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Sunday, September 20, 2026

  

Projections: Merz's conservatives set to crash out of state parliament

20.09.2026

Photo: Bernd von Jutrczenka/dpa

German Chancellor Friedrich Merz's conservative Christian Democrats (CDU) are on the brink of crashing out of the parliament in the north-eastern state of Mecklenburg-Vorpommern after latest projections showed the party falling under the 5% threshold needed to win seats. 

Broadcasters ZDF and ARD both projected the CDU to win 4.9%, down from 13.3% in the last election in 2021. The result would be a nightmare scenario for Merz, whose political future has been the source of intense speculation as his approval ratings have plummeted in recent months. 

Long the largest party in post-war Germany, the CDU has never previously failed to hit the 5% threshold in any state, European or federal election. Its record low of 9% was set in Bremen in 1951. 

Even with initial projections showing the party above the 5% mark, Merz called the situation in Mecklenburg-Vorpommern a "disaster," while continuing to insist on the need to implement his government's unpopular reform agenda. 

But falling out of the state parliament would represent a massive shock for the chancellor's party, raising fresh doubts over Merz's position after the debacle in nearby Saxony-Anhalt two weeks ago. 

Sunday's election was won by the far-right Alternative for Germany (AfD) on around 38% of the vote, narrowly ahead of the centre-left Social Democrats (SPD) on 35.5%. 

The CDU was not the only party hanging close to the 5% threshold: the populist Sahra Wagenknecht Alliance (BSW) was also on 4.9% in the latest projections, while the Greens were on around 5.5%.

The Left - which also defeated the CDU to win the state election in Berlin on Sunday - was on 6.5% according to the latest projections.

German far-right AfD wins second state election in major blow to Merz

21.09.2026, DPA

Photo: Michael Kappeler/dpa

The far-right Alternative for Germany (AfD) won the state election in Mecklenburg-Vorpommern, its second state victory in just two weeks, while German Chancellor Friedrich Merz's conservative party suffered its worst-ever showing in its 81-year history, according to preliminary results.

Merz's Christian Democrats (CDU) crashed out of the parliament in the north-eastern state with just 4.9% of the vote, down from 13.3% in the last election in 2021 and just short of the 5% threshold required to win seats.

The AfD earned around 38.2% of the vote, ahead of the centre-left Social Democrats (SPD) on 35.5%, according to the election commission.

The populist Sahra Wagenknecht Alliance (BSW) also missed parliament, with 4.8%, while the Greens garnered 5.7% of the vote.

The Left - which also defeated the CDU to win the state election in Berlin on Sunday - was on 6.5%. 

The result is a nightmare scenario for Merz, whose political future has been the source of intense speculation as his approval ratings have plummeted in recent months. 

Long the largest party in post-war Germany, the CDU has never previously failed to hit the 5% threshold in any state, European or federal election. Its previous record low of 9% was set in Bremen in 1951. 

Merz admitted the result was a "disaster" but insisted he would push forward with his government's unpopular economic and social reform package, signalling he does not intend to resign.

He conceded that it was not possible to "sugar-coat" Sunday's result, but vowed "to prepare our country for the future."

"What needs to be done now requires backbone, steadfastness and patience. I will muster these qualities - as chairman of the CDU and, above all, as chancellor of our country."

Leif-Erik Holm, the AfD's candidate for state premier, hailed a "wonderful evening" on election night, saying his party would offer to hold talks with all other factions.

Tense Berlin election finale: who is to emerge strongest in the capital?

Campaign posters of the leading candidates from the CDU, SPD and Greens for the Berlin House of Representatives election, Berlin, 15 September 2026.
Copyright AP Photo/Markus Schreiber

By Johanna Urbancik
Published on

The Left and the CDU are vying for first place, with the AfD and the Greens trailing and the SPD suffering heavy losses. An overview of parties, leading candidates, key issues and possible coalitions.

On Sunday, Berliners will vote to elect a new state parliament, the Abgeordnetenhaus, alongside the regional vote in Mecklenburg-Western Pomerania. The race is wide open: the Left party and the CDU are neck and neck in the latest polls, both at around 20-23%, with the AfD at 18% and the Greens at 16% close behind. The SPD, with 10-12%, is now clearly below its 2023 result.

That means it is also unclear what the political landscape will look like after the vote.

According to recent surveys, the current black-red coalition of the CDU and SPD would no longer have a majority. The CDU’s campaign has also shifted: instead of incumbent Governing Mayor Kai Wegner, finance and culture senator Stefan Evers is running as lead candidate. Wegner announced in the summer, after months of criticism of his handling of the January power outage, that he would not run again as the party’s frontrunner.

On policy, the CDU is focusing on law and order, a more capable state and economic growth. To that end, both the police and the judiciary are to be strengthened, approval procedures accelerated, and public administration digitised.

Based on current polls, several coalition options are on the table, including a government of the Left, Greens, and SPD, or a CDU-Green-SPD alliance. Whether such constellations materialise will also depend on which parties ultimately make it into the Abgeordnetenhaus.

In the latest ZDF projection (source in German) published on 11 September, the Left stands at 23%, the CDU at 21%, the AfD at 17%, the Greens at 16%, and the SPD at 10%. On that basis, both a Left-Green-SPD alliance and a CDU-Green-SPD coalition would have a numerical majority. The current BerlinTREND (source in German) survey by Infratest dimap paints a similar picture: the Left at 21%, CDU at 20%, AfD at 18%, Greens at 16%, and SPD at 12%.

SPD fighting to stay in government

The Social Democrats have now slipped to between 10 and 12% in the polls. In 2023, they were still at 18.4%. Their lead candidate is Berlin SPD co-chair Steffen Krach from Lower Saxony, who is under investigation by the Hanover public prosecutor over allegations linked to a donation of 9,900 euros to the Berlin SPD. Krach rejects the accusations and is continuing his campaign under the slogan "Wieder Berlin" – "Berlin again" – despite them.

Substantively, the SPD, like most other parties, is focusing on affordable housing, investment and a functioning infrastructure. In its manifesto, it promises 100,000 new homes over the next legislative period and aims to increase the share of social housing in new-build projects from 30% to 50%. It also plans to invest in roads and bridges, schools, hospitals, and public transport.

Rents, housing shortages and new-build projects are among the top issues in Berlin’s 2026 election campaign Copyright AP. All rights reserved.

Affordable housing is also a central campaign issue for the other parties. According to Berlin’s Senate Department for Urban Development, Building and Housing, more than 100,000 new homes are missing in the capital. On top of that comes demand for additional housing for the roughly 200,000 people expected to move to Berlin by 2040. This translates into an average need for around 20,000 new homes per year in the coming years.

The CDU is relying above all on faster construction and more homeownership. The Greens place greater emphasis on housing oriented towards the common good. The Left, by contrast, is calling for large housing portfolios to be brought into public ownership. The AfD and FDP reject this approach and likewise want to prioritise private construction and less regulation.

The Left eyes the Red Town Hall

The Left has gained significant support since the 2023 election. At the time, it stood at 12.2%; in current polls, it is around 21-23% and is now one of the two strongest parties in the race.

Lead candidate Elif Eralp is campaigning primarily on rents and social policy. The Left is calling, among other things, for the socialisation of large housing stocks and stronger tenant protections. In public transport, social benefits and climate policy, the party also wants the state to play a bigger role.

Campaign poster of the Left’s lead candidate, Elif Eralp Euronews

The Berlin Left’s campaign is, however, overshadowed by a debate over how the party deals with antisemitism and the Middle East conflict. One trigger was a performance by rapper Dahabflex at a campaign event organised by the Neukölln district branch of the Left at the end of August, where he chanted "Yalla Yalla Intifada, Westbank, Palestine, Gaza" and "Death to the IDF" (death to the Israeli armed forces).

CDU lead candidate Evers accused Eralp of not acting decisively enough against antisemitic tendencies in her party. Eralp rejects that and stresses her commitment to combating antisemitism and protecting Jewish life. The Berlin Left has also adopted its own guidelines on dealing with antisemitism and says it wants to protect Jewish life in the city. As T-Online reports, the party’s Berlin executive invited the Neukölln district spokespeople to an extraordinary meeting at which "a unanimous decision was taken that Dahabflex’s performance was a mistake and that we reject all forms of violence", according to Eralp.

AfD also on course to double its vote in Berlin?

The AfD has also made strong gains in Berlin. In the 2023 repeat election, it took 9.1%; it now stands at 17-18% in most polls. In the latest BerlinTREND survey by Infratest dimap, it reached 18%, making it the third-strongest force behind the Left and the CDU. Compared with 2023, it has almost doubled its share of the vote.

AfD lead candidate Kristin Brinker Euronews


The party is once again led by Kristin Brinker, who is running as the AfD's top candidate for the third time. As with the Greens, however, Brinker is not widely known. In the current Infratest dimap poll (source in German), around two-thirds of respondents say they do not know Brinker, or do not know her well enough to judge her. The picture is similar to the Greens’ Werner Graf.

In the campaign, the AfD is focusing above all on migration and internal security. The party wants a halt to the admission of asylum seekers in Berlin and the "immediate deportation of all of the up to 20,000 people in Berlin who are required to leave the country".

For subsidised and state-owned housing, the AfD wants to allocate it using a points system so that it primarily benefits Berliners who have lived in the city for a long time and work in "system-relevant professions" such as the police, fire service, health care, or refuse collection. Otherwise, building should be encouraged by scrapping the property transfer tax or speeding up planning approvals.

Despite its high poll ratings, the party remains excluded from any role in government: CDU, SPD, Greens and Left all rule out forming a coalition with the AfD.

Will the Greens be the kingmakers?

The Greens are currently polling at around 16

5, clearly below their 2023 result of 18.4%. Nevertheless, they could play a crucial role in forming a government: both a Left-Green-SPD alliance and a CDU-Green-SPD coalition would have a mathematical majority in current projections.

Lead candidate Werner Graf is trying to present the Greens in a less confrontational way during the campaign. He wants to avoid the major rows of recent years, such as the dispute over Friedrichstrasse. Graf himself told rbb that the Greens "have learned from that". Instead of sharply polarising demands, he is adopting a more pragmatic tone and presenting himself as someone who can bring different parties together.

In the election arena, shortly before polling day, both the Left's lead candidate, Eralp, and the SPD frontrunner, Krach, explicitly courted cooperation with the Greens. Graf signalled openness to an alliance and called for a "progressive government". He rules out any cooperation with the AfD.

Volt, FDP and BSW battling to enter parliament

Alongside the larger parties, Volt, the FDP and the BSW are also competing to enter the Abgeordnetenhaus. For all three, the five% threshold is the decisive hurdle. Volt is standing in a Berlin Abgeordnetenhaus election for the first time and is focusing above all on digitalisation, administrative reform and faster housing construction.

The FDP wants to return to the state parliament with its lead candidate, Christoph Meyer, and is campaigning for less regulation, more private investment, and homeownership. In the final stretch, Meyer is also backed by party chairman Wolfgang Kubicki, who has appeared with him in Berlin on several occasions. 

Campaign posters for BSW, Volt and the FDP in Berlin Euronews

The Sahra Wagenknecht Alliance (BSW) is polling at 3-4% and therefore has to fight to clear the threshold for the Abgeordnetenhaus. The party is running in a Berlin Abgeordnetenhaus election for the first time and is led by Alexander King and Michael Lüders.

In this campaign, foreign and peace policies are playing an unusually prominent role for a state election. King is calling for an end to sanctions against Russia and for negotiations with Moscow. BSW also wants to improve relations with Russia and is targeting Russian-speaking Berliners. The party, moreover, wants to prevent the Russian House on Friedrichstrasse, operated by Russia, from being closed.

Vandalism: campaign posters damaged

During the current election campaign in Berlin, the police have recorded more than 1,300 incidents of damaged campaign posters between 2 August and 16 September.

Election posters in Berlin: AfD posters particularly often affected by vandalism Euronews


Posters belonging to the AfD are particularly frequently affected, according to Bild, which asked the Berlin police for figures: across the city, 801 cases of criminal damage to AfD posters have been recorded so far. Next come the CDU with 148 cases, independent candidates or lists with 102, the Left with 95, the SPD with 88, Alliance 90/The Greens with 37, the FDP with 30, BSW with 16, Volt with 13 and the ÖDP with two cases.




INTERVIEW


As far right gains ground in Germany, Berlin election tests Europe's centre


Berliners go to the polls on Sunday to elect the city-state’s parliament and district councils, in a vote taking place just two weeks after the far-right Alternative for Germany (AfD) secured a historic victory in the eastern state of Saxony-Anhalt. The implications could extend beyond Germany.


Issued on: 19/09/2026 - RFI

An election poster for the far-right, anti-immigration party Alternative for Germany (AfD), reading "It's time for free opinion", in Magdeburg, 7 February 2025. © Ebrahim Noroozi / AP




The AfD won 43.8 percent of the vote in Saxony-Anhalt on 6 September, falling three seats short of an absolute majority in the state parliament.

The result has intensified debate about the strength of the democratic centre in Germany and beyond.

The AfD has received support from figures associated with United States President Donald Trump, including alt-right billionaire Elon Musk, while also positioning itself alongside Hungary’s former leader Viktor Orban and Russian President Vladimir Putin.

In France, Marine Le Pen is leading in polling ahead of the 2027 presidential election, with recent surveys giving her between 29 and 36 percent in the first round.

Against this backdrop, what does the AfD’s breakthrough mean for Germany, Europe and the future of the political right?

RFI spoke to Bernd Hüttemann, secretary-general of the German chapter of the European Movement, a non-partisan civil society organisation that promotes European integration.

Bernd Hüttemann, secretary-general of the European Movement Germany, interviewed in Paris, 12 September 2026. © RFI/Jan van der Made

RFI: Berlin’s elections are taking place shortly after the AfD’s historic victory in Saxony-Anhalt. What does that result mean for German politics?

Bernd Hüttemann: It is something very dark, because it has really started a new era in Germany. For the first time, there is a right-wing extremist party that could potentially take power at state level.

Saxony-Anhalt is a small state, but the Länder [federal states] are powerful in Germany. They are responsible for areas such as education, policing, security and a large part of public administration. So the result will change things at that level.

It will not necessarily change the balance of power at federal level, because Saxony-Anhalt has relatively few votes in the Bundesrat [upper house of the German parliament]. But if the democratic majority becomes nervous and starts following extremist ideas, that can become very dangerous.

AfD candidate Ulrich Siegmund speaks in front of a poster reading "It starts here" at a rally after the Saxony-Anhalt regional elections in Magdeburg, eastern Germany, 6 September 2026. @ AP Photo/Matthias Schrader

Merz ‘deeply shocked’ as far-right victory tests Germany’s political firewall

RFI: If you look at the map of the 2025 election results, it appears that AfD is most popular in former East Germany. How do you explain people who lived under an authoritarian communist system now voting for an extreme-right party?

BH: There was always an East-West divide. As a young West German in the 1980s, I saw a great deal of propaganda saying that East Germans were different from us. They were portrayed as living under a very bad social system and an undemocratic regime.

After the Berlin Wall came down, the divide became more complicated. Around one-third of East Germans moved to the West, particularly young people, women, skilled workers and liberal-minded citizens.

At the same time, many West Germans moved east and took senior positions. Judges, professors and many other professionals came from the West. It is not pleasant for people in the east to feel that there is a ruling class imposed from outside.

East German workers build up a section of the Berlin wall, on 15 August 1961. @ AFP

That does not mean that all of these voters are anti-democratic. But many people have little experience of taking social responsibility outside the state. They do not want to join political parties or associations. They simply want an easier life, especially after the hardship they experienced before the Wall fell.

So this is not only about an East-West divide. It is about whether authoritarian ideas can find fertile ground. That is certainly more likely in eastern Germany.

RFI: Do you believe Germany’s political diversity can act as a safeguard?

BH: Yes. Germany is a very diverse country. It contains Catholic, Protestant, atheist, Muslim and East German traditions, among many others. Its political system is also complex: it is federal, decentralised and based on cooperation with many social forces.

That makes Germany complicated and slow, but it also makes it more resilient. I would not be excessively concerned. The important thing now is for democratic movements and parties to stay together.


Map of the 2025 German election results, with the Christian Democrats (CDU, in grey) dominating in former West Germany and the Alternative for Germany (AfD, shown in blue) dominating in what was communist East Germany. © Image generated via Perplexity

RFI: How much influence do Trump-style populist politics and US-based propaganda have on the AfD and German politics more broadly?

BH: The AfD has a problem here. Particularly in eastern Germany, there is not a strong appetite for American influence. On the other hand, the party has very few friends. It has Vladimir Putin. Viktor Orban congratulated the party. There are links with MAGA supporters and with Elon Musk.

The party’s psychology is perhaps this: nobody likes us, the public rejects us and everybody is trying to exclude us. So we align ourselves with people who are even more extreme.

But it could backfire. People in western Germany, as well as many liberals in the east, do not necessarily like this association.


US billionaire Elon Musk attends the AfD's election campaign kickoff in Halle via video link, on 25 January 2025. @ AP - Sebastian Willnow

RFI: Marine Le Pen is leading polls ahead of France’s 2027 presidential election. Could the AfD’s breakthrough influence the discourse here?

BH: The fear of Germany that existed during my childhood is not as widespread as it once was. But now there is a kind of flashback. People are asking: Germany was one of the most liberal countries in Europe in recent decades, including on issues such as refugees. Is it now showing its ugly face again?

That may also explain Marine Le Pen’s efforts to distance herself strategically from the AfD in the European Parliament. There was a well-known meeting in Paris with Alice Weidel, the AfD leader, where Weidel reportedly entered through a back door to avoid being photographed with Le Pen.

If France, a proud nation, moves towards the right, it will want to draw a clear line between itself and German extremism.

But that is not good for Europe, because we do not need a return to nationalism. We do not need national answers to nationalist movements in Germany. We need European answers – particularly when it comes to war, China and the United States. Europe has to remain united, and it is also developing closer links with Canada.



Thursday, September 17, 2026

 


Article Collection: AI and data-driven biomaterials



KeAi Communications Co., Ltd.






Bioactive Materials (Impact Factor: 23.6) is an international, peer-reviewed research publication covering all aspects of bioactive materials.

The journal welcomes the submission of research papers, reviews and rapid communications that are concerned with the science and engineering of next-generation biomaterials that come into contact with cells, tissues or organs across all living species. 

This collection features articles on “AI and data-driven biomaterials” published in Bioactive Materials. All articles are free to read and download.

AI-enabled organoids: Construction, analysis, and application

Bai, Long; Wu, Yan; Li, Guangfeng; Zhang, Wencai; Zhang, Hao; Su, Jiacan

AI-driven 3D bioprinting for regenerative medicine: From bench to bedside

Zhang, Zhenrui; Zhou, Xianhao; Fang, Yongcong; Xiong, Zhuo; Zhang, Ting

Harnessing the power of artificial intelligence for human living organoid research

Wang, Hui; Li, Xiangyang; You, Xiaoyan; Zhao, Guoping

Synchrotron microtomography reveals insights into the degradation kinetics of bio-degradable coronary magnesium scaffolds

Menze, Roman; Hesse, Bernhard; Kusmierczuk, Maciej; Chen, Duote; Weitkamp, Timm; Bettink, Stephanie; Scheller, Bruno

Emerging brain organoids: 3D models to decipher, identify and revolutionize brain

Zhao, Yuli; Wang, Ting; Liu, Jiajun; Wang, Ze; Lu, Yuan

Harnessing advanced computational approaches to design novel antimicrobial peptides against intracellular bacterial infections

Fang, Yanpeng; Fan, Duoyang; Feng, Bin; Zhu, Yingli; Xie, Ruyan; Tan, Xiaorong; Liu, Qianhui; Dong, Jie; Zeng, Wenbin

Throw out an oligopeptide to catch a protein: Deep learning and natural language processing-screened tripeptide PSP promotes Osteolectin-mediated vascularized bone regeneration

Chen, Yu; Chen, Long; Wu, Jinyang; Xu, Xiaofeng; Yang, Chengshuai; Zhang, Yong; Chen, Xinrong; Lin, Kaili; Zhang, Shilei

Quantum machine learning-based electrokinetic mining for the identification of nanoparticles and exosomes with minimal training data

Thakur, Abhimanyu; Bezerra, Pedro Correia Santos; Abhishek; Zeng, Shihao; Zhang, Kui; Treptow, Werner; Luna, Alexander; Dougherty, Urszula; Kwesi, Akushika; Huang, Isabella R.; Bestvina, Christine; Garassino, Marina Chiara; Duan, Fuyu; Gokhale, Yash; Duan, Bin; Chen, Yin; Lian, Qizhou; Bissonnette, Marc; Huang, Jianpan; Chen, Huanhuan Joyce

Lung cancer intravasation-on-a-chip: Visualization and machine learning-assisted automatic quantification

Wong, Christy Wing Tung; Lee, Joyce Zhi Xuen; Jaeschke, Anna; Ng, Sammi Sze Ying; Lit, Kwok Keung; Wan, Ho-Ying; Kniebs, Caroline; Ker, Dai Fei Elmer; Tuan, Rocky S.; Blocki, Anna

###

Contact the author:

Jessica Wang, jessica.wang@keaipublishing.com

The publisher KeAi was established by Elsevier and China Science Publishing & Media Ltd to unfold quality research globally. In 2013, our focus shifted to open access publishing. We now proudly publish more than 200 world-class, open access, English language journals, spanning all scientific disciplines. Many of these are titles we publish in partnership with prestigious societies and academic institutions, such as the National Natural Science Foundation of China (NSFC).

Journal

Manuscripts-turned AI agents can now ‘talk’ to each other, make new discoveries



Papers, reimagined as AI collaborators


Stanford Medicine





Since 1665, scholarly journals have stood as written record of scientific advancement — static words on a page, a reference written by people for other people to read. That’s about to change.

A team of Stanford Medicine researchers led by postdoctoral scholar Jiacheng Miao, PhD, and associate professor of biomedical data science James Zou, PhD, designed an artificial intelligence program called Paper2Agent that turns any scientific manuscript — including the text, figures and data — into an interactive AI agent that can chat about the paper and interact with other paper agents.

“For essentially all of human history, the way that we represent knowledge is in the form of these very passive artifacts,” Zou said. “In old times people carved knowledge into stones, and now we type knowledge into words on pages — but in some sense pages aren’t that much better.”

Zou is programming a major update to the centuries-old practice of manuscript publishing. “This is an opportunity to fundamentally reimagine what knowledge looks like. Instead of having only passive artifacts, why don’t we convert each static record into an active embodiment of knowledge?” Zou said. Think of it, he said, like a virtual author who knows how that knowledge is generated — one that’s capable of explaining it and extending it by connecting with other papers and initiating new collaborations.

A paper describing the AI work will publish on Sept. 16 in Nature. Zou is the senior author, and Miao is the lead author.

Manuscripts manifested

The paper agents can answer questions about the work, apply methods from the paper to new data and even engage in conversations with other paper agents. The transformation from paper to AI agent starts with a team of bustling AI “worker agents” that pore over a single published paper and any associated code and data. But they’re not just reading the paper. What’s the best way to learn? Do it yourself.

The agents try to reproduce the original research from scratch. In a virtual environment, the agents simulate the research documented in the paper, and through that process, they capture the know-how a reader would otherwise have to dig out manually, from reagents needed to the experimental setup and execution.

The agents store that knowledge using something called an MCP, or model context protocol.

“An MCP lets AI essentially represent a paper PDF in a form that’s easy for agents to access, almost like a filing system,” Zou said. Each section of the paper is stored in a different folder, while the introduction, methods, results and conclusion are all organized into a separate file that lives in a parent file of a given paper.

AI does the heavy lifting, but Zou and the other human authors still have a role. The manuscript won’t capture things like failed experiments or judgment calls behind experimental setups. So humans have to supply that context to the paper agent in conversational exchanges in which the agent can question the authors about the paper and research.

AI-to-AI collaboration

A “live action” embodiment of knowledge can be a boon for readers of scientific manuscripts who seek to deeply understand the research, but these paper whisperers can do something even more impressive. They can talk to each other. That kind of agent-to-agent collaboration could become a vast research network — one with potential to make real discoveries.

Zou and his team demonstrated the power of agent-to-agent collaboration by converting two unrelated papers into agents. One described a tool for predicting how genetic mutations affect the genome; the other described a genome-wide association study of the risk of developing attention-deficit/hyperactivity disorder. With both papers spun up into agents, the two began to find common ground. The genome prediction agent applied its knowledge to the ADHD dataset and flagged a molecular variant near a gene called MPHOSPH9 that’s associated with increased ADHD risk — a connection that, according to Zou, had not been reported before.

“In the past, if there are two research groups that publish two different papers, those two research groups have to somehow find each other,” Zou said. With paper agents, that overlap can surface without human legwork. Zou’s team chose these two initial papers and paired them for this demonstration, but the eventual goal, he said, is something closer to manuscript speed dating at scale: Millions of paper agents surfacing common ground among themselves and working together to produce new insights.

Checking knowledge as it’s built

Zou is careful to note that attribution still matters. Agents that extend a paper’s reach are meant to help disseminate the original researchers’ work, not obscure whose work it is. “It’s still important to attribute the final discoveries and reference them back to original papers and original human authors,” he said.

Zou also noted that the parameters under which agents collaborate — and make new discoveries — should be closely guided and monitored to ensure the agents’ collaborations prioritize safety and ethical research.

The team is still expanding what a paper agent can do, including working out how, at scale, thousands or millions of these agents might productively find each other. Right now, the team has created more than 100 paper agents, but eventually, Zou hopes most manuscripts will have an associated paper agent. “Millions of papers are published every year,” he said. “There’s enormous potential here.”

This work was supported by funding from the Chan-Zuckerberg Biohub.

# # #

 

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.

 

Journal

DOI

Method of Research

Article Title

Article Publication Date

ChatGPT at university: What determines whether students will continue using it?

What really matters when it comes to using ChatGPT?

Beyond usefulness, trust is also key

DOI

Article Title

As AI enters health care, are we ready?


In new perspective piece, researchers call for health-literate AI




CUNY Graduate School of Public Health and Health Policy






New York, NY | September 16, 2026 – Artificial intelligence is rapidly becoming part of how people seek, interpret, and act on health information. Yet the technology is advancing faster than the evidence needed to determine whether these systems actually help people understand what matters, make informed health decisions, and know what to do next.

A new perspective led by University of Alabama Professor Rebecca K. Ivic, PhD, with CUNY SPH Distinguished Lecturer Scott C. Ratzan, MD and Emory University School of Medicine Professor Emerita Ruth M. Parker, MD, introduces the concept of health-literate artificial intelligence and proposes four principles for designing and governing AI-mediated health communication: comprehension, agency, accountability, and proportionality.

“We are deploying AI into health contexts faster than we are building the evidence needed to know whether it actually helps people understand, decide, and act,” says Dr. Ivic.

As AI systems are used to answer questions about symptoms, summarize health guidance, interpret risk and support decisions, a technically plausible response may be provided, while still failing to communicate how urgent a situation is, how certain the information is, what alternatives exist, when professional care is needed, and how to garner human judgment and dialogue for appropriate decision-making.

The authors define health-literate AI as AI designed to align information, guidance, and responsibility with users’ abilities, contexts, and needs. The framework shifts attention beyond whether AI produces information that is technically accurate or explainable to whether people can understand what that information means, make informed decisions, and determine what to do next.

The four components are:

  • Comprehension: Can people interpret AI output in relation to their language, prior knowledge, and circumstances?
  • Agency: Does the information support meaningful and informed action, including clear choices and next steps?
  • Accountability: Are evidence, uncertainty, limitations, and responsibility visible?
  • Proportionality: Does the amount and urgency of guidance match the stakes of the situation?

Together, these components provide a basis for considering whether AI-mediated communication is fit for purpose in health-relevant settings.

“Given all the discussion and warnings about the potential harms of AI, we need expert thinking, research, and analysis that protects people from potential harms while realizing the promise of this new technology for health,” says Dr. Ratzan, co-chair of the Nature Medicine Commission on Quality Health Information for All and editor-in-chief of the Journal of Health Communication.

“Is AI in healthcare the holy grail or the tower of Babel?” asks Dr. Parker. “In medicine, there are immediate questions: Can all people understand and safely use what these systems tell them in order to improve health outcomes? Is its use cost-effective and also aligned with our human values?”

The framework builds on decades of health literacy research that has increasingly examined not only individuals’ skills but also how governments, organizations, and systems make health information easier or harder to understand and use. For over 30 years, Drs. Parker and Ratzan have contributed substantially to this body of work, including research on health literacy as a systems and policy concern. Dr. Ivic proposes a novel model for today’s digital information environment, examining how platforms, institutions, and emerging technologies shape the production, interpretation, and use of health information.

Rather than placing the burden entirely on individuals to interpret increasingly complex automated information, health-literate AI asks how the design and governance of AI systems themselves can support understanding and informed action. The authors also challenge designers to envision how AI could help operationalize affordability of healthcare, a long-standing, well-acknowledged goal that we have not achieved.  

“This model gives researchers, developers, and regulators a shared way to address a more consequential question,” says Dr. Ivic, commissioner of the Nature Medicine Commission on Quality Health Information for All and executive editor of the Journal of Health Communication. “The question is not simply whether AI can generate an answer, but whether people can understand it, use it, and act on it appropriately. Health-literate AI should do more of the work of making quality health information understandable, actionable, and accountable, with design and governance working together to advance responsible AI in health.”

The authors argue that this is particularly important in high-stakes or ambiguous situations. AI systems should distinguish among informing, advising, and deciding and make those roles clear to users. When automated output is insufficient, systems should also identify when human judgment, clinical evaluation, or ethical deliberation is needed.

“The goal is not to make people better at navigating increasingly complex AI,” Ivic says. “It is to give the field a way to begin measuring whether that is actually happening.”

The perspective argues that health literacy should not simply require people to adapt to increasingly complex technologies. As AI becomes an increasingly important intermediary between people and health information, the systems themselves should be designed around the people who must understand and use them.

The authors call for adoption of the principles of health-literate AI to inform design, evaluation, research, and governance across health-relevant AI ecosystems. They also point to an important evidence gap: More research is needed to determine whether AI actually improves comprehension, informed decision-making, and health-related action.

“AI in healthcare no doubt offers opportunities for innovation, but more research, guardrails, and regulation are needed to ensure its benefits clearly outweigh its risks,” says Dr. Parker. “Its design and use needs to enhance users’ abilities to understand and make decisions that improve health, are affordable, and consistently aligned with our human values.”

Ivic, R.K., Ratzan, S.C. & Parker, R.M. Building health-literate artificial intelligence. Nat Hum Behav (2026).

Media contact:

Ariana Costakes

Communications Editorial Manager

ariana.costakes@sph.cuny.edu

About CUNY SPH

The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to promoting and sustaining healthier populations in New York City and around the world through excellence in education, research, and service in public health and by advocating for sound policy and practice to advance social justice and improve health outcomes for all.