Judges worry that it could happen.”The Marshals Service said in a statement that it acted “at the direction of the federal courts” and “effectuate all lawful orders of the federal court.” The integrity of the judicial process, the statement read, depends on “protecting judges, jurors and witnesses.”Harrison Fields, a White House spokesman, said Mr. Trump’s decision to strip security from Mr. Pompeo and Mr. Bolton, two former officials, had no bearing on his approach to sitting judges. He called worries that the president would deprive judges of their security “speculation” that was “dangerous and irresponsible.”Founded in 1789, the U.S. Marshals Service has a wide range of law-enforcement duties, in addition to its central function of supporting the judiciary. There are now 94 presidentially appointed and Senate-confirmed U.S. marshal positions, one for each judicial district. The agency’s director reportsto the deputy attorney general.The concerns about who oversees the marshals come as threats against judges have been on the rise, expanding the burdens on the service.Statistics released by the agency show that the number of judges targeted by threats more than doubled from 2019 to 2024, before Mr. Trump returned to office. In those years, he disputed the result of the 2020 election in court, and the Supreme Court overturned Roe v. Wade, the ruling that made access to abortion a constitutional right. In June 2022, after the Supreme Court’s ruling on Roe leaked, an armed man made an attempt to assassinate Justice Brett M. Kavanaugh at his home.In his end-of-year report for 2024, Chief Justice John G. Roberts Jr. noted “a significant uptick in identified threats at all levels of the judiciary.”Mr. Trump with his national security adviser John Bolton, right, at the White House in 2018. The president has removed Mr. Bolton’s security protections.Al Drago for The New York TimesSince Mr. Trump took office in January, he and his supporters have insulted individual judges on social media and called for their impeachment in response to rulings they don’t like. In a message posted on Easter, Mr. Trump referred to “WEAK and INEFFECTIVE Judges” who are allowing a “sinister attack on our Nation to continue” in regard to immigration.Judges and their family members have in recent weeks reported false threats of bombs in their mailboxes. As of mid-April, dozens of pizzas have been anonymously sent to judges and their family members at their homes, a means of signaling that your enemy knows where you live.According to Ron Zayas, the chief executive of Ironwall, a company that contracts with district courts, state courts and some individual judges to provide data protection and security services for judges and other public officials, the number of judges using his services for emergency protection is more than four times the average number for last year. He said 40 judges also used their own money to bolster their security with Ironwall, twice as many as on Jan. 1.In a letter to Congress dated April 10, Judge Robert J. Conrad Jr., who directs the Administrative Office of the U.S. Courts, complained that funding for court security remained frozen at 2023 levels through the 2025 fiscal year “at a time when threats against federal judges and courthouses are escalating.” Judges have issued similar warnings for years.The total amount spent has remained nearly flat, rising to $1.34 billion in 2024 from $1.26 billion in 2022, according to statistics from the administrative office and the marshals, despite inflation and staff pay increases.At the same time, burdens on the service have grown.In recent years, the U.S. Marshals said in a statement, they have started helping to protect the homes of the Supreme Court justices, whose security is primarily handled by the separate Supreme Court Marshal’s Office. Last summer, a U.S. marshal stationed outside Justice Sonia Sotomayor’s home in Washington shot and wounded an armed man in an attempted carjacking.The Supreme Court in Washington. After its ruling on Roe v. Wade leaked in 2022, an armed man made an attempt to assassinate Justice Brett M. Kavanaugh at his home.Haiyun Jiang for The New York TimesIn January, the Trump administration gave the marshals, along with other law enforcement agencies, the new power to enforce immigration laws. That move prompted Judge Edmond E. Chang, who chairs the Judicial Conference’s criminal law committee, to write a memo to all district-court and magistrate judges warning about the potential impact on the marshals’ ability to protect them. (Judge Chang declined to comment; his memo was reported earlier by Reuters.)In addition to protecting judges’ lives, U.S. law states the marshals’ “primary role and mission” is “to obey, execute, and enforce all orders” from the federal courts. Enforcing court orders can entail imposing fines and imprisonment for anyone judges find to be in contempt of court, including, in theory, executive branch officials.The Trump administration’s posture in some cases raises the possibility that the already-stretched marshals could emerge as a crucial referee between the branches. In the courtroom, Justice Department lawyers have come close to openly flouting court orders stemming from the unlawful deportation to a prison in El Salvador of a group of nearly 140 Venezuelans and Kilmar Armando Abrego Garcia, whose removal officials admitted was an “administrative error.” Two judges have responded by opening inquiries that could lead to administration officials being held in contempt of court.“What happens if the marshals are ordered to deliver a contempt citation to an agency head that has defied a court order?” asked Paul W. Grimm, a retired federal judge who leads the Bolch Judicial Institute at Duke University. “Are they going to do that? The question of who the Marshals Service owes their allegiance to will be put to the test in the not-too-distant future, I suspect.”Concern over the oversight of the Marshals Service is not new. A 1982 report by the Government Accountability Office called the marshals’ oversight arrangement “an unworkable management condition.” As a possible solution, it proposed legislation to move control of the marshals to the judiciary.Some members of Congress have begun proposing a similar solution.“Do you think you could better protect judges if your security was more independent?” Representative Eric Swalwell, Democrat of California, asked a federal judge testifying on behalf of the Judicial Conference at a hearing in February, two weeks before Judge Sullivan’s remarks.About 50 judges gathered in Washington for the biannual meeting of the Judicial Conference, which oversees the administration of the federal courts. It was the first time the conference had met since Mr. Trump retook the White House.Eric Lee/The New York TimesRepresentative Darrell Issa, Republican of California, responded that he considered the question of independent oversight legitimate. The judge answered that the conference would consider the matter.In an interview, Mr. Swalwell said he was drafting legislation that would put the judiciary in charge of its own security.Last month, Ronald Davis, who led the agency under President Joseph R. Biden Jr., issued a stark warning on LinkedIn of “a constitutional crisis if a president refuses to enforce or comply with a federal court order.” He too proposed measures to insulate the marshals from potential interference by the executive branch.In the meantime, the administration’s immediate goal for the Marshals Service may be to shrink it.On April 15, Mark P. Pittella, the agency’s acting director, sent a letter to more than 5,000 employees of the service as part of the staff-cutting measures associated with Elon Musk’s project, known as the Department of Government Efficiency, offering them the opportunity to resign and be eligible for more than four months of administrative leave with full pay. In the letter, obtained by The New York Times, Mr. Pittella wrote that agency leadership would review applications to ensure they did not “adversely impact U.S.M.S. mission-critical requirements.”But a spokesman for the service said the offer was open to employees in all areas of responsibility, including marshals tasked with protecting judges.

The New England Journal of Medicine received a letter suggesting that it was biased and compromised by external pressure. Other journals have also received the letter.A federal prosecutor in Washington has contacted The New England Journal of Medicine, considered the world’s most prestigious medical journal, with questions that suggested without evidence that it was biased against certain views and influenced by external pressures.Dr. Eric Rubin, the editor in chief of N.E.J.M., described the letter as “vaguely threatening” in an interview with The New York Times.At least three other journals have received similar letters from Edward Martin Jr., a Republican activist serving as interim U.S. attorney in Washington. Mr. Martin has been criticized for using his office to target opponents of the administration.His letters accused the publications of being “partisans in various scientific debates” and asked a series of accusatory questions about bias and the selection of research articles.Do they accept submissions from scientists with “competing viewpoints”? What do they do if the authors whose work they published “may have misled their readers”? Are they transparent about influence from “supporters, funders, advertisers and others”?News of the letter to N.E.J.M. was reported earlier by STAT, a health news outlet.Mr. Martin also asked about the role of the National Institutes of Health, which funds some of the research the journals publish, and the agency’s role “in the development of submitted articles.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

After 20 percent of the agency’s work force was cut, federal health officials have decided to bring back some experts and review firings to fill gaps in critical roles.Federal health officials have reversed the decision to fire a few dozen scientists at the Food and Drug Administration’s food-safety labs, and say they are conducting a review to determine if other critical posts were cut.A spokesman for the Department of Health and Human Services confirmed the rehirings and said that several employees would also be restored to the offices that deal with Freedom of Information requests, an area that was nearly wiped out.In the last few months, roughly 3,500 F.D.A. jobs, about 20 percent, were eliminated, representing one of the largest work force reductions among all government agencies targeted by the Trump administration.The H.H.S. spokesman said those employees called back had been inadvertently fired because of inaccurate job classification codes.The decision to rehire specialists on outbreaks of food-related illnesses and those who study the safety of products like infant formula follows contradictory assertions made by Dr. Marty Makary, the F.D.A. commissioner, in media interviews this week.“I can tell you there were no cuts to scientists or inspectors,” Dr. Makary said Wednesday on CNN.In fact, scientists had been fired from several food and drug safety labs across the country, including in Puerto Rico, and from the veterinary division where bird flu safety work was underway. Scientists in the tobacco division who were dismissed in February — including some who studied the health effects of e-cigarettes — remain on paid leave and have not been tapped to return, according to employees who were put on leave.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

A $56 million grant to train emergency responders and supply them with the overdose reversal spray, plus other programs that address addiction, could be eliminated.The opioid overdose reversal medication commercially known as Narcan saves hundreds of thousands of lives a year and is routinely praised by public health experts for contributing to the continuing drop in opioid-related deaths. But the Trump administration plans to terminate a $56 million annual grant program that distributes doses and trains emergency responders in communities across the country to administer them, according to a draft budget proposal.In the document, which outlines details of the drastic reorganization and shrinking planned for the Department of Health and Human Services, the grant is among many addiction prevention and treatment programs to be zeroed out.States and local governments have other resources for obtaining doses of Narcan, which is also known by its generic name, naloxone. One of the main sources, a program of block grants for states to use to pay for various measures to combat opioid addiction, does not appear to have been cut.But addiction specialists are worried about the symbolic as well as practical implications of shutting down a federal grant designated specifically for naloxone training and distribution.“Reducing the funding for naloxone and overdose prevention sends the message that we would rather people who use drugs die than get the support they need and deserve,” said Dr. Melody Glenn, an addiction medicine physician and assistant professor at the University of Arizona, who monitors such programs along the state’s southern border.At the scene of an emergency, first responders can hand out extra doses of Narcan and information about addiction recovery services.Arin Yoon for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

We explain the administration’s cuts to research.Late yesterday, Sethuraman Panchanathan, whom President Trump hired to run the National Science Foundation five years ago, quit. He didn’t say why, but it was clear enough: Last weekend, Trump cut more than 400 active research awards from the N.S.F., and he is pressing Congress to halve the agency’s $9 billion budget.The Trump administration has targeted the American scientific enterprise, an engine of research and innovation that has thrummed for decades. It has slashed or frozen budgets at the National Institutes of Health, the National Science Foundation, the Centers for Disease Control and Prevention and NASA. It has fired or defunded thousands of researchers.The chaos is confusing: Isn’t science a force for good? Hasn’t it contained disease? Won’t it help us in the competition with China? Doesn’t it attract the kind of immigrants the president says he wants? In this edition of the newsletter, we break out our macroscope to make sense of the turmoil.An investmentAmerican research thrives under a patronage system that funnels congressionally approved dollars to universities, national labs and institutes. This knowledge factory employs tens of thousands of researchers, draws talent from around the world and generates scientific breakthroughs and Nobel Prizes.It’s a slow-moving system, because science moves slowly. Discoveries are often indirect and iterative, involving collaboration among researchers who need years of subsidized education to become expert. Startups and corporations, which need quick returns on their investment, typically can’t wait as long or risk as much money.Science is capital. By some measures, every dollar spent on research returns at least $5 to the economy.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

32 minutes agoShareSaveEleanor LawrieSocial Affairs ReporterShareSaveGetty ImagesSupported housing, which helps vulnerable or disabled people live independently, is in crisis, an open letter signed by more than 170 organisations in the sector claims.Services at one in three providers in England had to shut last year, adding to a total shortfall of about 325,000 places, says the letter, which will be delivered to Prime Minister Keir Starmer today. Signatories to it include Refuge, Age UK and the National Housing Federation (NHF).Blaming cuts to council funding and rising costs, the NHF says a further one in three providers fear they may close unless the government pledges more money.The government says supported housing is vital and it is focused on building more homes.About half a million people in the UK currently live in supported housing, including young care leavers, army veterans, people with learning disabilities and those escaping homelessness or domestic abuse.”Supported housing plays an indispensable role in cutting NHS waiting list backlogs, and reducing pressure on social care, temporary accommodation, and other vital public services,” the open letter says.However, it says the future of supported housing is now at risk following “years of funding cuts” and that local authorities have now been forced to “decommission vital services”.”Rising costs alongside reduced funding have rendered many services unviable, forcing many to close, while demand for supported housing continues to rise. The decision to increase employers’ National Insurance contributions has placed even further pressure on providers’ budgets.”The organisations are calling for long-term increased funding for housing-related support of at least £1.6bn per year for councils and for supported homes to be among the 1.5 million new houses planned by the government.”We recognise the vital role played by supported housing in helping vulnerable people to live independently and well, and the contribution it makes to tackling rough sleeping and timely hospital discharge,” a spokesperson for the Department for Housing, Communities and Local Government said.The spokesperson said the government was putting £2bn into increasing social and affordable housebuilding in 2026-27, with further details to be set out in a long-term housing strategy later this year.Family pictureProponents of austerity measures say tough funding choices need to be made to balance the UK’s finances.However, Shaoxiong Liu says his family do not know what they would have done without a supported housing place for his son Jason.Aged 39, Jason has autism, a learning disability and mental health challenges. As he grew older, this became increasingly unmanageable for his family. After falling ill, Jason was admitted to hospital with sepsis in 2017.Due to his challenging behaviour and a condition that induces severe vomiting, he remained in hospital for months as they struggled to find somewhere long term that could accommodate his needs.He was eventually placed with Advance Housing, where his family says Jason has flourished in the intervening eight years. His weight has risen from 35kg to 53kg, he can go on bus trips and attends social events organised by the housing provider.”Jason’s behaviour is so much better now. He’s lived there so long and he’s happy there,” Mr Liu says. “Jason is an adult now and we are in our 70s, so his behaviour could be quite dangerous for us if he lived with us – we couldn’t look after him.”The NHF says one in three providers in England it surveyed say they may have to stop providing services altogether, meaning the loss of 70,000 supported homes across the country.In 2009, ringfenced council funding for housing-related support was removed. When council budgets were cut during austerity from 2010, funding was needed in other areas, meaning some councils had to cut supported housing services.The NHF says that means there are now fewer supported homes than in 2007, including a net loss of 3,000 supported homes in the last three years. It calculates there is a total shortfall of up to 325,000 supported homes, based on unmet need.

The Women’s Health Initiative has produced thousands of research papers, altering medical care for patients around the world.Federal health officials plan to cut funding to the Women’s Health Initiative, effectively shuttering one of the largest and longest studies of women’s health ever carried out. Its findings changed medical practice and helped shape clinical guidelines, preventing tens of thousands of cases of cardiovascular disease and breast cancer.The study, which began in the 1990s when few women were included in clinical research, enrolled over 160,000 participants across the nation. It continues to follow some 42,000 women, tracking data on cardiovascular disease and aging, as well as frailty, vision loss and mental health.Researchers have hoped to use the findings to learn more about how to maintain mobility and cognitive function and slow memory loss, detect cancer earlier and predict the risks of other diseases.The Department of Health and Human Services is terminating contracts for the W.H.I.’s regional centers in September. The clinical coordinating center, based at Fred Hutch Cancer Center in Seattle, will be funded through at least January 2026.Whether it will continue to receive support next year remains uncertain. Even if funding continues, the coordinating office relies on the regional centers to gather data from participants, and so its functions will be limited.H.H.S. did not immediately respond to a request for comment. Recently, a spokeswoman said cuts to such funding “are designed to ensure that every dollar is used more efficiently while continuing to focus on our core mission of improving public health and services.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Every Monday, Maurine Gentis, a retired teacher, waits for a delivery from Meals on Wheels South Texas.“The meals help stretch my budget,” Ms. Gentis, 77, said. Living alone and in a wheelchair, she appreciates having someone look in on her regularly. The same group, a nonprofit, delivers books from the library and dry food for her cat.But Ms. Gentis is anxious about what lies ahead. The small government agency responsible for overseeing programs like Meals on Wheels is being dismantled as part of the Trump administration’s overhaul of the U.S. Department of Health and Human Services. Roughly half its staff has been let go in recent layoffs and all of its 10 regional offices are closed, according to several employees who lost their jobs.“I’m just kind of worried that the whole thing might go down the drain, too,” Ms. Gentis said.In President Trump ’s quest to end what he termed “illegal and immoral discrimination programs,” one of his executive orders promoted cracking down on federal efforts to improve accessibility and representation for those with disabilities, with agencies flagging words like “accessible” and “disability” as potentially problematic. Certain research studies are no longer being funded, and many government health employees specializing in disability issues have been fired.The downsizing of the agency, the Administration for Community Living, is part of far-reaching cuts planned at the H.H.S. under the Trump administration’s proposed budget.While some federal funding may continue through September, the end of the government’s fiscal year, and some workers have been called back temporarily, there is significant uncertainty about the future. And some groups are reporting delays in receiving expected federal funds.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Acadia Healthcare’s chief executive was awarded a $1.8 million bonus to respond to “unprecedented governmental inquiries” into allegations of holding psychiatric patients against their will.Last year was tough for Acadia Healthcare, one of the country’s largest providers of mental health services.A slew of federal agencies opened investigations into whether Acadia illegally held patients against their will in its psychiatric hospitals, as described in a New York Times investigation in September. The federal inquiries rattled investors, causing Acadia’s stock to plummet.But Acadia’s troubles have been a boon to the company’s chief executive, Christopher Hunter. Its board of directors awarded him a $1.8 million bonus to help respond to “unprecedented governmental inquiries,” according to a financial filing this month. The bonus comes on top of his regular compensation, which totaled more than $7 million in 2024.Acadia’s chief financial officer and general counsel were also granted bonuses of about $1 million, and the chief operating officer was promised $600,000. Acadia said the bonuses, which will be paid in March of next year, were awarded to ensure that the leaders did not leave before the investigations were completed.The company’s board decided that keeping its leadership team was “in the best long-term interest of the company and the patients and communities it serves,” said Tim Blair, a spokesman for Acadia. “The company follows a pay-for-performance philosophy, using peer market data for benchmarking and calibration,” he added.The Times reported that Acadia was holding patients against their will in order to maximize insurance payouts. Some patients arrived at emergency rooms seeking routine mental health care but were sent to Acadia facilities, where they were locked inside and isolated from their families. The practices began before Mr. Hunter became chief executive, in April 2022, but continued under his watch, The Times found.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.