24 minutes agoShareSaveAlix HattenstoneBBC News, EnglandShareSaveBBCMore than six million illegal vaping products have been seized by Trading Standards officers across England in the past three years, new analysis by the BBC has found. We joined one of the teams responsible for tracking down the illicit goods as they prepare for a ban on the sale of single-use disposable vapes.Paul Leighton is packing his rucksack with a heavy-duty hammer, pry bar and evidence bags for what he describes as “just an average day out”.As the senior Trading Standards officer at Newcastle City Council, he has learned the hiding places used to conceal illegal vapes can be sophisticated. Sometimes, he has to force his way in.He has found them hidden everywhere from inside fridges and barbecues to behind fake fuse boxes and tiled panels complete with hydraulic lifts.”I’ve seen entire kitchens come away from walls and off the floor as well… so all sorts of hiding places,” he says.Classified as illicit or non-compliant vapes, the products he will be searching for today fail to meet the legal requirements for sale in the UK.More than six million of them were seized in England between 2022 and 2024, according to analysis by the BBC.The health risks posed to unwitting customers are summed up by Connor Lamb, a senior technician for licensing also taking part in the unannounced checks on shops.If you get a normal vape, he says, “they’ve got a capacity which is enough for 600 puffs – the equivalent to 20 cigarettes”.But if you get an illegal one, “it can be anything from 200 cigarettes in one vape. Obviously someone buying this to go on a night out or a kid might just be chuffing on it all day and you can imagine the drastic effect that’ll have on someone’s lungs.”According to Trading Standards, illicit or non-compliant vapes can be anything with tank sizes greater than 2ml, a nicotine strength of more than 20ml or labels that do not display manufacturer details and health warnings.The Medicines and Healthcare Products Regulatory Agency strongly advises consumers not to use them as the true content – and any possible health risk – is unknown.On the road, Paul and Connor quickly find a stash of between 12 and 20 packs of illegal vapes at the back of a shop counter.”It would be unusual to have so few in a shop that sells quite frequently like this, so it’s just a case of where they’re hiding the rest,” says Paul.We head to a room at the back of the shop. There is a stench of urine. It is full of litter and we are deep in seemingly empty cardboard boxes.Paul’s hunch is proven right though as a search among the rubbish unearths a box of illegal vapes.How widespread are illegal vapes?Of 136 local Trading Standards bodies in England, 133 responded to BBC Freedom of Information requests, showing that between 2022 and 2024:At least 6,169,822 illicit or non-compliant vaping products were seized, including those taken at ports as well as in shopsThere were 3,766 records of retailers selling vapes to children making test purchases, with some retailers potentially caught more than onceRetailers were recorded 7,594 times as selling illicit or non-compliant vapes on test purchasesSelling illegal vapes was a factor in at least 316 shop closures during that period, while selling to children was a factor in at least 67. Most of the closures were temporary and some retailers may have been shut down more than once.The Independent British Vape Trade Association (IBVTA) insists the majority of vape shops operate within the law, serving adults who would otherwise be smoking.A spokesperson said: “These business owners would never knowingly involve themselves in criminal activity. Rather, it is since the resurgence of popularity of single-use vapes, and therefore a popular ‘cash market’, that we’ve seen organised crime gangs get involved in importing and distributing vapes.”They said IBVTA had long called for greater enforcement action at borders to stem the flow of illegal products entering the country.The Department of Health and Social Care said it was allocating an extra £10m this financial year for Trading Standards to tackle underage and illicit sales, with an expected 80 additional apprentice enforcement officers to be funded.Paul and Connor agree single-use vapes are among the main driving forces of the illegal trade and hope the coming ban will improve the situation.”These are quite sophisticated networks that we’re up against who are also involved in lots of quite serious activities as well as modern day slavery, trafficking, drug supply,” says Paul.”I think we’ll see a lot less product taken off the street because we haven’t really had a massive issue with reusable vapes for quite some time.”They’ve always been broadly compliant in terms of the devices that are being used, the batteries, the liquids, the odd oversized tank here.”When does the disposable vapes ban start?From 1 June, it will be illegal for businesses in the UK to sell, supply or possess single-use vapes for sale.Those caught doing so will get a £200 on-the-spot fine in the first instance, rising to an unlimited fine and/or a prison sentence of up to two years for repeat offences.The government has said Trading Standards will be able to keep the full value of the on-the-spot fines, to reinvest into enforcement.Extra enforcement powers and funding are something IBVTA says it welcomes, noting “not all Trading Standards teams are equally or adequately resourced” and “some areas with low regulatory compliance are unable to carry out the enforcement they would want to”.But a national spokesperson for Trading Standards said its work was “definitely having an impact”.Government funding had enabled “extra boots on the ground” at Heathrow Airport and Dover Port, the spokesperson said, which explained the high number of seizures by the local authorities home to those border points – Hillingdon and Kent. In Hillingdon alone, 2,099,248 vaping products were seized between 2022-2024, making up a third of the total. They said Salford was home to a number of vape warehouses supplying products across England, meaning “seizing at this stage in the supply chain is really effective”.However, they said there was still a “huge challenge in terms of retailers prepared to sell illegal products as well as those who persistently sell to children”.Back in Newcastle, Paul offers a similar assessment of the task faced nationally.He estimates the number of illegal vapes still circulating in the country is “easily in the millions at the moment”, adding: “It’s a constant battle trying to make a difference.”Additional reporting by Jonathan Fagg and Miguel Roca-TerryMore on this story

6 minutes agoShareSaveNick TriggleShareSaveGetty ImagesExtreme tiredness and exhaustion among NHS staff poses a significant risk to patients, England’s NHS safety watchdog warns. The Health Services Safety Investigations Body said medication errors, impaired decision-making, reduced attention and rude and disrespectful behaviour were the most common problems associated with fatigued staff in hospitals.It said there was limited data on the scale of the problem, but cited evidence from staff surveys and information provided by safety experts that it was a contributory factor in safety incidents.In its report, the watchdog gave examples of mistakes being made with pregnancy scans and chemotherapy drugs.In one case a mother and baby were harmed after an inaccurate scan, with the staff member saying fatigue and workload contributed.In the chemotherapy case the staff were nearly nine hours into a 12.5-hour day shift and had only managed five to six hours of sleep between shifts and had limited breaks because of staffing pressures.The hospital investigation found fatigue was “likely to have been a factor”.Sleep-deprivedSome staff reported being sleep-deprived on a daily basis.And one doctor told the watchdog: “When it gets to that third day of doing these 12-hour nights it’s dangerous from 2am onwards… do I have the energy or the brain space or the mental space to even make a life-changing decision for a patient at this point?”The watchdog said exhaustion was also a risk to staff themselves with some complaining of nodding off at the wheel on the way home and reports of staff dying in road accidents after work.Shift work, long working hours, lack of breaks, caring responsibilities and financial pressures were all cited as factors in staff fatigue.The watchdog said the issue was often misunderstood in the NHS and thought of more as a wellbeing issue rather than a safety issue.It said the government and NHS England needed to introduce better systems to monitor fatigue and work with unions and employers to raise awareness about it.Support availableSenior safety investigator Saskia Fursland said: “Fatigue is more than just being tired – it can significantly impair decision-making, motor skills, and alertness. “We must move away from viewing fatigue as an individual issue and putting the onus on personal responsibility and instead treat it as a system-level risk that deserves urgent attention.”Dr Latifa Patel, of the British Medical Association, said the findings were concerning, but not surprising with doctors facing long shifts back-to-back with little respite.She said there needed to be better rota design to ensure staff could rest properly between shifts and improved rest facilities in hospitals. But she said fatigue was also “often driven by workforce shortages” too.A spokesperson for NHS England said it recognised staff were at risk of burnout and was “committed” to ensuring they got the support they needed to provide safe care.”Staff should always feel confident to report patient safety concerns, including those that are linked to fatigue, and we will work with local NHS systems to address any issues,” he added.He said the NHS was offering more flexible working options than ever before and there was a range of mental health support available for staff.

18 minutes agoShareSavePhilippa RoxbyHealth reporterShareSaveBBCChris Brookes-Smith, 28, used to live in fear of dying from eating even the smallest trace of peanut.Ten years ago he had his worst allergic reaction after ordering a curry at a local Indian takeaway. The trauma of it is seared into his memory.”I knew I was in trouble after one bite,” he says. “Within seconds there were spots on my lips. Within minutes I was vomiting. I could feel my throat closing up, hives forming in my armpits then over my whole body… My face going all puffy with the swelling.”His voice tails off, full of emotion. “I thought I was going to die.”Photos taken in hospital later that day show the toll the reaction took on his body. “I looked like a plucked turkey because my skin had blistered so much,” Chris says.But the most painful thing were the hives – red, raised bumps on the skin – which felt “like boiling water had been poured over me”.Chris Brookes-SmithTrying to avoid peanuts, one of the most common food allergies, has been a way of life for Chris and millions of other adults with a serious allergy. Eating out, going to social events and travelling abroad are all fraught with anxiety. As many as one in 200 adults and one in 50 children have a nut allergy, charities say. Some children grow out of their allergies, but many don’t – and they continue into adulthood, often getting worse.An allergic reaction occurs when the body reacts to the protein in peanuts, thinking it’s a threat, which triggers a sudden release of chemicals. Symptoms can range from the mild to very serious.Chris’s allergy first came to light as a baby, when he developed a rash as his mum made peanut butter sandwiches. Each reaction since has been worse than the one before, which means he’s become accustomed to living every day “on high alert hoping nothing bad happens”. Activities such as going out with friends or eating in restaurants, which should be enjoyable, turned into stressful, potentially life-threatening experiences.Despite a love of travel, Chris avoided going to countries where peanuts are commonly used, like south east Asia, after three allergic reactions on a trip to Italy.As Chris grew up, his family constantly worried about him. But then his mum heard about a clinical trial at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London that would change her son’s life.It would test whether adults like Chris with serious peanut allergies could be desensitised by training their bodies to tolerate the very thing that could kill it, calming down the immune system when it would usually over-react.Despite being “really nervous”, Chris agreed to sign up.From milligrams to whole nutsUnder the watchful eye of doctors, Chris started by eating a fraction of a milligram of peanut powder mixed with yoghurt. Over many months, the amount of peanut was gradually increased, slowly building up to Chris eating fractions of nuts and, finally, whole nuts.By the end of the nine-month study, 14 of the 21 patients could eat the equivalent of five peanuts without having allergic reactions – including Chris.Professor Stephen Till, who led the research, says the treatment “has potential to have a real impact on patients’ lives”.”Most severe reactions occur because of mistakes, usually by somebody else, and miscommunication. So it provides them with some protection against that.”They’ve taken control, if you like, of their peanut allergy now.”The method – called oral immunotherapy – is already proven to work for allergies to pollen, wasp and bee stings. It’s only been used on food allergies in the last 20 years, and mostly in children whose immune systems are still developing. Adult allergies are thought to be harder to shift.”Peanut allergy is very common in children and almost never goes away,” says Prof Till. “Those young people are going to become adults, so we need treatments for adults too.” This trial, published in the journal Allergy, shows adults with serious allergies can increase the amount of peanut they can tolerate by 100 times.Chris Brookes-SmithChris had no idea how he would react to even the slightest trace of peanut. Increasing that dose – willingly – every day was something he couldn’t imagine.”The first time I went there and I ingest this stuff, my heart’s going a million miles an hour,” he says. “The big jump in fear was going from peanut dust to half a whole nut.” But he was reassured by having a team of doctors and nurses present, with drugs such as adrenaline standing by in case of a severe, life-threatening reaction.”You’ve got 100 eyes on you – nothing is gonna happen.”However, experts stress no one should try this at home on their own because of the risk of a serious allergic reaction occurring.’Wonderful feeling’Not everyone who tried the treatment was desensitised, and larger trials in more people will have to work out why that is.”For some people, there were reactions and we had to slow down or go back a step,” explains Prof Till. “But the message is that you can desensitise adults to peanuts -and there should be more focus on adults in the future.”Being able to eat peanuts safely had a huge impact on the lives of those who took part, the researchers say. It has given them freedom to travel, reduced their anxiety when eating out and removed their fear of food.How to develop this into a practical treatment on the NHS is more of a challenge. First, larger trials are needed to prove it can work for more people.And researchers are looking at whether putting drops of peanut in solution under the tongue could be a safer way of achieving the same end result.Chris now eats four peanuts every morning with his breakfast granola to keep his allergy at bay – as recommended by his doctors.He’s grateful for having had the opportunity to take part in the trial and hopes many others with serious peanut allergies can also benefit from the treatment.While he admits he still hates the flavour of peanuts, he says knowing he can now eat something that once sent his body into “nuclear meltdown” has changed his life.”It’s a wonderful feeling,” Chris says. “I’m no longer afraid of dying.”

The few domestic companies that still make protective gear for health care workers have clamored for federal intervention. But they worry President Trump’s trade war with China won’t help.Few domestic industries have been as devastated by the flood of cheap Chinese imports as manufacturers of face masks, exam gloves and other disposable medical gear that protects health care workers from infectious pathogens.The industry’s demise had calamitous consequences during the Covid pandemic, when Beijing halted exports and American hospital workers found themselves at the mercy of a deadly airborne virus that quickly filled the nation’s emergency rooms and morgues.But as President Trump unveiled his tariff regimen earlier this month, and Beijing retaliated with an 84 percent tax on American imports, the few remaining companies that make protective gear in the United States felt mostly unease.“I’m pretty freaked out,” said Lloyd Armbrust, the chief executive of Armbrust American, a pandemic-era startup that produces N95 respirator masks at a factory in Texas. “On one hand, this is the kind of medicine we need if we really are going to become independent of China. On the other hand, this is not responsible industrial policy.”The United States once dominated the field of personal protective equipment, or P.P.E. The virus-filtering N95 mask and the disposable nitrile glove are American inventions, but China now produces more than 90 percent of the medical gear worn by American health care workers.Despite bipartisan vows to end the nation’s dependency on foreign medical products — and to shore up the dozens of domestic manufacturers that sprung up during the pandemic — federal agencies and state governments have resumed their reliance on inexpensive Chinese imports. Earlier this year, when California purchased millions of N95 masks for those affected by the Los Angeles wildfires, it chose masks made in China.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.

Health Secretary Robert F. Kennedy Jr. escalated his war against the food industry on Tuesday, declaring that “sugar is poison.”Mr. Kennedy’s comment came during a highly publicized news conference where he also asserted that he has “an understanding” with major food manufacturers to remove petroleum-based food colorings from their products by 2026.No one from the food industry attended the event, and none have publicly agreed to Mr. Kennedy’s demands, although the International Dairy Foods Association has pledged to eliminate artificial colors in milk, cheese and yogurt sold to schools as part of the federal lunch and breakfast programs by the start of the 2026 school year.However, Mr. Kennedy and his advisers said that every major food manufacturer and some fast-food companies have contacted the agency looking for guidance.“Four years from now, we are going to have most of these products off the market, or you will know about them when you go to the grocery store,” Mr. Kennedy said.Mr. Kennedy’s push to get food manufacturers to remove dyes from their products is his first effort at sweeping reform of the food industry, which he has long blamed for creating and marketing ultra-processed foods that he says are making Americans obese and contributing to a host of diseases, including diabetes and heart disease.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.

Despite a 1 percent increase in 2024, U.S. birthrates remained in a historic slump, a trend that worries demographers and cultural critics.Births in the United States increased by just 1 percent in 2024, still near the record low rates that have alarmed demographers and become a central part of the Trump administration’s cultural agenda, according to data released on Wednesday by the Centers for Disease Control and Prevention.More than 3.6 million babies were born in the United States last year, a meager rise from the record-setting low in 2023. The fertility rate, approximately 1.6 births per woman over her lifetime, is well below the 2.1 births needed to maintain the country’s population through births alone.The new data represent “the continuation of a long-term decline of births in the United States that began really with the Great Recession in 2007,” said Ken Johnson, a demographer at the University of New Hampshire.These numbers, and the reasons that they have experienced such a consistent decline, are widely seen as a problem that could affect the U.S. economy in coming decades, as fewer young workers support a growing aging population.President Trump has called for a “baby boom,” joining with a conservative “pronatalist” movement that aims to persuade more Americans to get married and have many babies.Vice President JD Vance and others in the pronatalist movement have criticized childless young Americans, arguing that they are contributing to the potential collapse of the U.S. population because of their disdain for nuclear families and traditional gender roles.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.

12 minutes agoShareSaveSarah HawleyBBC News, East MidlandsShareSaveSuppliedVanellope Hope Wilkins made medical history when she was born with her heart outside of her body in 2017. Described by experts as “one of a kind”, Vanellope had three operations to place her heart back in her chest due to an extremely rare condition called ectopia cordis.The hospital where she was born – Glenfield Hospital in Leicester – says it knows of no other case in the UK where the baby has survived.Now seven years old, Vanellope has undergone groundbreaking surgery to reconstruct a protective cage around her heart – using her ribs. The BBC was given exclusive access into theatre, when the operation took place at the East Midlands Congenital Heart Centre, based at the Leicester Royal Infirmary, last Wednesday.Warning: This story contains an image of surgeryGlenfield HospitalIt’s early morning outside theatre, and a team of specialist medical experts gather for a briefing to discuss the unprecedented surgery about to take place.Vanellope still has no breastbone, leaving her heart covered by just by a thin layer of skin. Surgeons have come up with a plan to use her ribs to form a protective cage inside her chest.Consultant paediatric surgeon Nitin Patwardhan was one of the 50-strong medical team at Vanellope’s birth on 22 November.Now he is set to play a leading role again in surgery, which has never been performed like this before.”I’d lie if I say I don’t get nervous,” he says. “But having been in this profession for so many years, you actually look forward to it because at the end of the day, you’re doing something that will change somebody’s life.”He remembers how “everything was unknown” when Vanellope was born, because no-one in the country had ever dealt with a similar case. A handful of children in the US have also survived this condition.Ectopia cordis affects only a few cases per million births – and Vanellope was given a less than 10% chance of survival. But she defied those odds and was allowed home after 14 months in hospital.Glenfield HospitalSince then, Vanellope has had to wear a brace around her chest to protect her heart. She has complex medical needs, which require one-to-one care, 24 hours a day. She is autistic and non-verbal.Mum Naomi Findlay, 39, who lives in Clifton, Nottinghamshire, described her daughter as “a happy little thing” who “brings a lot of joy and a lot of happiness”.She added: “It makes me extremely proud to see actually how how far she’s come, what she’s overcome and what she is achieving. It’s a real journey of strength and bravery… she’s so brave.” Having to kiss her daughter goodbye at the theatre door is difficult and the tears flow. “A lot of anxiety, a lot of worry and so many emotions,” she says. “For me, the biggest fear is handing her over and not getting her back.”The team waiting in theatre include specialists from the Congenital Heart Centre, Leicester Children’s Hospital and a visiting cardiothoracic surgeon from Great Ormond Street Hospital in London.Consultant congenital cardiac surgeon, Ikenna Omeje, operated on Vanellope just 50 minutes after she was born.He recalls there being a lot of “head scratching” among surgeons, because the condition was so rare. “It was exciting for everyone because it was something we had never seen before. So you made the news, not just within the UK, but all over the world,” he says.Explaining the current procedure, he points to a 3D scan of Vanellope’s chest, and describes how her heart has attached to the thin layer of skin protecting it. Detaching it “is risky”, he confesses. “You can damage the vessel trying to get into the chest cavity,” he said.Now aged seven, surgeons decided Vanellope had reached the right age for reconstructive surgery to form a permanent structure around her heart.University Hospitals of Leicester NHS TrustVanellope is first placed on a bypass machine, which temporarily takes over the functions of the heart and lungs. This allows her heart to deflate, allowing the “very tricky” procedure to detach part of her heart – the right ventricular outflow tract – and the pulmonary artery from where it has stuck to her skin.Next, the bilateral rib osteotomy takes place, which involves breaking Vanellope’s ribs on both sides to move them in order to form the protective cage around her heart.Carrying out all of the procedures at once, on a patient with ectopia cordis, has never been done in this country before, the team says.The extremely complex procedure lasts more than nine hours. And it’s a success. The surgeons are delighted. Mr Omeje is beaming as he says it “went a lot better than we expected”. He describes how he examined an X-ray of Vanellope’s chest after the operation, and called it “really beautiful”.Mr Omeje called Vanellope “one of a kind” and explained how fulfilling it was to have everything go so well. “The best satisfaction we derive from this is when you get a text message from the mum to say ‘thank you, you guys are amazing’,” he says. “I think personally, I have just done my job, but it has made a difference to someone and that is very satisfying.”SuppliedVanellope is taken to the children’s paediatric intensive care unit and will spend some time in hospital recovering. After a few weeks, she will be able to take off her protective chest brace and won’t require any further surgery in the future.Her mum called the NHS “amazing”, and says she can’t wait to take her home to her older brothers and little sister.Looking to the future, she hopes this surgery will improve Vanellope’s “already really, really good quality of life”. And Naomi says this time, she’s ready for the long journey ahead. “When [Vanellope] was born I was fearful. It was very scary for me, but this time round I’m ready. “We’ve got this,” she added.More on this storyRelated internet links

2 days agoShareSaveNatalia ZuoBBC Eye, World Service InvestigationsShareSaveBBCAbby Wu was just 14 when she had cosmetic surgery for the first time.After receiving hormone treatment for an illness, Abby’s weight increased from 42kg (6 stone 8lbs) to 62kg (9 stone 11lbs) in two months.The change hadn’t gone unnoticed by her drama teacher.”My teacher said, ‘You were our star but now you’re too fat. Either give up or lose weight fast,'” recalls Abby, who was preparing for her drama exams at the time.Abby’s mother stepped in, taking her to get liposuction to remove fat from her belly and legs.Abby remembers her mother’s words as she waited in the clinic in a hospital gown, nervous about the impending operation. “Just be brave and walk in. You’ll become pretty once you’re out.”The surgery was traumatic. Abby was only given partial anaesthesia and remained conscious throughout.”I could see how much fat was extracted from my body and how much blood I was losing,” she says.Family handoutNow 35, Abby has gone on to have more than 100 procedures, costing half a million dollars.She co-owns a beauty clinic in central Beijing and has become one of the most recognisable faces of China’s plastic surgery boom.But the surgeries have come at a physical cost.Sitting in front of a mirror inside her luxury duplex apartment in Beijing, she gently dabs concealer onto bruises from a recent face-slimming injection – a procedure she undergoes monthly to help her face appear “firmer and less chubby” after three jaw reduction surgeries removed too much bone.But she insists she has no regrets about the surgeries and believes her mother made the right decision all those years ago.”The surgery worked. I became more confident and happier, day by day. I think my mum made the right call.”Abby WuOnce seen as taboo, plastic surgery has exploded in popularity over the last 20 years in China, fuelled by rising disposable incomes and shifts in social attitudes, in large part driven by social media.Every year, 20 million Chinese people pay for cosmetic procedures.Overwhelmingly, it is young women who seek surgery. Eighty per cent of patients are women and the average age of someone receiving surgery is 25.While appearance has always been important in Chinese culture, particularly for women, beauty standards in the country are changing.For years, the most sought-after features were a blend of Western ideals, anime fantasy and K-Pop inspiration: The double eyelid, the sculpted jawline, the prominent nose, and the symmetrical face.But lately, more disturbing procedures are on the rise – chasing an unrealistic, hyper-feminine, almost infantile ideal.Details of help and support with body image concerns are available in the UK at BBC Action Line Botox is now injected behind the ears to tilt them forward, creating the illusion of a smaller, daintier face. Lower eyelid surgery, inspired by the glassy gaze of anime heroines, widens the eyes for an innocent, childlike look. Upper lip shortening narrows the space between lip and nose, thought to signal youth.But much of this beauty is built for the screen. Under filters and ring lights, the results can look flawless. In real life, the effect is often uncanny – a face not quite human, not quite child.TikTokSoYoungCosmetic surgery apps like SoYoung (New Oxygen) and GengMei (More Beautiful) – claiming to offer algorithm-driven analysis of “facial imperfections” – have been surging in popularity.After scanning and assessing users’ faces, they provide surgery recommendations from nearby clinics, taking a commission from each operation.These and other beauty trends are shared and promoted by celebrities and influencers on social media, rapidly changing what’s considered desirable and normal.As one of China’s earliest cosmetic surgery influencers, Abby has documented her procedures across major social media platforms and joined SoYoung soon after it launched.Yet despite having undergone more than 100 procedures, when she scans her face using SoYoung’s “magic mirror” feature, the app still points out “imperfections” and suggests a long list of recommended surgeries.”It says I have eye bags. Get a chin augmentation? I’ve done that.” Abby seems amused.”Nose-slimming? Should I get another nose surgery?”Unlike typical e-commerce sites, beauty apps like SoYoung also offer a social media function. Users share detailed before-and-after diaries and often ask superusers like Abby for their advice.’My skin felt like there was cement underneath’To meet surging demand, clinics are opening up rapidly across China.But there’s a shortage of qualified practitioners and large numbers of clinics are operating without a licence.According to a report by iResearch, a marketing research firm, as of 2019, 80,000 venues in China were providing cosmetic procedures without a licence and 100,000 cosmetic practitioners were working without the right qualifications.As a result, it’s estimated that hundreds of accidents are happening every day inside Chinese cosmetic surgery clinics.Dr Yang Lu, a plastic surgeon and owner of a licensed cosmetic surgery clinic in Shanghai, says in recent years the number of people coming for surgeries to repair botched operations has been growing.”I’ve seen many patients whose first surgery was botched because they went to unlicensed places,” Dr Yang says.”Some even had surgery inside people’s homes.”Yue Yue, 28, is among those to have had surgery that went badly wrong.In 2020 she received baby face collagen injections – designed to make the face appear more plump – from an unlicensed clinic opened by a close friend. But the fillers hardened.”My skin felt like there was cement underneath,” she says.Desperate to undo the damage, Yue Yue turned to clinics she found through social media – well-known names – but the repairs only made things worse.One clinic attempted to extract the filler using syringes. Instead of removing the hardened material, they extracted her own tissue, leaving her skin loose.Another clinic tried lifting the skin near her ears to reach the filler underneath, leaving her with two long scars and a face that looked unnaturally tight.”My entire image collapsed. I lost my shine and it’s affected my work [in human resources for a foreign company in Shanghai] too.”She found Dr Yang through SoYoung last year and has since undergone three repair surgeries, including for her eyelids which were damaged during a previous operation by another clinic.But while Dr Yang’s surgeries have brought visible improvements, some of the damage from the botched procedures may be permanent.”I don’t want to become prettier any more,” she says.”If I could go back to how I looked before surgery, I’d be quite happy.”‘It ruined my career’Every year, tens of thousands like Yue Yue fall victim to unlicensed cosmetic clinics in China.But even some licensed clinics and qualified surgeons aren’t following the rules strictly.In 2020, actress Gao Liu’s botched nose operation – in which the tip of her nose turned black and died – went viral.”My face was disfigured and I was very down. It ruined my acting career.”She had received the nose surgery at a licensed Guangzhou clinic called She’s Times from Dr He Ming, who was described as its “chief surgeon” and a nose surgery expert.But in reality Dr He was not fully qualified to perform the surgery without supervision and had not obtained his licensed plastic surgeon status from the Guangdong Provincial Health Commission.Authorities fined the clinic, which closed soon after the scandal, and barred Dr He from practising for six months.However, weeks before She’s Times was officially dissolved, a new clinic, Qingya, requested to register at the same address.Gao LiuBBC Eye has found strong links between She’s Times and Qingya, such as the same Weibo account and the retention of several staff, including Dr He.The BBC has also learned that Dr He only obtained the licensed plastic surgeon qualification in April 2024, even though he was technically barred from applying for the status for five years from the date he was sanctioned in 2021.Qingya now claims to have opened 30 branches.Dr He, Qingya and Guangdong Provincial Health Commission did not respond to the BBC’s requests for comment.The Chinese Embassy in the UK said: “The Chinese government consistently requires enterprises to operate in strict compliance with national laws, regulations, and relevant policy provisions.”Four years and two repair operations later, Gao Liu’s nose remains uneven. “I really regret it. Why did I do it?”China’s Central Health Commission has been trying to crack down on the issue of under-qualified health practitioners performing tasks beyond their expertise in recent years – including ordering local health bodies to improve regulation and issuing stricter guidelines – but problems persist.From job offer to debt and surgery – within 24 hoursIn today’s China, looking good is important for professional success.A quick search on popular job recruitment platforms reveals many examples of employers listing physical requirements for roles, even when they have little to do with the actual work.One receptionist role asks for candidates to be “at least 160cm tall and aesthetically pleasing”, while an administrative job demands “an appealing look and an elegant presence”.And now that pressure is being exploited by a growing scam in some Chinese clinics in which vulnerable young women are offered jobs, but only if they pay for expensive surgeries carried out by their would-be employers.Da Lan, not her real name, applied for a “beauty consultant” job at a clinic in Chengdu, south-western China, on a popular recruitment website in March 2024.After the interview, she was offered the position that same evening.But she says when she began her role the next morning, she was taken to a small room by her manager, who scanned her up and down and gave her an ultimatum – get cosmetic work done or lose out on the job.Da Lan says she was given less than an hour to decide.Under pressure, she agreed to undergo double eyelid surgery – priced at over 13,000 yuan (£1,330) – more than three times the monthly salary of the role – with more than 30% annual interest.She says staff took her phone and used it to apply for a so-called “beauty loan,” falsifying her income details. Within a minute, the loan was approved.By noon, she was undergoing medical tests. An hour later, she was on the operating table.From job offer to debt and surgery – all within 24 hours.The surgery did nothing for her job prospects. Da Lan says her manager belittled her, shouting her name in public and swearing at her.She quit after just a few weeks. Looking back, she believes the job was never real.”They wanted me to leave from the beginning,” she says.Despite having worked there for more than 10 days, she was paid only 303 yuan ($42). With help from her friends, Da Lan paid off the debt for her surgery after six months.BBC Eye spoke to dozens of victims, and met three including Da Lan in Chengdu, a city that has set out to become China’s “capital of cosmetic surgery”. Some have been trapped in much larger debt for years.The clinic Da Lan says scammed her had previously been reported by other graduates and exposed by local media, but it remains open and is still recruiting for the same role.This scam isn’t limited to clinic jobs – it’s creeping into other industries.Some live-streaming companies pressure young women to take out loans for surgery, promising a shot at influencer fame. But behind the scenes, these firms often have undisclosed agreements with clinics – taking a cut from every applicant they send to the operating table.In a bohemian-style café in Beijing, the perfect setting for a selfie, Abby meets her friends for coffee.The trio adjust their poses and edit their faces in great detail – extending eyelashes and reshaping their cheekbones.When asked what they like most about their facial features, they hesitate, struggling to name a single part they wouldn’t consider altering.The conversation turns to chin implants, upper-lip shortening, and nose surgery.Abby says she’s thinking about another nose job – her current one is six years old – but surgeons are finding it difficult to operate.”My skin isn’t as stretchable after so many procedures. The doctors don’t have much to work with. You can’t give them enough fabric for a vest and expect a wedding dress.”The metaphor lingers in the air, underscoring the toll taken by all of the operations.But despite everything, Abby has no plans to stop.”I don’t think I’ll ever stop my journey of becoming more beautiful.”

The agency targeted grants focused on diversity, equity and inclusion, as well as research on misinformation.Casey Fiesler, an information science professor at the University of Colorado Boulder, learned late on Friday evening that one of the three grants she had been awarded by the National Science Foundation was being terminated.“It was a total surprise,” Dr. Fiesler said. “This is the one that I thought was totally safe.”The grant supported Dr. Fiesler’s research on building A.I. literacy. She received no official explanation for why the grant was being terminated more than a year ahead of its scheduled end. But Dr. Fiesler speculated that it had something to do with the word “misinformation” in the award’s abstract.Dr. Fiesler was not alone. As of Monday, the National Science Foundation had canceled more than 400 active awards, according to a list obtained by The New York Times. The decision comes after months of scrutiny of the agency, including a report released by Senator Ted Cruz, Republican of Texas, last October and, in February, an internal review of awards containing words related to diversity, equity and inclusion, or D.E.I.In January, the Trump administration attempted to freeze grant payments for existing awards at the N.S.F.. A temporary restraining order lifted the freeze. The order also said that the agency could not terminate active awards to comply with President Trump’s executive orders, one of which called for an end to “illegal and immoral discrimination programs” under the premise of D.E.I. across the federal government.In a statement on Friday, the N.S.F. said that its grant cancellations were not in violation of the temporary restraining order. When asked by The Times to provide clarification on the legality of the grant cancellations, the agency declined to comment.The National Science Foundation, established in 1950, finances much of the scientific research that takes place in the United States, ranging from astronomy and quantum computing to microbiology and education in science technology, engineering and mathematics, or STEM.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.

Growing case numbers suggest that national total will surpass that seen during the last large outbreak in 2019.The spread of measles in the Southwest now constitutes the largest single outbreak since the United States declared the disease eliminated in 2000, federal scientists told state officials in a meeting on Monday.The New York Times obtained a recording of the meeting. Until now, the Centers for Disease Control and Prevention had not publicly described the outbreak in such stark terms.More measles cases were reported mostly in Orthodox Jewish communities in New York City and New York State in 2019. But health officials regard those as separate outbreaks, because they were fueled by multiple introductions of the virus by international travelers.C.D.C. officials now view the spread of measles in Texas, Oklahoma and New Mexico as a single outbreak, Dr. Dan Filardo, who leads the agency’s task force for the measles response, told state health officials at the meeting.“This is the largest outbreak in the U.S. since measles elimination was declared in 2000,” he said. The agency was sending seven additional officials to Texas, epicenter of the escalating crisis, he added.