BIOTECH — STILL A BUY. THE CLIFF THE THESIS.IS
MS Exhibit 9, 12 largest US biopharma. Numbers first:
• $258bn of 2026 revenue — 48% of the group's $540bn — sits on molecules losing exclusivity before 2033 • Still $226bn / 35% in 2030. Launches only partially plug it: revenue +18% over the period, LOE-exposed revenue -12% • Nearer window: ~25% of 2026 revenue rolls off by end-2030 on avg • Dispersion is the trade: MRK 59%, AMGN 48%, BMY 47%, PFE 35% vs VRTX 3%, ABBV 9%, REGN 10%, LLY 13%
Why that's bullish for biotech, not bearish for it:
- The hole is too big to invent your way out of in the window. Nobody replaces $200bn+ organically by 2030. The gap closes with BD/M&A. Full stop.
- The deadline is fixed. Unlike every other M&A cycle, LOE dates don't slip with sentiment or rates. Boards can defer a deal a quarter; they can't defer Keytruda 2028.
- Buyers are price-insensitive at the margin. A 60-80% premium on a $5bn asset is rounding error against a $30bn revenue cliff. That's why deal multiples hold even in soft tape.
- Supply is cheap. SMID biotech has spent three years de-rating on rates and funding; a large slice of the universe still trades near/below cash-adjusted book with clinical optionality unpaid-for.
- Dispersion tells you who's forced. MRK/AMGN/BMY/PFE are structural buyers. The low-exposure names (VRTX/LLY/REGN/ABBV) are the ones who can sit out — and they're mostly not sitting out either.
Positioning: own the supply, not the cliff. SMID with de-risked Ph2/3 assets in the therapeutic areas the exposed names actually need. XBI as the beta wrapper, single names for the alpha.
Risks to flag: policy (MFN, IRA pill-vs-biologic asymmetry), FTC posture on large-cap deals, and pharma choosing buybacks over BD. Rates still set the funding window for the sellers. But none of those move the LOE dates — worst case they change how the gap gets filled, not whether.
BIOTECH — STILL A BUY. THE CLIFF THE THESIS.IS
MS Exhibit 9, 12 largest US biopharma. Numbers first:
• $258bn of 2026 revenue — 48% of the group's $540bn — sits on molecules losing exclusivity before 2033 • Still $226bn / 35% in 2030. Launches only partially plug it: revenue +18% over the period, LOE-exposed revenue -12% • Nearer window: ~25% of 2026 revenue rolls off by end-2030 on avg • Dispersion is the trade: MRK 59%, AMGN 48%, BMY 47%, PFE 35% vs VRTX 3%, ABBV 9%, REGN 10%, LLY 13%
Why that's bullish for biotech, not bearish for it:
- The hole is too big to invent your way out of in the window. Nobody replaces $200bn+ organically by 2030. The gap closes with BD/M&A. Full stop.
- The deadline is fixed. Unlike every other M&A cycle, LOE dates don't slip with sentiment or rates. Boards can defer a deal a quarter; they can't defer Keytruda 2028.
- Buyers are price-insensitive at the margin. A 60-80% premium on a $5bn asset is rounding error against a $30bn revenue cliff. That's why deal multiples hold even in soft tape.
- Supply is cheap. SMID biotech has spent three years de-rating on rates and funding; a large slice of the universe still trades near/below cash-adjusted book with clinical optionality unpaid-for.
- Dispersion tells you who's forced. MRK/AMGN/BMY/PFE are structural buyers. The low-exposure names (VRTX/LLY/REGN/ABBV) are the ones who can sit out — and they're mostly not sitting out either.
Positioning: own the supply, not the cliff. SMID with de-risked Ph2/3 assets in the therapeutic areas the exposed names actually need. XBI as the beta wrapper, single names for the alpha.
Risks to flag: policy (MFN, IRA pill-vs-biologic asymmetry), FTC posture on large-cap deals, and pharma choosing buybacks over BD. Rates still set the funding window for the sellers. But none of those move the LOE dates — worst case they change how the gap gets filled, not whether.
Trump Is Pushing Nuclear Energy. His Family and Supporters Could Benefit.
In some cases, no direct line can be drawn from the president’s domestic nuclear agenda to his family or close allies. But they have overlapping business ties that could position them for gains.
The decision by President Trump to grant Saudi Arabia access to American nuclear technology aligns with his administration’s push to accelerate domestically backed nuclear power projects around the world.
But it may also contribute to a major trend in Mr. Trump’s second term: allowing the government to help enrich the president, his family, advisers and others in his orbit.
There is no evidence at this point that Mr. Trump’s friends or family helped orchestrate the Saudi nuclear deal. Yet a number of the president’s allies and relatives, including members of his cabinet, stand to benefit if his big bet on nuclear power pays off. Certain investors with ties to these deals are positioned to profit, even if the delivery of large new loads of nuclear-powered electricity remains years away.
The overarching goal is to generate more electricity as the demand surges worldwide, driven by a data-center building boom and growing consumer consumption. Investors are financing traditional, large-scale nuclear power plants along with a new technical approach called small modular reactors. Others are mining the uranium needed to power nuclear plants. Some others are vying to build those plants.
In some cases, how the Trump family or the president’s allies could potentially gain from the president’s nuclear plans is straightforward. In others, no direct line can be drawn, but there are such overlapping business ties that it is hard to separate the policy decisions from the potential personal benefits.
For example, Westinghouse, the Canadian-owned but U.S.-based company that developed the technology behind the AP1000, a large-scale reactor whose design has been used in China and for plans in Eastern Europe, is expected to be part of the deal, according to three people familiar with the matter.
The majority owner of Westinghouse is Brookfield Asset Management, one of North America’s largest commercial real estate owners. It is a frequent business partner with Newmark, the real-estate firm run and owned in part by the sons of Commerce Secretary Howard Lutnick.
Taylor Rogers, a White House spokeswoman, said in a statement that Mr. Trump’s position is about increasing electricity supply, rather than helping any companies with which he or his circle might have connections.
“Thanks to President Trump’s leadership, our country has seen historic advancements for civilian nuclear energy development, innovation, and technology, which is a critical component to meet the nation’s growing energy needs while keeping prices low for families and businesses,” she said. “The media’s continued attempts to fabricate conflicts of interest are irresponsible and reinforce the public’s distrust in what they read.”
Westinghouse’s chief executive, Dan Sumner, in a statement called the Saudi deal a “landmark step” that “expands opportunities for U.S. industry and workers.”
Kerrie McHugh, a Brookfield spokeswoman, said that the company, with more than $1 trillion in assets, has an enormous number of business partners and “robust processes in place to manage any potential conflicts, consistent with our fiduciary responsibilities.”
Officials at the Energy Department did not respond to requests for comment.
Here is a look at Mr. Trump and some of those with ties to him that could benefit from his nuclear goals.
The president and his family
Trump Media & Technology Group, the money-losing company that hosts Truth Social, the platform where Mr. Trump first posts most of his White House announcements, has moved recently to add — incongruously — nuclear energy to its portfolio.
The company announced in December that it intends to merge as part of a $6 billion deal with a nuclear fusion start-up called TAE Technologies. During Mr. Trump’s first term, and again last year, TAE won financial support from the Energy Department’s Office of Fusion Energy Science.
The president’s shares in the publicly traded Trump Media are worth about $875 million as of earlier this month, according to other public filings. The value of those shares could grow if the TAE merger proves a success.
Eric Trump and Donald Trump Jr.’s nuclear investments
Separately, two of the president’s sons, Eric Trump and Donald Trump Jr., in November became part owners through an investment partnership in a company called Quantum Leap Energy, which is working to develop certain isotopes that can be used as nuclear fuel.
Quantum Leap reached a deal last year with a Texas-based company co-founded by Rick Perry, who was energy secretary during Mr. Trump’s first term and is now seeking federal assistance to build nuclear power plants in Texas. Mr. Perry did not respond to requests for comment.
Asked about any potential conflict of interest, a spokesman for Donald Trump Jr. said that he was working on deals that were good for the country.
“Don is a lifelong businessman and investor who tends to invest in companies that align with his America First worldview,” said the spokesman, Andy Surabian. “He does not interface with anyone in the federal government on behalf of any company that he invests in.”
Eric Trump did not respond to requests for comment.
Jared Kushner’s dealings with Saudi Arabia
Mr. Trump’s son-in-law, Jared Kushner, has a complicated relationship with those involved in the recent nuclear agreement.
He participated in discussions related to Saudi Arabia’s push for access to U.S. nuclear technology when he worked at the White House during Mr. Trump’s first term. He also helped establish agreements between Israel and multiple Arab countries to normalize their relationship, called the Abraham Accords.
Now, Saudi Arabia’s sovereign wealth fund is one of Mr. Kushner’s biggest backers. The fund committed $2 billion to Mr. Kushner’s investment firm, Affinity Partners, shortly after he left the White House in 2021. Crown Prince Mohammed bin Salman, an ally during Mr. Kushner’s government tenure, helped convince the sovereign wealth fund to provide the money.
It is unclear whether Affinity will invest in Saudi’s nuclear energy initiative. For now, the kingdom expects to finance the effort itself, according to an official with knowledge of its plans.
On Thursday, the Trump family’s connections to all of this were on display when the president announced on Truth Social that the nuclear agreement would be contingent on Saudi Arabia joining the Abraham Accords.
The Cabinet
The Commerce and Energy Departments have been at the forefront of pushing Mr. Trump’s nuclear agenda. Both are led by secretaries who have either direct ties to the industry or family ones.
Mr. Lutnick has been leading an effort to invest U.S. tax dollars into companies in the nuclear sector, including Westinghouse. Companies his family members help run could profit.
Cantor Fitzgerald, the investment bank that Mr. Lutnick led until he was hired by Mr. Trump, is at the center. Cantor has over the last year helped several companies in the nuclear sector raise money, which generates millions of dollars in fees for the firm.
Among them are Oklo, Energy Fuels Inc and enCore Energy. Each is seeking permits, financial assistance or Trump administration contracts for its nuclear projects.
Oklo, based in Santa Clara, Calif., in 2019 became the first nuclear power company to receive site-use permit from the Energy Department for commercial operations.
Oklo also has links to Chris Wright, the energy secretary. Mr. Wright was a director at Oklo until he joined Mr. Trump’s cabinet. That connection spurred a Democratic lawmaker to complain to the White House that Oklo stood to benefit improperly from government nuclear permits and programs.
Bonita Chester, Oklo’s head of communications, said in a statement that Mr. Wright has had “no role in Oklo’s governance” since resigning from the board.
“We’ve worked with leaders across both sides of the aisle to advance policies that accelerate the deployment of safe, commercially viable nuclear technology,” she added.
Energy Fuels, which Cantor helped last year raise money to expand its mining efforts, disclosed in June it is slated to get a $725 million federal loan from the Pentagon.
The company — one of the top U.S. producers of natural uranium concentrate sold to nuclear plants — has noted to The Times that it began working with Cantor before Mr. Trump’s second presidency. It declined to comment.
The network goes beyond these smaller nuclear companies.
Westinghouse, in which the U.S. government has an option to take an equity stake, is at the fulcrum of the proposed nuclear deal with Saudi Arabia, as the plan is for its government to back the construction of multiple AP1000 reactors there.
The Trump administration in October announced plans to partner with Westinghouse to build $80 billion worth of its nuclear reactors across the United States, a deal negotiated in part by Mr. Lutnick.
“Together with Westinghouse we will unleash American energy,” Mr. Lutnick said in a statement then. “This partnership embodies the bold vision of President Trump — to rebuild our energy sovereignty, create high-paying jobs, and drive America to the forefront of the nuclear renaissance.”
Newmark has made money over the past year by helping finance billions of dollars worth of United States data center projects that were promoted by Mr. Lutnick and Mr. Trump, as The Times previously reported.
Blake Ruppe, a Commerce Department spokesman, said that Mr. Lutnick has complied with all requirements that he divest from his family companies. “There is no conflict of interest,” he said in a statement. “It is knowingly false to suggest otherwise.”
A prominent Trump donor: Peter Thiel
Peter Thiel, a billionaire investor and entrepreneur, was an early political backer of Mr. Trump and helped Vice President JD Vance begin his political career, serving as one of the largest donors to Mr. Vance’s Senate race in 2022.
Mr. Thiel is a major investor in General Matter, a U.S. nuclear fuel company focused on producing what is known as high-assay low-enriched uranium. A giant load of new nuclear fuel will be needed if all these new nuclear power plants are built, and General Matter is positioned to benefit.
The Energy Department in January awarded General Matter a $900 million contract to build out its nuclear fuel effort. The U.S. Export-Import Bank, where Mr. Lutnick is a board member, also issued up to $4.2 billion in “letters of interest” to finance the export of General Matter’s domestically enriched uranium to nuclear operators in South Korea and Japan.
Mr. Thiel did not respond to a request for comment. A spokesman for General Matter said that the federal support started under the Biden administration and that the company had not engaged with Mr. Vance since he became vice president.
“Our contract is 100 percent milestone based, so we don’t get paid until we fulfill our commitments to taxpayers,” Lee Robinson, a co-founder of General Matter, said in a statement.
The tech titans
As the explosive growth of artificial intelligence strains the nation’s power capacity, tech companies are turning to nuclear energy. Among them are Amazon, Meta, Google and Microsoft — all of which have backed at least some of Mr. Trump’s energy policy goals.
Each of those companies donated $1 million to Mr. Trump’s 2025 inauguration, placing some of their executives — including the Amazon founder and executive chair Jeff Bezos, Meta’s chief executive, Mark Zuckerberg, and Google’s chief executive, Sundar Pichai — in prominent seats at the event.
The companies have supported the White House in other ways.
Amazon spent $40 million to acquire a documentary on Melania Trump, the first lady, generating a licensing fee of more than $10 million.
Amazon, Google, Microsoft and OpenAI — whose chief executive, Sam Altman, personally donated $1 million to the inauguration — have helped finance an Energy Department project called Genesis Mission, which will use AI to further the nation’s energy goals, among other objectives.
In announcing its $60 million investment in the program on July 22, Chris Barry, who runs Microsoft’s public sector business, called Genesis Mission “exactly the kind of moonshot that defines American science.” A Microsoft spokesman declined to comment on the Saudi deal.
A spokeswoman for Meta, which operates several data centers overseas, declined to comment on whether the company might benefit from the Saudi nuclear deal. Amazon, Google and OpenAI did not respond to requests for comment.
How Google Is Using Wall Street Financing Techniques to Expand Chip Sales
The Takeaway
- Google commits $44 billion in off-balance sheet data center lease backstops.
- Google uses financial backstops to boost TPU chip sales.
- Google gains equity warrants in some data center developer deals.
Until a year or two ago, big tech firms like Google had relatively simple balance sheets, stuffed with cash that covered any debt several times over. Nowadays, thanks to massive AI spending, Google and others are adopting techniques long used on Wall Street to expand their business without taking on all the risk themselves.
Google, for example, disclosed last week that it had agreed to cover as much as $44 billion worth of lease payments on data centers owned by others, if the tenant defaults. That figure, which has risen from $6.5 billion as of the end of September, reflects Google’s efforts to supply Anthropic and others with its alternative to Nvidia’s AI chips.
This exposure is just one sign of how radically Alphabet’s capital structure has changed over the past year as its huge AI investments have forced it to raise money beyond its own cash. Its debt has grown to $98 billion as of June 30 from $23.6 billion a year earlier, while it issued equity for the first time in more than two decades. The reason for the fundraising became clear last week, when Alphabet reported it had burned cash—on a free cash flow basis—in the second quarter for the first time as a public company.
But the $44 billion of exposure to potential defaults of data center tenants isn’t on Google’s balance sheet, although it is disclosed in the footnotes. The balance sheet shows a much smaller figure—$815 million—reflecting Google’s estimate of its likely exposure.
Google has taken on these commitments—also known as backstops—as it expands its sale of AI chips known as tensor processing units. While Google rents servers powered by its TPU AI chips through Google Cloud, it is now expanding TPU use by putting them in data centers operated by other companies. These include some developed by former crypto miners, such as Hut 8 and TeraWulf, that have pivoted to running their facilities for AI.
In taking on the commitments, Google is calculating that the revenue to come from TPU sales will outweigh the financial obligations of providing backstops on the leases for the data centers that will hold them, according to two people with direct knowledge of the company’s thinking. Company executives feel confident that the financial calculus pencils out well in Alphabet’s favor, one of the people said.
In many of the deals, cloud startup Fluidstack is leasing and operating the planned data centers and filling them with TPU chips, then renting that capacity to Anthropic, according to people familiar with the arrangements and company disclosures. Alphabet executives look through the Fluidstack lease when they think about the backstops to consider if the end user will default on a payment or go insolvent, one of the people said.
Alphabet has backstopped leases on about 2.4 gigawatts of capacity across roughly ten projects, one of the people familiar with Alphabet’s thinking said. None of those projects are yet complete, which means Alphabet’s backstops are not yet in force.
The actual TPUs going in the data centers are financed separately, many via arrangements where Broadcom, which works with Google on the TPU’s design, provides a guarantee of its own.
The setup means Google is essentially acting as a corporate guarantor for space to house the chips, allowing the developers to secure cheaper debt and build capacity faster than they could on their own. The figure that the company discloses in its securities filings is the maximum amount of future payments it could be on the hook for—what Google calls the notional value.
A smaller figure reflects its estimate of what it is likely to pay under the guarantees. Changes in this figure, a derivatives position carried at fair value, flow through to Google’s profit and loss statement.
Alphabet’s estimate of the fair value is based on its assumptions about the probability and timing of defaults and any amounts it could recover.
Recent filings show how Google’s exposure has mushroomed. In October, Google said that even as the notional value was $6.5 billion, the fair value was not material. In the most recent quarter, the fair value recorded on the balance sheet was $815 million, while the notional value had ballooned to $43.8 billion.
Jordan Chalfin, head of technology research at CreditSights, cautioned against getting too concerned about Alphabet’s notional numbers, at least at this point in time. “The figures that they do disclose are the max possible loss, so keep that in mind,” Chalfin said in an interview. And, he said, “there are various kinds of things that could mitigate the exposure.”
Indeed, Alphabet’s disclosures say it has several options if a tenant defaults. It generally retains the right to assume the underlying lease for its own use or the use of customers, adding scarce capacity, or lease the data center space to others. Also, the company notes that many of the leases carry terms of up to 15 years, and the potential exposure declines over time.
Alphabet even has the option to terminate the backstop, though two people familiar with how the termination payments can be structured said that would likely require a hefty one-time payment to compensate bond holders who relied on the backstop when they purchased the debt. The payment would effectively get converted into an ownership interest in the project, with the size of the stake based on the size of the payment and the total cost of the project, one of the people with knowledge of Alphabet’s thinking said.
Not all of Alphabet’s backstop arrangements are created equally. In one transaction with Hut 8, where Google is responsible for the entirety of a 15-year lease payment if Fluidstack defaults, neither party can get out of their obligations if there’s a major construction delay, according to Fitch Ratings. That’s a contrast to deals with other developers including TeraWulf and Cipher, where there’s a termination provision for delays, Fitch said.
The Hut 8 data center lease has a contract value of $7 billion, as well as another $2 billion in other expenses such as power and property tax insurance, CEO Asher Genoot said on a conference call when the deal was announced.
Yet to Commence
Google’s approach reflects one approach to financial engineering supporting the build-out of AI infrastructure. Its competitors have employed others. Meta, for example, has entered into joint ventures as a minority partner to build data centers in Louisiana and Texas and keep them off its balance sheet. Oracle has also relied on arrangements off the balance sheet to support its ambitions.
In addition to the backstops and other guarantees, Alphabet, Meta, Oracle and others have signed hundreds of billions of dollars in data center leases that have not yet begun, keeping them off the balance sheet for now. In most deals, the leases don’t officially begin until the data center is built, the chips are installed and the facility is turned on.
For Alphabet, those yet-to-commence leases totaled $85.2 billion at the end of June. Another obligation, financial guarantees that act as backstops allowing its partners to secure power and energy equipment, totaled an additional $7.6 billion.
And more backstops are coming that Alphabet will likely have to account for. It said it has agreed to provide another $24.1 billion of future backstops to support data center and energy assets, subject to the finalization of terms.
Google’s business remains strong, to be sure. The company generated more than $185 billion in operating cash flow over the past 12 months, and despite its recent stock and bond sales, it still has a robust ability to raise more funding. If the worst were to happen, Alphabet could also dial back on spending.
Anubhav Arora, a credit analyst at Fitch Ratings, underlined the importance of that financial strength when the firm rates debt related to the data center deals. He explained that Fitch relies “very heavily on the backstop that Google has provided” to assign the projects an investable rating. He doesn’t anticipate Google’s activity slowing down anytime soon.
“We continue to see more deals with Google backstops for unrated tenants, so I clearly expect the trend to continue,” he said.
Sharing in the Upside
At the same time, Google has structured many of its deals so it stands to collect some of the upside if the data center developers’ shares perform well.
In some cases, but not all, the company has collected equity warrants in return for its backstop. It holds warrants, for example, that would allow it to own 14% of TeraWulf, which is building a data center for Fluidstack in Barker, N.Y. Google also has warrants potentially worth 5.4% of Cipher Digital, which is building a data center in Colorado City, Texas, in a similar arrangement.
There’s one notable exception so far. When Hut 8 announced its own deal with Fluidstack and Anthropic in December, the company didn’t give up warrants in return for Google’s backstop.
That deal, one of the people with knowledge of Alphabet’s thinking said, was an anomaly and isn’t likely to be repeated.
Your Mouth Could Hold the Secrets to a Longer and Healthier Life
As scientists link oral bacteria to heart disease and cognitive decline, a push is under way to treat the mouth as a source of bodywide inflammation
- Scientists are increasingly linking oral diseases, particularly gum bacteria and immune responses, to chronic inflammation and systemic conditions like heart disease.
- New diagnostic tools and treatments are emerging, including an experimental drug that reduced gum inflammation and a therapeutic vaccine cleared for a Phase 2 trial.
- Efforts are under way to integrate medical and dental care through shared records and to expand dental insurance coverage, especially for older adults.
The eyes are a window to the soul, but the mouth may reveal just as much about a person’s health—and the diseases that shape how we age.
To better understand those connections, scientists are studying how issues that start in the mouth may contribute to chronic inflammation elsewhere in the body. In particular, they’re examining how bacteria from diseased gums, and the immune response they trigger, may contribute to conditions including heart disease, diabetes, cognitive decline, arthritis, respiratory disease and chronic liver disease.
The emerging science poses a challenge for healthcare, given the traditional divide between medicine and dentistry—fields that have long been divided by separate training, records and insurance systems. “Dentists haven’t traditionally been trained to think about whole-body health in relation to the mouth, and doctors haven’t been trained to see dental health as a first step to overall well-being,” says Dr. Jessica Lederhausen, a dentist and author of “Oral,” a book exploring the role of lifestyle on oral health.
But that is changing. Dental schools, which have taught how diseases like diabetes affect the mouth, are also placing greater emphasis on how oral disease can affect the rest of the body. Medical-education leaders have called on medical schools to better integrate oral health into physician training.
At the Harvard School of Dental Medicine, the Initiative to Integrate Oral Health and Medicine is researching how oral-health policy and health-system design can better support “whole-person care,” according to its director, Dr. Lisa Simon, who is both a dentist and a physician.
“We envision a future where a heart doctor asks patients if they are seeing their dentist regularly, and whether they are aware their periodontal disease could mean they have a much worse heart situation,” says Wenyuan Shi, an oral-microbiology researcher who heads the ADA Forsyth Institute, the research arm of the American Dental Association.
With better coordination, including shared medical and dental records, experts say, primary-care doctors might increasingly refer patients with diabetes or at high risk for heart disease to a dentist or periodontist for evaluation and treatment of gum disease. Meanwhile, more dentists may identify signs of uncontrolled diabetes and coordinate care with the patient’s physician.
The longevity link
The growing understanding of the mouth-body connection is also leading to new diagnostic tools, prevention strategies and treatments. And it is intensifying calls to provide more widespread coverage for preventive dental procedures, especially for older adults who are at highest risk.
According to the Centers for Disease Control and Prevention, nearly half of all adults aged 30 years and older have periodontitis, the more serious type of gum disease that involves bone loss around teeth. But federal data also shows prevalence increases with age, when close to 60% of those 65 or older have some level of disease—just as people become more vulnerable to conditions that can dramatically affect a healthy lifespan. In turn, conditions such as diabetes can make gum disease more severe or harder to treat.
A 2023 review in the journal Biogerontology concluded that oral health plays a significant role in reaching “exceptional longevity,” in part because of its connection to inflammation. And research on adults 65 and older has found that oral diseases—including periodontal disease, tooth decay and tooth loss—remain a substantial source of years lived with disability, suggesting that oral health can shape the quality, not just the length, of later life.
The plaque connection
At the heart of current research is the oral microbiome, the community of hundreds of bacteria, fungi and other microbes that live in the mouth. Most are part of a healthy ecosystem, but a smaller group can thrive below the gumline, inflame the gums and drive diseases such as gingivitis and periodontitis. Over time, severe gum disease can destroy the tissue and bone that hold teeth in place.
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A big challenge is dental plaque, a protective structure known as a biofilm that helps bacteria adhere to teeth and makes them more resistant to removal by saliva, mouth rinses and some antimicrobial agents. When plaque builds up, it can harden into tartar and trigger chronic gum inflammation.
Periodontists often manage patients with deep cleaning and scaling, and occasionally lasers. The procedures remove plaque below the gumline and disrupt bacterial biofilms that contribute to gum inflammation.
But plaque can shed bacteria or bacterial products into the bloodstream, says Dr. George Hajishengallis, a professor at the University of Pennsylvania’s dental school specializing in microbiology and immunology. Most of the time, the immune system clears them quickly. With periodontitis, inflamed gums can weaken the body’s usual barriers, and ordinary activities such as chewing, brushing or flossing can allow small amounts of bacteria or bacterial products to enter the bloodstream repeatedly, potentially adding to inflammation elsewhere in the body.
Research by Hajishengallis and another Penn professor, immunologist John Lambris, led to the development of an experimental drug applied into gum tissue, aimed at calming the immune response. In an early trial in people with gum disease, the drug was reported to reduce gum inflammation for several months. While the researchers say it won’t replace traditional dental cleaning, it could be used along with such cleanings to keep gum-disease inflammation at bay.
Amyndas Pharmaceuticals, a company founded by Lambris and spun off from Penn, is planning larger trials, says Lambris.
Another company, Denteric, is developing a therapeutic vaccine designed to help patients who already have gum disease. Earlier this year, the FDA cleared the vaccine for a Phase 2 clinical trial in the U.S.
“The goal is not to replace existing dental care, but to work alongside it by helping the body address one of the key biological drivers of disease progression,” says CEO Sean McLoughlin.
A dose of prevention
A growing number of startups are entering the oral-health field, developing new approaches to preventing and managing disease, such as reducing harmful bacteria in the mouth while preserving helpful ones, and controlling biofilms before they cause lasting damage.
Dr. Ana Becil Giglio, a New York periodontist and president of the American Academy of Periodontology, says some of the most promising future treatments for gum disease are aimed at controlling the body’s inflammatory response rather than simply removing plaque or killing bacteria.
One approach would block destructive enzymes that break down gum tissue; another would help the body naturally turn off inflammation once it has done its job; and a third would slow the loss of gum tissue and bone that keep teeth firmly in place.
A recent report in the Journal of Periodontology predicts that technology such as AI, diagnostic saliva tests and sensor-based monitoring will allow for more early detection and individualized treatment. Sensors, for example, could be placed in the oral cavity for real-time monitoring, continuously tracking changes in the oral environment and watch for things like markers of inflammation. The sensors could also pair with apps or wearable technology to offer users feedback.
Oral-health experts are also turning to AI to analyze the growing amount of data from patients’ mouths. A group of ADA Forsyth researchers is using AI in a five-year federally funded project to help develop smart dental-filling materials and to assist in reading dental X-rays and other digital images for signs of cavities, gingivitis and gum disease. Machine-learning models have already shown promise in analyzing radiographs, according to a 2025 review.
Better care, shared records
A big challenge is the lack of dental-care insurance for those 65 and older, according to Dr. Frank A. Scannapieco, a professor at the University at Buffalo School of Dental Medicine. A study he co-wrote, published in 2023, found that a preventive dental visit in the year before hospitalization was associated with a 10% lower risk of a type of pneumonia that strikes hospitalized patients, while periodontal therapy within six months was associated with a 30% lower risk.
And a review of research he co-wrote concluded that the addition of dental benefits to the Medicare program for diagnosis, prevention and control of oral diseases could improve health and potentially reduce medical costs.
Meanwhile, there are efforts to overcome a behind-the-scenes barrier between doctors and dentists: records systems. Very often, the two types of caregivers use different digital systems to store patients’ vital information, and those systems can’t talk to each other.
One effort comes from PDS Health, a Henderson, Nev.-based company that supplies business and administrative support services for more than 1,200 dental and primary-care practices nationwide, including the widely used Epic electronic health records system. That has helped dental and medical providers collaborate around a shared patient record, and allows patients to see their oral and medical information via a single patient portal, says Chief Executive Stephen V. Thorne IV.
Since 2020, more than 303 million patient records have been exchanged between medical and dental providers, and PDS is working with dental schools including the University of Michigan to expand the use of Epic records in dental education. The university’s health system and its medical school already use Epic, and a dental-school spokesperson says the ability to view a complete health record will enable its students and faculty to get a complete view of patients’ unique healthcare needs.
The push toward better oral health isn’t confined to dentists’ and doctors’ offices. A global oral-care industry worth roughly $40 billion a year is promoting new products such as smart toothbrushes connected to an app and more natural toothpaste ingredients.
And some companies are promoting brushing and flossing to younger consumers as part of a broader wellness routine, “like skin care,” says Stephan Habif, chief technology officer and head of research and development at oral-care giant Colgate-Palmolive. “We are trying to create an experience for the consumer, so they are doing the right thing, but also not seeing it as a chore.”
THE MOUTH-BODY CONNECTION
- Cancer: Scientists have found a correlation between gum disease and certain cancers, including of the kidneys, pancreas and blood, says the American Academy of Periodontology.
- Diabetes: Gum disease often goes hand-in-hand with diabetes and may make it more difficult to control blood sugar.
- Heart disease: Studies link gum disease to an increased risk of heart disease. Scientists suspect inflammation is the culprit.
- Respiratory disease: Research suggests bacteria from gum disease can get into the lungs, contributing to illnesses such as pneumonia.
- Alzheimer’s: Research suggests gum-disease bacteria may travel to the brain, contributing to the development of Alzheimer’s disease.
- Liver disease: Systemic inflammation and changes in the oral microbiome from periodontal disease may be linked to chronic liver disease and cirrhosis.
- Rheumatoid arthritis: There is a significant association between rheumatoid arthritis and periodontitis, and treatment of gum disease can reduce the severity of RA.
GRAHAM ADVISORS | MACRO — EUROPE | 26 JUL 2026
SPAIN: THE TRUE REALITY OF THE OUTPERFORMANCE
(Country deep-dive, 5pp, 4 exhibits. LC.)
- Spain grows 3x the euro area (2.4% vs 0.9% 2026f, EC Spring) and has closed to within 10% of EU average income. Real, not spin.
- But it is quantity-led: foreign-born = ~2/3 of net job creation since the pandemic. Output per employed person +0.3%; GDP per hour still 7% below EU average.
- Absorptive capacity is the binding constraint: 226k new households in 2025 vs ~83.5k homes completed. Prices +12.9% y/y.
- Unemployment 10.83% (Q1) — still the EU's highest after a five-year boom. Structural, not cyclical.
- Debt falling on nominal growth, not adjustment. No budget passed since 2023; spending ceiling voted down twice in late 2025.
The question is not whether Spain is growing. It is what the growth rate does when immigration moderates and the productivity gap is still open.
Full note attached.
LC / Graham Advisors.
Institutional clients only — not for redistribution.
What is the risk of using Chinese open AI models like Kimi K3?
The real problem is not overseas open-source but lack of co-ordination to protect infrastructure in the face of cyber attacks
Earlier this month, I sat in the Radiohead-themed conference room of Beijing start-up Moonshot and watched a demonstration of its powerful new Kimi K3 AI model. Founder Yang Zhilin, a music fan, named his company for Pink Floyd’s album Dark Side of the Moon — a fitting reference to uncharted yet high-reward territory.
Within China, the surprise release of Kimi K3 has been hailed as another chance for the country to flex its tech expertise at the expense of US rivals. More US companies are opting to lower their costs by switching to cheaper, high-performing Chinese open AI models such as K3, Z.AI’s GLM, DeepSeek’s R-1 and Alibaba’s new Qwen 3.8 Max.
“Saves us millions of $ and we’re actually seeing an *increase* in performance on many core use cases. Transformative,” wrote Flo Crivello, CEO of San Francisco-based digital assistant platform Lindy AI, which switched to DeepSeek this year.
What is the security risk of using open-source AI models created by foreign companies? Washington seems focused on surveillance, IP theft, espionage and potential Chinese involvement in critical domestic infrastructure. The White House is reportedly exploring tools to curb the spread of, or even sanction, open Chinese models. The debate may look like a stand-off between national security and innovation, but it is not quite that simple.
The first point to make is that asking whether a model has been developed by a Chinese company is the wrong question for those concerned about security.
Open-source models such as Kimi K3 allow the parameters (the numbers learnt in training that determine how an AI model uses information to predict what comes next) to be downloaded and run by anyone. Companies download the weights, fine-tune the model and then run it on their own cloud or infrastructure.
What matters more, therefore, is who owns and operates the server that runs the model. US users worried about data being sent to China could run the AI models on domestic hardware they control or through third-party inference providers.
Chinese open models do not uniformly censor information either. Again, where the model is hosted changes things. When hosted on US infrastructure, models will answer questions that would be blocked inside China. Since weights are open, users can change content restrictions.
Even if data is hosted within China, where companies are required to co-operate with the National Intelligence Law, some push back in ways that mean the government does not necessarily have unfettered access. In March this year, Chinese government inspectors seeking access to data from the ecommerce platform Pinduoduo got into a brawl with staff trying to block entry. One official left with a broken finger.
The US does need a viable open-source option of its own. It is quickly becoming a crucial lever of national power projection. Kevin Xu of Interconnected Capital compares it to Disney movies and K-pop. But the real problem is that Washington lacks a comprehensive approach to shore up critical infrastructure in the face of powerful, AI-enabled cyber attacks that are no longer hypothetical.
Here the transparency provided by open weights (including those from China) could in fact improve security. Last week, Hugging Face used an open Chinese AI model to analyse an AI agent cyber breach. This all happened without data leaving Hugging Face’s system.
Governments on all sides still insist on framing AI as a global arms race. But neither threats nor innovation map neatly on to national boundaries. Addressing data access and control in an interconnected world requires a new way of understanding security protocols.
The writer is a senior fellow at New America and the Institute for America, China, and the Future of Global Affairs at Johns Hopkins University
Suspect in Deadly Berlin Pride Attack Had Been Investigated for Terrorism Plans
The man, 21, was still at large Sunday after a van rammed into a crowd in the German capital, killing one and injuring more than a dozen
German police are searching for a 21-year-old suspect after a van plowed into a Berlin LGBTQ festival, leaving at least one dead and 16 wounded.
Authorities are treating the incident as a terrorist attack, and police said the suspect is a known Islamist.
The attack is expected to rekindle a debate over security and immigration, which could bolster the far-right Alternative for Germany.
The main suspect in a car-ramming attack that left at least one dead in Berlin had previously been investigated for planning a terrorist attack, a person familiar with the investigation said.
Authorities are on the hunt for Abdul Ballout, a 21-year-old German citizen of Lebanese descent and the main suspect for the attack at the margins of the Christopher Street Day LGBTQ festival at the center of the German capital.
A white van plowed into a crowd of people who were leaving the festival shortly before 10 p.m. local time on Saturday in what authorities are treating as a terrorist attack.
The small van later crashed into a tree and was found abandoned. Police said some passersby sustained what appeared to be knife wounds. Several of the wounded were in life-threatening condition, the police said.
Police called on the public to report any sighting of Ballout, described as about 6 feet tall, slimly built, with black hair and wearing a black hoodie and white pants. They only identified the man as Abdul B., in keeping with German privacy laws.
Ballout had been detained in Lebanon and extradited to Germany before being convicted of a crime in Berlin in May, the person familiar with the investigation said.
The man has a history of low-level criminality and it wasn’t clear whether the May conviction was related to his terrorism investigation, or why he wasn’t serving his sentence at the time of the attack.
Germany’s Bild daily first reported about Ballout’s criminal background and previous conviction.
The person said authorities were investigating eyewitness reports that a second suspect was sitting in the van at the time of the attack. Organizers ended the Christopher Street Day festival after the incident, and police said the crowd dispersed quickly.
“What a disgusting act in Berlin,” Chancellor Friedrich Merz wrote on X. “The crime will be investigated and pursued with the full force of the law.”
The suspect’s alleged Islamist links could rekindle a debate about security and immigration, presenting Merz’s deeply unpopular government with its latest challenge.
Pollsters attribute Merz’s unpopularity largely to his failure to reboot a stagnant economy with rapidly rising unemployment. His cabinet has also struggled in the past week with a reshuffle interrupted by the withdrawal of a ministerial candidate.
Germany has enjoyed a respite from politically motivated violence after a string of attacks, mostly perpetrated by recent Muslim migrants, in the run-up to the last election in February 2025.
Merz’s government has since cracked down on immigration, bringing the number of new arrivals sharply down in one of the few policy areas where pollsters said voters were crediting the government with success.
Still, the fact that the main suspect was known to authorities will likely raise questions about why he and thousands of others with similar profiles were allowed to walk freely without tight surveillance.
Such questions could further bolster the far-right anti-immigration Alternative for Germany, or AfD, ahead of key elections in the fall.
The AfD is now Germany’s most popular party in all opinion polls and is on course to win two state elections in the country’s former Communist east in September. In the state of Saxony-Anhalt, it could even garner an absolute majority, allowing it to govern alone, a rarity in Germany given the country’s proportional electoral system.
Germany has suffered a number of vehicle rammings in the past. In December 2016, an Islamist terrorist drove a stolen truck into a Christmas market in Berlin, leaving 13 dead. In 2024, an anti-Islam activist from Saudi Arabia killed six people and injured more than 300 after driving his car into another Christmas market in the eastern city of Magdeburg.
Markets, festivals and other outdoor events are now heavily fortified, with most access routes blocked by vehicles or concrete barriers. This may explain why Saturday’s attack happened just outside the festival area.
Saint-Gobain pushes ahead with US expansion despite slow housing market
French building materials giant wants to more than double North American business through capex and acquisitions
French building materials giant Saint-Gobain will push ahead with a major expansion of its American business despite a US housing slump, transatlantic trade wars and a volatile political climate.
The plasterboard to roofing-shingles maker, which ranks among Europe’s biggest industrial groups, wants to more than double its North American footprint to almost 30 per cent of revenue as it pursues chunkier margins outside its traditional base.
In an interview, chief executive Benoît Bazin said neither political upheaval nor a sluggish US residential construction market had deterred it from this strategy.
“We continue to invest in North America. It’s a growing market for us. It’s good profitability. We continue to gain share,” Bazin told the FT.
“We take a long-term view,” he added. “The game plan is to continue to grow through both capex and acquisitions.”
European industrial groups from CRH to Schneider Electric have been shifting capital towards the US in pursuit of higher margins and market share in an economy that is building out infrastructure from manufacturing plants to data centres. “You need to build everywhere,” said Bazin.
Saint-Gobain, whose overall revenues reached €46.5bn in 2025, has increased its North American revenue share from about 13 per cent of revenue to 22 per cent since it announced a new growth strategy in 2018. Bazin said the company wanted to raise this figure “closer to 30 per cent in the coming years”. It is also expanding aggressively in Asia in a pivot away from its European roots.
The company has pumped $8bn into acquisitions, capital expenditure and research in the US and Canada since 2020 while managing a steady flow of disposals elsewhere. It has snapped up two listed American companies over the period and this month extended the push with deals to buy a North Carolina glass fibre plant and a Vancouver-based concrete chemicals group.
North America now accounts for about a third of profits, roughly on par with Europe, which previously made up as much as 60 per cent of earnings. The US has become its biggest single market, ahead of France.
Saint-Gobain traces its roots back to the 17th century, when it made the mirrors for one of the Palace of Versailles’s most famous galleries.
“We have been in Europe for 360 years in France and 170 years in Germany,” said Bazin. “We have a very strong presence already in Europe, and therefore more opportunities to gain market share in North America, Asia and emerging markets.”
The North American expansion drive comes in spite of a sharp slowdown in the US housing market. Single-family housing starts last month were down by a quarter from their early 2022 level, while existing home sales were more than a third lower than their pandemic-era peak. The 30-year mortgage rate has climbed to 6.58 per cent, up from 2.65 per cent in early 2021.
But Bazin said Saint-Gobain would “continue to invest” despite what he described as a “bit of a dip” in the market. Higher rates, he said, were not “killing” housing demand, but rather “delaying it a bit and changing a bit the scope of what is being built”.
The company said it had been largely unscathed by the upheaval in transatlantic relations as President Donald Trump has ratcheted up tariffs on America’s trading partners, unveiling further new duties this week.
Saint Gobain said it had been insulated by its local production model — one European companies are increasingly favouring. Bazin said the group had “anticipated a bit the de-globalisation of the world of today”.
“We act as a North American organisation with North American leadership and are viewed that way within the area,” said Mark Rayfield, the company’s North America boss. “There’s no ‘Oh your name sounds French, I don’t think I want to buy from you’. None of that.”
Under Bazin, Saint-Gobain has pursued a sustainability push into materials that are less polluting, both in the way they are produced and in the emissions then generated by buildings.
This ethos has not been an impediment in the US where buyers are drawn by the promise of durability, executives at Saint-Gobain said, even though the Trump administration has rolled back some climate policies and been hostile to imposing environmental goals on businesses.
“We leaned into resilience as a positive thing before sustainability was popular and before CO₂ was popular,” said Rayfield. “It is just an apolitical solution: you want a better house that has a higher resale value and is cheaper to operate.”