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Untapped Gold Mine

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Published February 14, 2026

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Good morning and Happy Valentine’s Day! For Heart Month, we dusted off Neil Armstrong’s famous line: “I believe every human has a finite number of heartbeats. I don’t intend to waste any of mine.” The finite heartbeat theory, the folkloric idea that we’re born with a nonrefillable supply of heartbeats (~2.5 billion), has fueled the influencer-backed claim that exercise prematurely drains this fictional reserve.

Luckily, science intervened. In a narrow study of trained athletes, researchers tested the second part of that myth and found the opposite. Despite exercise-induced spikes, athletes maintained lower resting heart rates across the day, totaling ~11,500 fewer beats (~10% less) per day than untrained adults.

One small step for cardio; one giant leap for common sense.

Crossing the Vitamin D Threshold in Post-MI Care

CARDIO CORNER

Nearly two-thirds of adults fall short on vitamin D. While low levels are linked to poor heart health, past supplementation studies—much like a sunscreen ad in Seattle—struggled to make a convincing case. Why? Most relied on a poncho-style fix: one-size-fits-all dosing. But a new study reveals how outcomes shift with precision vitamin D dosing.

Enter TARGET-D

Attendees of American Heart Association Scientific Sessions 2025 perked up at results from the TARGET-D trial. This aptly named study assessed targeted vitamin D supplementation in patients with a recent myocardial infarction (MI), with doses adjusted every three months to maintain serum 25(OH)D levels above 40 ng/mL. The primary composite outcome—death, stroke, MI, or heart failure hospitalization—held steady. But the secondary outcome sparked a wave of slide captures: Patients who reached target levels saw a 52% drop in recurrent MI.

A few asterisks

The study enrolled only patients with established heart disease, most of whom were White—limiting generalizability. The modest sample size offered little reassurance, and nearly a quarter of the treatment group stalled below target vitamin D levels.

Key takeaways

TARGET-D points toward a more tailored approach to supplementation. If vitamin D plays a role in secondary MI prevention, it likely depends on more than a standard daily dose. The findings suggest a threshold effect: Outcomes improved only when clinicians tracked levels and adjusted dosing to stay above target. Dip below and the benefit unraveled. It’s Speed, but for lab values: Keep 25(OH)D above 40 ng/mL and the bus above 50 mph—or the wheels could fall off.

For more education on vitamin D supplementation, check out this CME podcast: For more education on vitamin D supplementation, check out this CME podcast:

The Antibiotic We Walked Past for 50 Years

INFECTIOUS FINDINGS

The World Health Organization is wringing its hands over drug-resistant bacterial infections and warning that the antibiotic pipeline looks like a Whole Foods dairy case pre-blizzard. But new research pulls a powerful antibiotic from a bacterium with decades of lab mileage and offers cautious optimism that science hasn’t yet picked all the low-hanging fruit.

Hidden in plain sequence

While the known antibiotic methylenomycin A has lived under a microscope for 50 years, no one thought to test its synthetic intermediates—the molecular precursors in the biosynthetic assembly line. But when researchers deleted specific genes to isolate these earlier stage compounds, they found pre-methylenomycin C lactone, a long-overlooked intermediate that demonstrated >100 times more potency than methylenomycin A—especially against resistant strains like MRSA and VRE. Even better, no resistance emerged under lab conditions that usually trigger it.

Key takeaways

It’s early days, but pre-methylenomycin C lactone checks several key antibiotic boxes: potent, structurally clean, active against tough Gram-positive pathogens, and, so far, resistance-proof. The real headline? It came from a microbe that had already been dissected within an inch of its genome. If pre-methylenomycin C lactone’s activity and resistance profile hold, biosynthetic intermediates may be a vast, untapped gold mine. For now, this compound looks promising—the kind of discovery that keeps microbiologists warm at night, and Big Pharma awake with hindsight.

For more education on antibiotics, check out this CME activity: Antibiotics in Office Practice

Acetaminophen–Autism: A Reality Check

SPECIAL CONTRIBUTOR—FRANK DOMINO, MD

It’s been a challenging stretch for acetaminophen recently, following claims of a possible link with autism spectrum disorder (ASD), but findings from a pair of publications may offer relief to expectant parents and PR teams alike.

In a 2024 cohort study based in Sweden (home of IKEA, Spotify, and apparently very large datasets), researchers analyzed data from 2.4 million children and used sibling control analysis to address previous uncontrolled findings linking acetaminophen (paracetamol) use during pregnancy and ASD. They found no evidence that acetaminophen use during pregnancy was associated with the risk of ASD (HR, 0.98; 95% CI, 0.93-1.04), attention-deficit/hyperactivity disorder (ADHD) (HR, 0.98; 95% CI, 0.94-1.02), or intellectual disability (HR, 1.01; 95% CI, 0.92-1.10).

Last month, an international team published an evaluation of 43 studies from around the world and found that, in sibling comparison studies, acetaminophen exposure during pregnancy was not associated with the risk of ASD (OR, 0.98; 95% CI, 0.93-1.03; P=0.45), ADHD (OR, 0.95; 95% CI, 0.86-1.05; P=0.31), or intellectual disability (OR, 0.93; 95% CI, 0.69-1.24; P=0.63).

Key takeaways

Taken together, these studies indicate that acetaminophen use during pregnancy is not linked to ASD. So, what does correlate with ASD? The greatest single risk factor is having a sibling with ASD, followed by pregestational diabetes, severe COVID-19 infection during pregnancy among unvaccinated mothers, and some environmental exposures.

For more education on this topic, check out this Frankly Speaking podcast episode: Autism and Acetaminophen—Separating Fact from Misinformation

Interested in more healthcare news? Here are some other articles we don’t want you to miss:

Morning Report is written by:

Alissa Scott, Author
Aylin Madore, MD, MEd, Editor
Margaret Oliverio, MD, Editor
Ariel Reinish, MD, MEd, Editor
Emily Ruge, Editor

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