CHICAGO (AP) —&nbsp;<a href="https://apnews.com/article/ivf-frozen-embryo-alabama-court-7c968cc00201731d7baba5a284655b0d">The recent ruling in Alabama</a>&nbsp;that frozen embryos are legally considered children created a political firestorm after&nbsp;<a href="https://publicportal-api.alappeals.gov/courts/68f021c4-6a44-4735-9a76-5360b2e8af13/cms/case/343D203A-B13D-463A-8176-C46E3AE4F695/docketentrydocuments/E3D95592-3CBE-4384-AFA6-063D4595AA1D">the decision</a>&nbsp;halted treatment for many couples seeking to have families through fertility treatments. It also has turned the spotlight on the importance of institutions that are poised to play a central in this year's elections: state supreme courts.

<a href="https://publicportal-api.alappeals.gov/courts/68f021c4-6a44-4735-9a76-5360b2e8af13/cms/case/343d203a-b13d-463a-8176-c46e3ae4f695/docketentrydocuments/e3d95592-3cbe-4384-afa6-063d4595aa1d">Click here to read</a>&nbsp;the ruling

Decisions by states' highest courts have become especially critical in the nearly two years since the U.S. Supreme Court overturned a constitutional right to abortion. This year, campaigns for state supreme court seats are expected to be among the most expensive and bitterly contested races on the ballot. At stake are future decisions over abortion, other reproductive rights, gerrymandering, voting rights and other crucial issues.

“This is where the action is,” said Jessie Hill, a law professor at Case Western Reserve University School of Law in Cleveland.

<a href="https://apnews.com/article/alabama-frozen-embryos-pause-4cf5d3139e1a6cbc62bc5ad9946cc1b8">The ruling</a>&nbsp;on Feb. 16 by the Republican-majority Alabama Supreme Court to consider frozen embryos created through IVF to be children under state law has unexpectedly made&nbsp;<a href="https://apnews.com/article/election-ivf-embryos-ruling-republicans-campaign-democrats-5fa61803333ab1ec1062835397c15570">in vitro fertilization, or IVF,</a>&nbsp;an emerging&nbsp;<a href="https://apnews.com/article/alabama-ivf-legislation-0506c070085407b8983bf55409b1465c">issue</a>&nbsp;in campaigns up and down the ballot. With multiple providers&nbsp;<a href="https://apnews.com/article/alabama-ivf-legislation-0506c070085407b8983bf55409b1465c">pausing fertility treatments</a>&nbsp;in the state, fearing criminal charges or punitive damages, the GOP-controlled Legislature is under pressure&nbsp;<a href="https://www.msn.com/en-us/health/other/alabama-lawmakers-look-for-ivf-solution-as-patients-remain-in-limbo/ar-BB1iYLgW">to come up with a fix</a>.

After the U.S. Supreme Court&nbsp;<a href="https://apnews.com/article/abortion-supreme-court-decision-854f60302f21c2c35129e58cf8d8a7b0#:~:text=WASHINGTON%20(AP)%20%E2%80%94%20The%20Supreme,Wade.">overturned Roe v. Wade</a>&nbsp;in 2022, eliminating federal protections for abortion rights, the decision unleashed a flurry of activity in the states, from legislation to lawsuits that often have ended up before state supreme courts. Those cases have magnified the stakes of having liberals or conservatives controlling a majority on those courts.

“Many people may not have realized that state supreme courts can decide on these kinds of issues that have such a direct impact on their everyday lives," Hill said. "But this Alabama ruling is a reminder that these courts hold so much power, especially now, over people’s rights.”

This year's elections bring&nbsp;<a href="https://apnews.com/article/state-supreme-courts-abortion-redistricting-2024-931a453131fac282815ae31b4f0ea271">80 races</a>&nbsp;for supreme court seats in 33 states, including a few such as Michigan, Ohio and West Virginia where partisan control is on the line. At least four states will have state supreme court races on Super Tuesday, including Alabama, Arkansas, North Carolina and Texas. Others, including Idaho, Illinois, Kentucky, Ohio, Oregon and West Virginia will have contests through the spring.

In Alabama, five of the nine seats on the all-Republican Supreme Court are on the ballot.&nbsp;<a href="https://apnews.com/article/alabama-frozen-embryos-conservative-christian-views-ruling-d9b7f720b5ef865ab35205ad36061f2d?utm_campaign=TrueAnthem&amp;utm_medium=AP&amp;utm_source=Twitter">Chief Justice Tom Parker</a>, 72, who cited verses from the Bible and Christian theologians in his concurring opinion in the IVF case, is unable to seek another term because the Mississippi Constitution does not allow judges older than 70 to be elected.

Since Roe fell in the Dobbs v. Jackson Women’s Health Organization decision,&nbsp;<a href="https://www.brennancenter.org/our-work/research-reports/state-court-abortion-litigation-tracker#arizona">about 40 lawsuits</a>&nbsp;challenging abortion bans have been filed in 23 states, and many have worked their up to to states' highest courts as advocates search state constitutions for protections to abortion rights.

According to the&nbsp;<a href="https://reproductiverights.org/maps/state-constitutions-and-abortion-rights/">Center for Reproductive Rights</a>, 30 state supreme courts have decided cases challenging abortion restrictions under their state constitutions. Of these, 12 have recognized protections for abortion rights in state constitutions, while four have denied their state constitutions protect abortion rights. Other state high courts have either upheld or blocked abortion restrictions without explicitly deciding on whether their state constitutions protect abortion rights.

These rulings have had direct consequences for those trying to access abortion care. In December, the Texas Supreme Court&nbsp;<a href="https://apnews.com/article/texas-abortion-ban-supreme-court-decision-10767891a475e7ce2c82b1404450908a">overturned a court order</a>&nbsp;that would have allowed a&nbsp;<a href="https://apnews.com/article/abortion-kate-cox-texas-exceptions-e85664b2ab76bcb689b1b91913d3e33e">Dallas woman</a>&nbsp;to get an abortion after&nbsp;<a href="https://apnews.com/article/abortion-texas-court-kate-cox-complications-3e24f473b0eab907993ddcad189e8115">her story</a>&nbsp;of being forced to leave the state to terminate her nonviable pregnancy sparked a national outcry.

Abortion rights are just one recent example of the U.S. Supreme Court deferring to states on major issues, said Douglas Keith, senior counsel in the judiciary program at the Brennan Center for Justice, which tracks spending in judicial races. The U.S. Supreme Court also stepped back from ruling on issues such as&nbsp;<a href="https://apnews.com/article/54daa625511445969fee66696f7979c2">partisan gerrymandering</a>&nbsp;and&nbsp;<a href="https://apnews.com/article/voting-rights-act-supreme-court-black-voters-6f840911e360c44fd2e4947cc743baa2">voting rights</a>, often making state supreme courts the final word on those issues.

“The Dobbs decision and others made clear that these courts would be the ones to decide these fundamental issues during a time where the U.S. Supreme Court was taking a step back from protecting certain rights,” Keith said.

State courts also are involved in the process of getting statewide citizen initiatives to the ballot, often deciding disputes over the technical requirements of petitions and the signature-gathering process. They will be play a pivotal role this year, as reproductive rights groups seek to place measures protecting abortion before voters in&nbsp;<a href="https://apnews.com/article/abortion-ballot-amendment-ban-protection-states-2024-052ff9846f8416efb725240af22b92ec">a number of states</a>.

State supreme courts are expected to rule on such measures planned in Florida, Missouri and Nevada.

Florida’s Republican attorney general in January&nbsp;<a href="https://apnews.com/article/florida-abortion-ballot-elections-931be34f9ffdd6d74f6beade05eeee47">asked</a>&nbsp;the state Supreme Court to keep a proposed abortion rights amendment off the ballot.&nbsp;<a href="https://apnews.com/article/abortion-missouri-ballot-constitution-ruling-edb5f44fc0f9799d01cda22cd1f70b40">In Missouri</a>, an appeals court ruled in October that summaries written by Republican Secretary of State Jay Ashcroft, an abortion opponent who is running for governor, were politically partisan and misleading. The Missouri Supreme Court declined to hear Ashcroft's appeal of the ruling.

A Nevada district court judge in January&nbsp;<a href="https://apnews.com/article/nevada-abortion-access-ballot-471e9036864c030cc5296e7c78da8dad">approved</a>&nbsp;an abortion-rights ballot measure petition as eligible for signature-gathering, despite a legal challenge by anti-abortion groups. In November, the judge rejected an earlier petition that was much broader, including protections for prenatal care, postpartum care, vasectomies, tubal ligations, miscarriages and infertility. Nevadans for Reproductive Freedoms, the group behind the petition, appealed that rejection to the Nevada Supreme Court and is awaiting a ruling.

Activists also aim to place abortion rights on the ballot in Arizona, where Republican governors have appointed all seven of the Supreme Court justices.

“In many cases, state supreme courts have a lot of power to shut down direct democracy by preventing a question from getting on the ballot,” said Brian Fitzpatrick, a professor at Vanderbilt Law School.

Strategies that attempt to derail ballot initiatives are part of a&nbsp;<a href="https://apnews.com/article/abortion-ballot-initiatives-voters-democracy-2024-602ebb8a74d7ae45163d79c065a23ef0">blueprint</a>&nbsp;created by anti-abortion groups in other states, including Ohio, where voters last year overwhelmingly decided to&nbsp;<a href="https://apnews.com/article/ohio-abortion-amendment-election-2023-fe3e06747b616507d8ca21ea26485270">enshrine abortion rights</a>&nbsp;in the state constitution.

Even with voter approval, the Ohio Supreme Court will be the “ultimate arbiter” of how to interpret the constitutional amendment and how it will affect existing abortion laws, said Hill, the Case Western law professor who served as a consultant to the Ohio campaign to enshrine abortion rights. This means the state's Supreme Court races this year, starting with a March 19 primary, will be vital to abortion rights in the state, as well as other topics including gerrymandering, environmental protections and criminal justice, she said.

With three seats up for a vote and a current 4-3 Republican majority, Democrats have an opportunity to flip the majority of the court for the first time since 1986 while Republicans will try to expand their control.

The&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-election-abortion-0d188b5c6f841546f98436c1ab8180fa">result</a>&nbsp;of a&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-abortion-spending-82a3481a75665110e6d4b3d503ee2a24">heated race</a>&nbsp;in Wisconsin last year already has had an impact, after that state's Supreme Court flipped to a liberal majority for the first time in 15 years.

In December, the new Wisconsin Supreme Court&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-redistricting-eccbcfee414d1943073a9fb949743860">overturned</a>&nbsp;Republican-drawn&nbsp;<a href="https://apnews.com/article/wisconsin-redistricting-legislature-5bc5c0347b26a40fd615f4faf7583b46">legislative maps</a>&nbsp;and ordered new district boundary lines to be drawn. Wisconsin is a swing state but also is one of the&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-impeachment-republicans-gerrymandering-legislature-21fc8c3cf99623a379cbf4dd01ed0b8c">most heavily gerrymandered</a>&nbsp;in the country, allowing Republicans to have outsized majorities in the Legislature. A&nbsp;<a href="https://apnews.com/article/wisconsin-abortion-ban-lawsuit-planned-parenthood-1518465359ed39a39d38e14a8d97a94e">lawsuit</a>&nbsp;challenging Wisconsin’s abortion ban might also be headed to the state supreme court.

“There have been immediate consequences for redistricting that have fundamentally reshaped politics in Wisconsin,” said Kyle Kondik, managing editor of an elections and campaign newsletter published by the University of Virginia Center for Politics. “It goes to show just how important these races are.”

CHICAGO (AP) —&nbsp;<a href="https://apnews.com/article/ivf-frozen-embryo-alabama-court-7c968cc00201731d7baba5a284655b0d">The recent ruling in Alabama</a>&nbsp;that frozen embryos are legally considered children created a political firestorm after&nbsp;<a href="https://publicportal-api.alappeals.gov/courts/68f021c4-6a44-4735-9a76-5360b2e8af13/cms/case/343D203A-B13D-463A-8176-C46E3AE4F695/docketentrydocuments/E3D95592-3CBE-4384-AFA6-063D4595AA1D">the decision</a>&nbsp;halted treatment for many couples seeking to have families through fertility treatments. It also has turned the spotlight on the importance of institutions that are poised to play a central in this year's elections: state supreme courts.<a href="https://publicportal-api.alappeals.gov/courts/68f021c4-6a44-4735-9a76-5360b2e8af13/cms/case/343d203a-b13d-463a-8176-c46e3ae4f695/docketentrydocuments/e3d95592-3cbe-4384-afa6-063d4595aa1d">Click here to read</a>&nbsp;the rulingDecisions by states' highest courts have become especially critical in the nearly two years since the U.S. Supreme Court overturned a constitutional right to abortion. This year, campaigns for state supreme court seats are expected to be among the most expensive and bitterly contested races on the ballot. At stake are future decisions over abortion, other reproductive rights, gerrymandering, voting rights and other crucial issues.“This is where the action is,” said Jessie Hill, a law professor at Case Western Reserve University School of Law in Cleveland.<a href="https://apnews.com/article/alabama-frozen-embryos-pause-4cf5d3139e1a6cbc62bc5ad9946cc1b8">The ruling</a>&nbsp;on Feb. 16 by the Republican-majority Alabama Supreme Court to consider frozen embryos created through IVF to be children under state law has unexpectedly made&nbsp;<a href="https://apnews.com/article/election-ivf-embryos-ruling-republicans-campaign-democrats-5fa61803333ab1ec1062835397c15570">in vitro fertilization, or IVF,</a>&nbsp;an emerging&nbsp;<a href="https://apnews.com/article/alabama-ivf-legislation-0506c070085407b8983bf55409b1465c">issue</a>&nbsp;in campaigns up and down the ballot. With multiple providers&nbsp;<a href="https://apnews.com/article/alabama-ivf-legislation-0506c070085407b8983bf55409b1465c">pausing fertility treatments</a>&nbsp;in the state, fearing criminal charges or punitive damages, the GOP-controlled Legislature is under pressure&nbsp;<a href="https://www.msn.com/en-us/health/other/alabama-lawmakers-look-for-ivf-solution-as-patients-remain-in-limbo/ar-BB1iYLgW">to come up with a fix</a>.After the U.S. Supreme Court&nbsp;<a href="https://apnews.com/article/abortion-supreme-court-decision-854f60302f21c2c35129e58cf8d8a7b0#:~:text=WASHINGTON%20(AP)%20%E2%80%94%20The%20Supreme,Wade.">overturned Roe v. Wade</a>&nbsp;in 2022, eliminating federal protections for abortion rights, the decision unleashed a flurry of activity in the states, from legislation to lawsuits that often have ended up before state supreme courts. Those cases have magnified the stakes of having liberals or conservatives controlling a majority on those courts.“Many people may not have realized that state supreme courts can decide on these kinds of issues that have such a direct impact on their everyday lives," Hill said. "But this Alabama ruling is a reminder that these courts hold so much power, especially now, over people’s rights.”This year's elections bring&nbsp;<a href="https://apnews.com/article/state-supreme-courts-abortion-redistricting-2024-931a453131fac282815ae31b4f0ea271">80 races</a>&nbsp;for supreme court seats in 33 states, including a few such as Michigan, Ohio and West Virginia where partisan control is on the line. At least four states will have state supreme court races on Super Tuesday, including Alabama, Arkansas, North Carolina and Texas. Others, including Idaho, Illinois, Kentucky, Ohio, Oregon and West Virginia will have contests through the spring.In Alabama, five of the nine seats on the all-Republican Supreme Court are on the ballot.&nbsp;<a href="https://apnews.com/article/alabama-frozen-embryos-conservative-christian-views-ruling-d9b7f720b5ef865ab35205ad36061f2d?utm_campaign=TrueAnthem&amp;utm_medium=AP&amp;utm_source=Twitter">Chief Justice Tom Parker</a>, 72, who cited verses from the Bible and Christian theologians in his concurring opinion in the IVF case, is unable to seek another term because the Mississippi Constitution does not allow judges older than 70 to be elected.Since Roe fell in the Dobbs v. Jackson Women’s Health Organization decision,&nbsp;<a href="https://www.brennancenter.org/our-work/research-reports/state-court-abortion-litigation-tracker#arizona">about 40 lawsuits</a>&nbsp;challenging abortion bans have been filed in 23 states, and many have worked their up to to states' highest courts as advocates search state constitutions for protections to abortion rights.According to the&nbsp;<a href="https://reproductiverights.org/maps/state-constitutions-and-abortion-rights/">Center for Reproductive Rights</a>, 30 state supreme courts have decided cases challenging abortion restrictions under their state constitutions. Of these, 12 have recognized protections for abortion rights in state constitutions, while four have denied their state constitutions protect abortion rights. Other state high courts have either upheld or blocked abortion restrictions without explicitly deciding on whether their state constitutions protect abortion rights.These rulings have had direct consequences for those trying to access abortion care. In December, the Texas Supreme Court&nbsp;<a href="https://apnews.com/article/texas-abortion-ban-supreme-court-decision-10767891a475e7ce2c82b1404450908a">overturned a court order</a>&nbsp;that would have allowed a&nbsp;<a href="https://apnews.com/article/abortion-kate-cox-texas-exceptions-e85664b2ab76bcb689b1b91913d3e33e">Dallas woman</a>&nbsp;to get an abortion after&nbsp;<a href="https://apnews.com/article/abortion-texas-court-kate-cox-complications-3e24f473b0eab907993ddcad189e8115">her story</a>&nbsp;of being forced to leave the state to terminate her nonviable pregnancy sparked a national outcry.Abortion rights are just one recent example of the U.S. Supreme Court deferring to states on major issues, said Douglas Keith, senior counsel in the judiciary program at the Brennan Center for Justice, which tracks spending in judicial races. The U.S. Supreme Court also stepped back from ruling on issues such as&nbsp;<a href="https://apnews.com/article/54daa625511445969fee66696f7979c2">partisan gerrymandering</a>&nbsp;and&nbsp;<a href="https://apnews.com/article/voting-rights-act-supreme-court-black-voters-6f840911e360c44fd2e4947cc743baa2">voting rights</a>, often making state supreme courts the final word on those issues.“The Dobbs decision and others made clear that these courts would be the ones to decide these fundamental issues during a time where the U.S. Supreme Court was taking a step back from protecting certain rights,” Keith said.State courts also are involved in the process of getting statewide citizen initiatives to the ballot, often deciding disputes over the technical requirements of petitions and the signature-gathering process. They will be play a pivotal role this year, as reproductive rights groups seek to place measures protecting abortion before voters in&nbsp;<a href="https://apnews.com/article/abortion-ballot-amendment-ban-protection-states-2024-052ff9846f8416efb725240af22b92ec">a number of states</a>.State supreme courts are expected to rule on such measures planned in Florida, Missouri and Nevada.Florida’s Republican attorney general in January&nbsp;<a href="https://apnews.com/article/florida-abortion-ballot-elections-931be34f9ffdd6d74f6beade05eeee47">asked</a>&nbsp;the state Supreme Court to keep a proposed abortion rights amendment off the ballot.&nbsp;<a href="https://apnews.com/article/abortion-missouri-ballot-constitution-ruling-edb5f44fc0f9799d01cda22cd1f70b40">In Missouri</a>, an appeals court ruled in October that summaries written by Republican Secretary of State Jay Ashcroft, an abortion opponent who is running for governor, were politically partisan and misleading. The Missouri Supreme Court declined to hear Ashcroft's appeal of the ruling.A Nevada district court judge in January&nbsp;<a href="https://apnews.com/article/nevada-abortion-access-ballot-471e9036864c030cc5296e7c78da8dad">approved</a>&nbsp;an abortion-rights ballot measure petition as eligible for signature-gathering, despite a legal challenge by anti-abortion groups. In November, the judge rejected an earlier petition that was much broader, including protections for prenatal care, postpartum care, vasectomies, tubal ligations, miscarriages and infertility. Nevadans for Reproductive Freedoms, the group behind the petition, appealed that rejection to the Nevada Supreme Court and is awaiting a ruling.Activists also aim to place abortion rights on the ballot in Arizona, where Republican governors have appointed all seven of the Supreme Court justices.“In many cases, state supreme courts have a lot of power to shut down direct democracy by preventing a question from getting on the ballot,” said Brian Fitzpatrick, a professor at Vanderbilt Law School.Strategies that attempt to derail ballot initiatives are part of a&nbsp;<a href="https://apnews.com/article/abortion-ballot-initiatives-voters-democracy-2024-602ebb8a74d7ae45163d79c065a23ef0">blueprint</a>&nbsp;created by anti-abortion groups in other states, including Ohio, where voters last year overwhelmingly decided to&nbsp;<a href="https://apnews.com/article/ohio-abortion-amendment-election-2023-fe3e06747b616507d8ca21ea26485270">enshrine abortion rights</a>&nbsp;in the state constitution.Even with voter approval, the Ohio Supreme Court will be the “ultimate arbiter” of how to interpret the constitutional amendment and how it will affect existing abortion laws, said Hill, the Case Western law professor who served as a consultant to the Ohio campaign to enshrine abortion rights. This means the state's Supreme Court races this year, starting with a March 19 primary, will be vital to abortion rights in the state, as well as other topics including gerrymandering, environmental protections and criminal justice, she said.With three seats up for a vote and a current 4-3 Republican majority, Democrats have an opportunity to flip the majority of the court for the first time since 1986 while Republicans will try to expand their control.The&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-election-abortion-0d188b5c6f841546f98436c1ab8180fa">result</a>&nbsp;of a&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-abortion-spending-82a3481a75665110e6d4b3d503ee2a24">heated race</a>&nbsp;in Wisconsin last year already has had an impact, after that state's Supreme Court flipped to a liberal majority for the first time in 15 years.In December, the new Wisconsin Supreme Court&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-redistricting-eccbcfee414d1943073a9fb949743860">overturned</a>&nbsp;Republican-drawn&nbsp;<a href="https://apnews.com/article/wisconsin-redistricting-legislature-5bc5c0347b26a40fd615f4faf7583b46">legislative maps</a>&nbsp;and ordered new district boundary lines to be drawn. Wisconsin is a swing state but also is one of the&nbsp;<a href="https://apnews.com/article/wisconsin-supreme-court-impeachment-republicans-gerrymandering-legislature-21fc8c3cf99623a379cbf4dd01ed0b8c">most heavily gerrymandered</a>&nbsp;in the country, allowing Republicans to have outsized majorities in the Legislature. A&nbsp;<a href="https://apnews.com/article/wisconsin-abortion-ban-lawsuit-planned-parenthood-1518465359ed39a39d38e14a8d97a94e">lawsuit</a>&nbsp;challenging Wisconsin’s abortion ban might also be headed to the state supreme court.“There have been immediate consequences for redistricting that have fundamentally reshaped politics in Wisconsin,” said Kyle Kondik, managing editor of an elections and campaign newsletter published by the University of Virginia Center for Politics. “It goes to show just how important these races are.”___

IVF ruling highlights importance of state court races in US elections

CRAWFORD COUNTY —One person died in an accident just after 3a.m. Sunday in Crawford County.

The Kansas Highway Patrol reported a 2001 Chrysler PT Cruiser driven by Ashley M.&nbsp;Rendon, 26, Parsons,&nbsp;was westbound on Kansas 126 four miles west of Pittsburg. The car traveled off the roadway into the south ditch, struck a culvert, rolled onto its top and caught on fire

Rendon was pronounced dead at the scene and was transported to&nbsp;Derfelt Funeral Home. The KHP did not have seat belt usage details.

CRAWFORD COUNTY —One person died in an accident just after 3a.m. Sunday in Crawford County.The Kansas Highway Patrol reported a 2001 Chrysler PT Cruiser driven by Ashley M.&nbsp;Rendon, 26, Parsons,&nbsp;was westbound on Kansas 126 four miles west of Pittsburg. The car traveled off the roadway into the south ditch, struck a culvert, rolled onto its top and caught on fireRendon was pronounced dead at the scene and was transported to&nbsp;Derfelt Funeral Home. The KHP did not have seat belt usage details.

Kansas woman dies after rollover crash, fire

JACKSON COUNTY, Kan. —Law enforcement authorities are investigating to suspects on drug allegations.

On Feb. 26, a sheriff's deputy conducted a&nbsp;traffic stop on 198th Road near Q. Road in rural Jackson County, according to Sheriff Tim Morse.

 Deputies seized illegal drug contraband during the stop.  John Albert Johnston, 39, and Melissa Ann Hibbs, 40, both of Topeka, were arrested and booked into the Jackson County Jail. Johnston was booked on requested charges of possession of methamphetamine, possession of drug paraphernalia, driving while suspended and driving while habitual violator. Hibbs was booked on requested charges of possession of a hallucinogenic drug and possession of drug paraphernalia.

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/2/1709070678374.png" alt="Johnston-photo Jackson Co." />
 <figcaption>Johnston-photo Jackson Co.</figcaption>
 </figure>JACKSON COUNTY, Kan. —Law enforcement authorities are investigating to suspects on drug allegations.On Feb. 26, a sheriff's deputy conducted a&nbsp;traffic stop on 198th Road near Q. Road in rural Jackson County, according to Sheriff Tim Morse.<figure>
 <img src="https://media.eaglewebservices.com/public/2024/2/1709070654143.png" alt="Hibbs-photo Jackson Co." />
 <figcaption>Hibbs-photo Jackson Co.</figcaption>
 </figure> Deputies seized illegal drug contraband during the stop. John Albert Johnston, 39, and Melissa Ann Hibbs, 40, both of Topeka, were arrested and booked into the Jackson County Jail. Johnston was booked on requested charges of possession of methamphetamine, possession of drug paraphernalia, driving while suspended and driving while habitual violator. Hibbs was booked on requested charges of possession of a hallucinogenic drug and possession of drug paraphernalia.

Kansas couple caught transporting methamphetamine

WASHINGTON (AP) — The transcript of the congressional deposition of&nbsp;<a href="https://apnews.com/hub/hunter-biden">Hunter Biden</a>&nbsp;was released late Thursday, providing a full view of the contentious testimony that took place behind closed doors Wednesday as Republicans aggressively questioned the central figure in their impeachment inquiry.

<a href="https://oversight.house.gov/wp-content/uploads/2024/02/Hunter-Biden-Transcript_Redacted.pdf">Click here to read the</a> transcript

The nearly 230 pages of questioning laid bare the deep-seated hostility between President Joe Biden's son and the GOP lawmakers who have been investigating his family for the past several years. Arguments were frequent and tempers short, providing a preview of what is sure to come when Republicans hold a public hearing with Hunter Biden in the next several weeks.

He was defiant through the deposition as Republicans flooded him with questions about his former business affairs and his life, his answers veering from heated to emotional as he talked of his long battle with addiction and turmoil in his personal life.

Throughout the nearly seven-hour deposition, Hunter Biden remained adamant on one point, vehemently and repeatedly denying under oath that his father ever financially benefited or participated in any of his business work.

The 14-month Republican investigation into the Biden family has centered on Hunter Biden and his overseas work for clients in Ukraine, China, Romania and other countries. Republicans have long questioned whether those business dealings involved corruption and influence peddling by President Biden, particularly in the years when he was vice president.

Republican investigators zeroed in on a series of dinners and meetings that took place after Joe Biden left the vice presidency in which the younger Biden put his father on speakerphone while in the company of business partners.

“And why would you place your dad on speakerphone?” an unidentified Republican staffer asked.

“I’m surprised my dad hasn’t called me right now, and if he did, I would put him on speakerphone to say hi to you and to Congressman Raskin and everybody else in the room,” Hunter Biden replied. “It is nothing nefarious literally.”

He said that after the tragedies his family has suffered — including the death of his mother and two siblings — calls in his family are always answered, no matter what.

“You always pick up the phone. It’s something that we always do. And you can ask anybody that I know,” Hunter Biden added.

Large portions of the testimony Wednesday diverged into Hunter Biden's well-documented battle with drug and alcohol addiction.

In one particularly harsh exchange, Rep. Matt Gaetz, a Republican from Florida, questioned whether the president’s son’s business dealings, particularly with the Ukrainian energy firm Burisma, were legitimate. Gaetz asked, “Were you on drugs when you were on the Burisma board?”

Hunter responded: “Mr. Gaetz, look me in the eye. You really think that’s appropriate to ask me?”

Biden’s attorney, Abbe Lowell, intervened, telling his client he didn't need to respond.

“I will answer it this way: I have been absolutely transparent about my drug use,” Hunter Biden said. “I’m sorry; I’m an addict. I was an addict.”

He told the panel he has been in recovery for more than four years and works “really, really hard at it” under what he called an enormous amount of pressure.

“Was I an addict? Yes, I was an addict,” he said. “What does that have to do with whether or not you’re going to go forward with an impeachment of my father other than to simply try to embarrass me?”

Gaetz tried to interrupt, but Hunter Biden kept talking: “Why? Why?"

Another point of interest for House Republicans' investigation is what they describe as Hunter Biden and associates selling the Biden “brand” to clients overseas.

One of their purported key witnesses, Devon Archer, a former business associate of Hunter Biden, testified to the House Oversight Committee last year that the president's family sold “the illusion of access” to the corridors of power in Washington. Republicans questioned whether Burisma, the Ukrainian energy firm, wanted Hunter Biden on&nbsp;<a href="https://apnews.com/article/joe-biden-europe-business-c49555d51eb243e09a42f7577fc5937f">its board in 2014</a>&nbsp;"because your dad was the Vice President?”

“No, I don’t think that it’s fair,” Hunter Biden responded.

When asked about what value he brought to Burisma, Hunter Biden talked about the breadth of his resume and defended his family.

“Primarily, the name ‘Biden’ is my dad’s legacy. And he passed it down to me and, when my brother was alive, my brother, my sister, now to my children. It’s our responsibility to not screw that up."

He added, "If other people saw the brand as something that they could market, it’s not -- it was not with my -- without going through me first. And if they did so, they didn’t go through me first."

Rather than probe the Bidens, Democrats turn to the Trumps

Democrats at one point tried to turn the deposition back toward Donald Trump, contrasting the Bidens' business dealings with the former Republican president’s family and its business operations.

Rep. Eric Swalwell, the Democrat from California, led one particularly pointed exchange intended to draw out the differences between President Biden and Trump, the Republican front-runner to challenge him for the White House.

“Did your father ever employ in the Oval Office any direct family member to also work in the Oval Office?” Swalwell asked.

“My father has never employed any direct family members, to my knowledge,” Hunter Biden testified.

Swalwell went on to ask questions referring to the Trump hotel in Washington, D.C., Trump’s legal case in New York City, his daughter-in-law’s recent bid to lead the Republican National Committee and his son-in-law Jared Kushner’s business dealings with Saudi Arabia.

“As President and the leader of the party, has your father ever tried to install as the chairperson of the party a daughter-in-law or anyone else in the family?” Swalwell probed.

“No. And I don’t think that anyone in my family would be crazy enough to want to be the chairperson of the DNC” — the Democratic National Committee.

Had his father ever been fined $355 million? “No, he has not, thank God,” Hunter Biden testified.

The impeachment inquiry has focused on several pieces of evidence as Republicans try to build their case, including emails, text messages and a now-in-dispute laptop.

One email from a Hunter Biden business associate proposes a 10% equity stake in their firm to be held for “the big” guy, who Republicans say is Joe Biden. It's a message that has become central to the GOP claims of influence peddling, but one that another business associate Rob Walker has testified was all “bull-—-.”

Hunter Biden testified that he does not recall ever responding to the email. “I’m not even sure whether I ever fully read this.”

Further emails exhibited to the committee showed that any equity split would be made equally among the five partners, including Hunter Biden and his longtime business partner Jim Biden, who is the president’s brother and his uncle. The business deal with a Chinese energy company never happened, and no one was paid.

“There’s no secret big guy anywhere in this email?” asked a Democratic questioner.

“No, there’s not,” Hunter Biden replied.

“Joe Biden is not anywhere in this agreement?” he asked.

As for Hunter Biden’s laptop that was allegedly dropped off at a Delaware repair shop and the source for many allegations against the Biden family, he testified that he does not recall bringing it in.

If his computer needed repairs, Hunter Biden testified, “I would have gone to the Apple store.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/1/1704904282755.png" alt="File photo -Hunter Biden made a surprise appearance at the Capitol on Jan. 10-photo courtesy CSPAN" />
 <figcaption>File photo -Hunter Biden made a surprise appearance at the Capitol on Jan. 10-photo courtesy CSPAN</figcaption>
 </figure>WASHINGTON (AP) — The transcript of the congressional deposition of&nbsp;<a href="https://apnews.com/hub/hunter-biden">Hunter Biden</a>&nbsp;was released late Thursday, providing a full view of the contentious testimony that took place behind closed doors Wednesday as Republicans aggressively questioned the central figure in their impeachment inquiry.<a href="https://oversight.house.gov/wp-content/uploads/2024/02/Hunter-Biden-Transcript_Redacted.pdf">Click here to read the</a> transcriptThe nearly 230 pages of questioning laid bare the deep-seated hostility between President Joe Biden's son and the GOP lawmakers who have been investigating his family for the past several years. Arguments were frequent and tempers short, providing a preview of what is sure to come when Republicans hold a public hearing with Hunter Biden in the next several weeks.He was defiant through the deposition as Republicans flooded him with questions about his former business affairs and his life, his answers veering from heated to emotional as he talked of his long battle with addiction and turmoil in his personal life.Throughout the nearly seven-hour deposition, Hunter Biden remained adamant on one point, vehemently and repeatedly denying under oath that his father ever financially benefited or participated in any of his business work.Takeaways from the transcript:‘You always pick up the phone’The 14-month Republican investigation into the Biden family has centered on Hunter Biden and his overseas work for clients in Ukraine, China, Romania and other countries. Republicans have long questioned whether those business dealings involved corruption and influence peddling by President Biden, particularly in the years when he was vice president.Republican investigators zeroed in on a series of dinners and meetings that took place after Joe Biden left the vice presidency in which the younger Biden put his father on speakerphone while in the company of business partners.“And why would you place your dad on speakerphone?” an unidentified Republican staffer asked.“I’m surprised my dad hasn’t called me right now, and if he did, I would put him on speakerphone to say hi to you and to Congressman Raskin and everybody else in the room,” Hunter Biden replied. “It is nothing nefarious literally.”He said that after the tragedies his family has suffered — including the death of his mother and two siblings — calls in his family are always answered, no matter what.“You always pick up the phone. It’s something that we always do. And you can ask anybody that I know,” Hunter Biden added.Hunter Biden's ‘darkest days’Large portions of the testimony Wednesday diverged into Hunter Biden's well-documented battle with drug and alcohol addiction.In one particularly harsh exchange, Rep. Matt Gaetz, a Republican from Florida, questioned whether the president’s son’s business dealings, particularly with the Ukrainian energy firm Burisma, were legitimate. Gaetz asked, “Were you on drugs when you were on the Burisma board?”Hunter responded: “Mr. Gaetz, look me in the eye. You really think that’s appropriate to ask me?”“Absolutely,” Gaetz said.Biden’s attorney, Abbe Lowell, intervened, telling his client he didn't need to respond.“I will answer it this way: I have been absolutely transparent about my drug use,” Hunter Biden said. “I’m sorry; I’m an addict. I was an addict.”He told the panel he has been in recovery for more than four years and works “really, really hard at it” under what he called an enormous amount of pressure.“Was I an addict? Yes, I was an addict,” he said. “What does that have to do with whether or not you’re going to go forward with an impeachment of my father other than to simply try to embarrass me?”Gaetz tried to interrupt, but Hunter Biden kept talking: “Why? Why?"What was the ‘Biden brand’?Another point of interest for House Republicans' investigation is what they describe as Hunter Biden and associates selling the Biden “brand” to clients overseas.One of their purported key witnesses, Devon Archer, a former business associate of Hunter Biden, testified to the House Oversight Committee last year that the president's family sold “the illusion of access” to the corridors of power in Washington. Republicans questioned whether Burisma, the Ukrainian energy firm, wanted Hunter Biden on&nbsp;<a href="https://apnews.com/article/joe-biden-europe-business-c49555d51eb243e09a42f7577fc5937f">its board in 2014</a>&nbsp;"because your dad was the Vice President?”“No, I don’t think that it’s fair,” Hunter Biden responded.When asked about what value he brought to Burisma, Hunter Biden talked about the breadth of his resume and defended his family.“Primarily, the name ‘Biden’ is my dad’s legacy. And he passed it down to me and, when my brother was alive, my brother, my sister, now to my children. It’s our responsibility to not screw that up."He added, "If other people saw the brand as something that they could market, it’s not -- it was not with my -- without going through me first. And if they did so, they didn’t go through me first."Rather than probe the Bidens, Democrats turn to the TrumpsDemocrats at one point tried to turn the deposition back toward Donald Trump, contrasting the Bidens' business dealings with the former Republican president’s family and its business operations.Rep. Eric Swalwell, the Democrat from California, led one particularly pointed exchange intended to draw out the differences between President Biden and Trump, the Republican front-runner to challenge him for the White House.“Did your father ever employ in the Oval Office any direct family member to also work in the Oval Office?” Swalwell asked.“My father has never employed any direct family members, to my knowledge,” Hunter Biden testified.Swalwell went on to ask questions referring to the Trump hotel in Washington, D.C., Trump’s legal case in New York City, his daughter-in-law’s recent bid to lead the Republican National Committee and his son-in-law Jared Kushner’s business dealings with Saudi Arabia.“As President and the leader of the party, has your father ever tried to install as the chairperson of the party a daughter-in-law or anyone else in the family?” Swalwell probed.“No. And I don’t think that anyone in my family would be crazy enough to want to be the chairperson of the DNC” — the Democratic National Committee.Had his father ever been fined $355 million? “No, he has not, thank God,” Hunter Biden testified.Emails, text messages and the laptopThe impeachment inquiry has focused on several pieces of evidence as Republicans try to build their case, including emails, text messages and a now-in-dispute laptop.One email from a Hunter Biden business associate proposes a 10% equity stake in their firm to be held for “the big” guy, who Republicans say is Joe Biden. It's a message that has become central to the GOP claims of influence peddling, but one that another business associate Rob Walker has testified was all “bull-—-.”Hunter Biden testified that he does not recall ever responding to the email. “I’m not even sure whether I ever fully read this.”Further emails exhibited to the committee showed that any equity split would be made equally among the five partners, including Hunter Biden and his longtime business partner Jim Biden, who is the president’s brother and his uncle. The business deal with a Chinese energy company never happened, and no one was paid.“There’s no secret big guy anywhere in this email?” asked a Democratic questioner.“No, there’s not,” Hunter Biden replied.“Joe Biden is not anywhere in this agreement?” he asked.“No, he is not.”As for Hunter Biden’s laptop that was allegedly dropped off at a Delaware repair shop and the source for many allegations against the Biden family, he testified that he does not recall bringing it in.If his computer needed repairs, Hunter Biden testified, “I would have gone to the Apple store.”

Read transcript of Hunter Biden's deposition with GOP lawmakers

MIAMI COUNTY, Kan. —A Kansas man did what no man ever expects to do last week when he was forced to deliver his newborn baby.

On February 27,&nbsp; deputies along with Miami County EMS and Fire District #1 of Johnson County, Kansas responded to a medical call on the ramp of 169 Highway and 255th Street, according to a social media report from the Miami County Sheriff's office.

 When Deputies arrived, they were met with a father who had just delivered his baby in the front seat of their vehicle. 

While on scene, Deputies provided and helped the mother and father use medical equipment as <a href="https://www.facebook.com/JOCOECC911?__cft__[0]=AZVbjqxTzpNT12qV2nwNcPikoMQ-9PliPnEN61gUWnFawawcMHxwQNUCsenX0_jvIVCVnUVyFhsKZ8p2Fr9dVi_6QfDC4AGRMXLkMKvHJgwtJ-dyPrw0rOJmTsXu-F7Op315g49k2t7ArC0A2ix7-MuWT1wBfmUWsq3FlaUNdr6wAFsEClaNNPRLe1TBVa6hKOM&amp;__tn__=-]K-R">Johnson County Emergency Communications Center</a> provided life saving instructions until EMS and Fire personnel arrived to take over. Both mother and baby are doing great. Congratulations to the Redenbaugh Family.

MIAMI COUNTY, Kan. —A Kansas man did what no man ever expects to do last week when he was forced to deliver his newborn baby.On February 27,&nbsp; deputies along with Miami County EMS and Fire District #1 of Johnson County, Kansas responded to a medical call on the ramp of 169 Highway and 255th Street, according to a social media report from the Miami County Sheriff's office.<div><iframe src="https://www.facebook.com/plugins/video.php?height=420&href=https%3A%2F%2Fwww.facebook.com%2Fmicosheriff%2Fvideos%2F1470499557219815%2F&show_text=false&width=560&t=1" width="560" height="420" style="border:none;overflow:hidden" scrolling="no" frameborder="0" allowfullscreen="true" allow="autoplay; clipboard-write; encrypted-media; picture-in-picture; web-share" allowFullScreen="true"></iframe></div> When Deputies arrived, they were met with a father who had just delivered his baby in the front seat of their vehicle. While on scene, Deputies provided and helped the mother and father use medical equipment as <a href="https://www.facebook.com/JOCOECC911?__cft__[0]=AZVbjqxTzpNT12qV2nwNcPikoMQ-9PliPnEN61gUWnFawawcMHxwQNUCsenX0_jvIVCVnUVyFhsKZ8p2Fr9dVi_6QfDC4AGRMXLkMKvHJgwtJ-dyPrw0rOJmTsXu-F7Op315g49k2t7ArC0A2ix7-MuWT1wBfmUWsq3FlaUNdr6wAFsEClaNNPRLe1TBVa6hKOM&amp;__tn__=-]K-R">Johnson County Emergency Communications Center</a> provided life saving instructions until EMS and Fire personnel arrived to take over. Both mother and baby are doing great. Congratulations to the Redenbaugh Family.

🎥 Father delivers baby on side of Kansas highway

DUBAI, United Arab Emirates (AP) — A ship attacked by&nbsp;<a href="https://apnews.com/hub/houthis">Yemen's Houthi rebels</a>&nbsp;has sunk in the Red Sea after days of taking on water, officials said Saturday, the first vessel to be fully destroyed as part of their campaign over&nbsp;<a href="https://apnews.com/hub/israel-hamas-war">Israel's war against Hamas in the Gaza Strip</a>.

The sinking of the Rubymar, which carried a cargo of fertilizer and previously leaked fuel, could cause&nbsp;<a href="https://apnews.com/article/red-sea-environment-cargo-ship-sinking-houthis-1e130e15ca0863ab40966ea9676cf42b">ecological damage to the Red Sea and its coral reefs</a>.

Persistent Houthi attacks have already disrupted traffic in the crucial waterway for cargo and energy shipments moving from Asia and the Middle East to Europe. Already, many ships have turned away from the route.

The sinking could see further detours and higher insurance rates put on vessels plying the waterway —&nbsp;<a href="https://apnews.com/article/red-sea-houthi-attacks-shipping-inflation-124d5445bec8ce6864112e3095646308">potentially driving up global inflation and affecting aid shipments to the region</a>.

The Belize-flagged Rubymar had been drifting northward after being struck by a Houthi anti-ship ballistic missile on Feb. 18 in the Bab el-Mandeb Strait, a crucial waterway linking the Red Sea and the Gulf of Aden.

Yemen's internationally recognized government, as well as a regional military official, confirmed the ship sank. The official spoke on condition of anonymity as no authorization was given to speak to journalists about the incident.

The British military's United Kingdom Maritime Trade Operations center, which watches over Mideast waterways, separately acknowledged the Rubymar's sinking Saturday afternoon.

The U.S. military's Central Command said early Sunday the Rubymar sank at 2:15 a.m. local time Saturday. It released an image of the vessel on its side as it was sinking.

“The approximately 21,000 metric tons of ammonium phosphate sulfate fertilizer that the vessel was carrying presents an environmental risk in the Red Sea,” it said in a statement. “As the ship sinks it also presents a subsurface impact risk to other ships transiting the busy shipping lanes of the waterway.”

The Rubymar’s Beirut-based manager did not respond to a request for comment.

Yemen's exiled government, which has been backed by a Saudi-led coalition since 2015, said the Rubymar sank as stormy weather took hold over the Red Sea. The vessel had been abandoned for 12 days after the attack, though plans had been made to try and tow the ship to a safe port.

The Iran-backed Houthis had falsely claimed the ship sank almost instantly after the initial attack. Late Saturday, a Houthi leader tried to blame British Prime Minister Rishi Sunak over the Rubymar.

“You have an opportunity to salvage the ship M/V Rubymar by guaranteeing ... that the relief trucks agreed upon at that time would enter Gaza,” Mohammed al-Houthi wrote in an online message.

Ahmed Awad Bin Mubarak, the prime minister of Yemen's internationally recognized government, called the ship's sinking “an unprecedented environmental disaster.”

“It’s a new disaster for our country and our people,” he wrote on X, formerly Twitter. “Every day, we pay for the Houthi militia’s adventures, which were not stopped at plunging Yemen into the coup disaster and war.”

Greenpeace also raised concerns about the ship sinking.

“Without immediate action, this situation could escalate into a major environmental crisis,” said Julien Jreissati, program director at Greenpeace MENA.

“As well as any further leaks of fuel oil from the engines, the sinking of the vessel could further breach the hull, allowing water to contact with the thousands of tons of fertilizer, which could then be released into the Red Sea and disrupt the balance of the marine ecosystems, triggering cascading effects throughout the food web.”

The Houthis have held Yemen's capital, Sanaa, since 2014, expelling the government. The rebels have fought a Saudi-led coalition since 2015 in a stalemated war.

Satellite pictures analyzed by The Associated Press from Planet Labs PBC showed smaller boats alongside the Rubymar on Wednesday. It wasn't immediately clear whose vessels those were. The images showed the Rubymar's stern sinking into the Red Sea but still afloat, mirroring earlier video taken of the vessel.

The private security firm Ambrey separately reported Friday about a mysterious incident involving the Rubymar.

“A number of Yemenis were reportedly harmed during a security incident which took place” on Friday, Ambrey said. It did not elaborate on what that incident involved and no party involved in Yemen's yearslong war claimed any new attack on the vessel.

A satellite image taken Friday from Maxar Technologies showed new blast damage on the Rubymar not previously seen, with no other vessels around it. Additional satellite images taken Saturday by Planet Labs PBC of the area the Rubymar had been in recent days no longer showed the vessel.

Since November, the rebels have repeatedly targeted ships in the Red Sea and surrounding waters over the Israel-Hamas war. Those vessels have included&nbsp;<a href="https://apnews.com/article/yemen-ship-missile-houthi-rebels-attack-bab-elmandeb-strait-999b911c916f9266c07a6d29cc020e9e">at least one with cargo bound for Iran</a>, the Houthis’ main benefactor, and an aid ship later bound for Houthi-controlled territory.

Despite over a month of U.S.-led airstrikes,&nbsp;<a href="https://apnews.com/article/yemen-attacks-iran-ships-retaliation-houthis-d770a3fb0fab4c4b72e2459771833e11">Houthi rebels have remained capable</a>&nbsp;of launching significant attacks. That includes the attack on the Rubymar and the&nbsp;<a href="https://apnews.com/article/yemen-houthi-red-sea-israel-hamas-6ac2a1bf5032ed0531258816907cfe2c">downing of an American drone</a>&nbsp;worth tens of millions of dollars. The Houthis insist their attacks will continue until Israel stops its combat operations in the Gaza Strip, which have enraged the wider Arab world and seen the Houthis gain international recognition.

The attacks have also disrupted aid shipments to both Yemen and&nbsp;<a href="https://apnews.com/hub/sudan">Sudan, which is gripped by its own monthslong war</a>. In recent days, the International Rescue Committee said it suspended its aid shipments to Port Sudan through the Red Sea over long delays and drastically increased costs.

However, there has been a slowdown in attacks in recent days. The reason for that remains unclear. Between four to eight U.S. and allied warships now patrol the Red Sea on any given day, said Maj. Pete Nguyen, a Defense Department spokesperson.

On Saturday, the Italian Defense Ministry said one of its vessels, the destroyer Caio Duilio, shot down a suspected Houthi drone in self-defense that appeared to be flying toward it.

"The terrorist attacks by the Houthis are a serious violation of international law and an attack on the safety of maritime traffic, on which our economy depends," the ministry said.

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/3/1709470952151.png" alt="The U.S. military's Central Command said early Sunday the Rubymar sank at 2:15 a.m. local time Saturday-photo U.S. Central Command" />
 <figcaption>The U.S. military's Central Command said early Sunday the Rubymar sank at 2:15 a.m. local time Saturday-photo U.S. Central Command</figcaption>
 </figure>DUBAI, United Arab Emirates (AP) — A ship attacked by&nbsp;<a href="https://apnews.com/hub/houthis">Yemen's Houthi rebels</a>&nbsp;has sunk in the Red Sea after days of taking on water, officials said Saturday, the first vessel to be fully destroyed as part of their campaign over&nbsp;<a href="https://apnews.com/hub/israel-hamas-war">Israel's war against Hamas in the Gaza Strip</a>.The sinking of the Rubymar, which carried a cargo of fertilizer and previously leaked fuel, could cause&nbsp;<a href="https://apnews.com/article/red-sea-environment-cargo-ship-sinking-houthis-1e130e15ca0863ab40966ea9676cf42b">ecological damage to the Red Sea and its coral reefs</a>.Persistent Houthi attacks have already disrupted traffic in the crucial waterway for cargo and energy shipments moving from Asia and the Middle East to Europe. Already, many ships have turned away from the route.The sinking could see further detours and higher insurance rates put on vessels plying the waterway —&nbsp;<a href="https://apnews.com/article/red-sea-houthi-attacks-shipping-inflation-124d5445bec8ce6864112e3095646308">potentially driving up global inflation and affecting aid shipments to the region</a>.The Belize-flagged Rubymar had been drifting northward after being struck by a Houthi anti-ship ballistic missile on Feb. 18 in the Bab el-Mandeb Strait, a crucial waterway linking the Red Sea and the Gulf of Aden.Yemen's internationally recognized government, as well as a regional military official, confirmed the ship sank. The official spoke on condition of anonymity as no authorization was given to speak to journalists about the incident.The British military's United Kingdom Maritime Trade Operations center, which watches over Mideast waterways, separately acknowledged the Rubymar's sinking Saturday afternoon.The U.S. military's Central Command said early Sunday the Rubymar sank at 2:15 a.m. local time Saturday. It released an image of the vessel on its side as it was sinking.“The approximately 21,000 metric tons of ammonium phosphate sulfate fertilizer that the vessel was carrying presents an environmental risk in the Red Sea,” it said in a statement. “As the ship sinks it also presents a subsurface impact risk to other ships transiting the busy shipping lanes of the waterway.”The Rubymar’s Beirut-based manager did not respond to a request for comment.Yemen's exiled government, which has been backed by a Saudi-led coalition since 2015, said the Rubymar sank as stormy weather took hold over the Red Sea. The vessel had been abandoned for 12 days after the attack, though plans had been made to try and tow the ship to a safe port.The Iran-backed Houthis had falsely claimed the ship sank almost instantly after the initial attack. Late Saturday, a Houthi leader tried to blame British Prime Minister Rishi Sunak over the Rubymar.“You have an opportunity to salvage the ship M/V Rubymar by guaranteeing ... that the relief trucks agreed upon at that time would enter Gaza,” Mohammed al-Houthi wrote in an online message.Ahmed Awad Bin Mubarak, the prime minister of Yemen's internationally recognized government, called the ship's sinking “an unprecedented environmental disaster.”“It’s a new disaster for our country and our people,” he wrote on X, formerly Twitter. “Every day, we pay for the Houthi militia’s adventures, which were not stopped at plunging Yemen into the coup disaster and war.”Greenpeace also raised concerns about the ship sinking.“Without immediate action, this situation could escalate into a major environmental crisis,” said Julien Jreissati, program director at Greenpeace MENA.“As well as any further leaks of fuel oil from the engines, the sinking of the vessel could further breach the hull, allowing water to contact with the thousands of tons of fertilizer, which could then be released into the Red Sea and disrupt the balance of the marine ecosystems, triggering cascading effects throughout the food web.”The Houthis have held Yemen's capital, Sanaa, since 2014, expelling the government. The rebels have fought a Saudi-led coalition since 2015 in a stalemated war.Satellite pictures analyzed by The Associated Press from Planet Labs PBC showed smaller boats alongside the Rubymar on Wednesday. It wasn't immediately clear whose vessels those were. The images showed the Rubymar's stern sinking into the Red Sea but still afloat, mirroring earlier video taken of the vessel.The private security firm Ambrey separately reported Friday about a mysterious incident involving the Rubymar.“A number of Yemenis were reportedly harmed during a security incident which took place” on Friday, Ambrey said. It did not elaborate on what that incident involved and no party involved in Yemen's yearslong war claimed any new attack on the vessel.A satellite image taken Friday from Maxar Technologies showed new blast damage on the Rubymar not previously seen, with no other vessels around it. Additional satellite images taken Saturday by Planet Labs PBC of the area the Rubymar had been in recent days no longer showed the vessel.Since November, the rebels have repeatedly targeted ships in the Red Sea and surrounding waters over the Israel-Hamas war. Those vessels have included&nbsp;<a href="https://apnews.com/article/yemen-ship-missile-houthi-rebels-attack-bab-elmandeb-strait-999b911c916f9266c07a6d29cc020e9e">at least one with cargo bound for Iran</a>, the Houthis’ main benefactor, and an aid ship later bound for Houthi-controlled territory.Despite over a month of U.S.-led airstrikes,&nbsp;<a href="https://apnews.com/article/yemen-attacks-iran-ships-retaliation-houthis-d770a3fb0fab4c4b72e2459771833e11">Houthi rebels have remained capable</a>&nbsp;of launching significant attacks. That includes the attack on the Rubymar and the&nbsp;<a href="https://apnews.com/article/yemen-houthi-red-sea-israel-hamas-6ac2a1bf5032ed0531258816907cfe2c">downing of an American drone</a>&nbsp;worth tens of millions of dollars. The Houthis insist their attacks will continue until Israel stops its combat operations in the Gaza Strip, which have enraged the wider Arab world and seen the Houthis gain international recognition.The attacks have also disrupted aid shipments to both Yemen and&nbsp;<a href="https://apnews.com/hub/sudan">Sudan, which is gripped by its own monthslong war</a>. In recent days, the International Rescue Committee said it suspended its aid shipments to Port Sudan through the Red Sea over long delays and drastically increased costs.However, there has been a slowdown in attacks in recent days. The reason for that remains unclear. Between four to eight U.S. and allied warships now patrol the Red Sea on any given day, said Maj. Pete Nguyen, a Defense Department spokesperson.On Saturday, the Italian Defense Ministry said one of its vessels, the destroyer Caio Duilio, shot down a suspected Houthi drone in self-defense that appeared to be flying toward it."The terrorist attacks by the Houthis are a serious violation of international law and an attack on the safety of maritime traffic, on which our economy depends," the ministry said.___

Ship hit by Iran-backed rebels sinks in the Red Sea; first vessel lost in conflict

KANSAS CITY (AP) — Former President Donald Trump continued his march toward the GOP nomination on Saturday, winning caucuses in Idaho and&nbsp;<a href="https://apnews.com/article/missouri-republican-presidential-caucuses-trump-haley-delegates-7ce826ccc49909017784c3f99c146413">Missouri</a>&nbsp;and sweeping the delegate haul at a party convention in&nbsp;<a href="https://apnews.com/article/michigan-primary-1147200d96f45858f06023416e64efaf">Michigan</a>.

Trump earned every delegate at stake on Saturday, bringing his count to 244 compared to 24 for former U.N. Ambassador&nbsp;<a href="https://apnews.com/hub/nikki-haley">Nikki Haley</a>. A candidate needs to secure 1,215 delegates to clinch the Republican nomination.

The next event on the Republican calendar is Sunday in&nbsp;<a href="https://apnews.com/article/washington-dc-republican-primary-trump-haley-4598c50642fe17c700f87f7858cea4a9">the District of Columbia</a>. Two days later is&nbsp;<a href="https://apnews.com/article/super-tuesday-presidential-primary-caucuses-biden-trump-haley-49585962c1bca87fe53b1f40c282b509">Super Tuesday</a>, when 16 states will hold primaries on what will be the largest day of voting of the year outside of the November election. Trump is on track to lock up the nomination days later.

The steep odds facing Haley were on display in Columbia, Missouri, where Republicans gathered at a church to caucus.

Seth Christensen stood on stage and called on them to vote for Haley. He wasn't well received.

Another caucusgoer shouted out from the audience: “Are you a Republican?”

An organizer quieted the crowd and Christensen finished his speech. Haley went on to win just 37 of the 263 Republicans in attendance in Boone County.

Voters lined up outside a church in Columbia, home to the University of Missouri, before the doors opened for the caucuses. Once they got inside, they heard appeals from supporters of the candidates.

“Every 100 days, we’re spending $1 trillion, with money going all over the world. Illegals are running across the border,” Tom Mendenall, an elector for Trump in 2016 and 2020, said to the crowd. He later added: “You know where Donald Trump stands on a lot of these issues.”

Christensen, a 31-year-old from Columbia who came to the caucus with his wife and three children age 7, 5, and 2, then urged Republicans to go in a new direction.

“I don’t need to hear about Mr. Trump’s dalliances with people of unsavory character, nor do my children,” Christensen said to the room. “And if we put that man in the office, that’s what we’re going to hear about all the time. And I’m through with it.”

Supporters quickly moved to one side of the room or the other, depending on whether they favored Trump or Haley. There was little discussion between caucusgoers after they chose a side.

This year was the first test of the new system, which is almost entirely run by volunteers on the Republican side.

The&nbsp;<a href="https://apnews.com/article/presidential-caucus-primary-idaho-missouri-848804f822975481c69765e7b0f60878">caucuses were organized</a>&nbsp;after GOP Gov. Mike Parson&nbsp;<a href="https://apnews.com/article/2022-midterm-elections-voting-missouri-government-and-politics-342663e72a921cb9a5f55657d87a0910">signed a 2022 law</a>&nbsp;that, among other things, canceled the planned March 12 presidential primary.

Lawmakers&nbsp;<a href="https://apnews.com/article/presidential-caucus-primary-idaho-missouri-848804f822975481c69765e7b0f60878?utm_source=copy&amp;utm_medium=share">failed to reinstate</a>&nbsp;the primary despite calls to do so by both state Republican and Democratic party leaders. Democrats will hold a party-run primary on March 23.

Trump prevailed twice under Missouri's old presidential primary system.

Michigan Republicans at their convention in Grand Rapids began allocating 39 of the state’s 55 GOP presidential delegates. Trump won all 39 delegates allocated.

But a significant portion of the party’s grassroots force was skipping the gathering because of the lingering effects of a monthslong&nbsp;<a href="https://apnews.com/article/michigan-republican-party-rnc-trump-hoekstra-karamo-88d110d19ee2927a83844b9587b7148c">dispute</a>&nbsp;over the party's&nbsp;<a href="https://apnews.com/article/michigan-gop-presidential-convention-nominating-c39147c98073eea712611648b31345b8">leadership.</a>

Trump handily won Michigan’s&nbsp;<a href="https://apnews.com/article/michigan-primary-apathy-voters-a92790de4fd55639a55ea0f18af988c6">primary</a>&nbsp;this past Tuesday with 68% of the vote compared with Haley’s 27%.

Michigan Republicans were forced to split their delegate allocation into two parts after Democrats, who control the state government,&nbsp;<a href="https://apnews.com/article/politics-michigan-39eed7a1134a14a671de16487fec47a9">moved Michigan</a>&nbsp;into the early primary states, violating the national Republican Party’s rules.

Last year, Idaho lawmakers passed cost-cutting legislation that was intended to move all the state’s primaries to the same date in May. But the bill inadvertently eliminated the presidential primaries entirely.

The Republican-led Legislature considered holding a special session to reinstate the presidential primaries but failed to agree on a proposal in time, leaving both parties with presidential caucuses as the only option.

"I think there’s been a lot of confusion because most people don’t realize that our Legislature actually voted in a flawed bill,” said Jessie Bryant, who volunteered at a caucus site near downtown Boise. “So the caucus is really just the best-case scenario to actually get an opportunity to vote for a presidential candidate and nominate them for the GOP.”

One of those voters was John Graves, a fire protection engineer from Boise. He said the caucus was fast and easy, not much different from Idaho’s usual Republican primary. He anticipated the win would go to Trump.

“It’s a very conservative state, so I would think that Trump will probably carry it quite easily,” Graves said. “And I like that.”

The Democratic caucuses aren’t until May 23.

The last GOP caucuses in Idaho were in 2012, when about 40,000 of the state’s nearly 200,000 registered Republican voters showed up to select their preferred candidate.

KANSAS CITY (AP) — Former President Donald Trump continued his march toward the GOP nomination on Saturday, winning caucuses in Idaho and&nbsp;<a href="https://apnews.com/article/missouri-republican-presidential-caucuses-trump-haley-delegates-7ce826ccc49909017784c3f99c146413">Missouri</a>&nbsp;and sweeping the delegate haul at a party convention in&nbsp;<a href="https://apnews.com/article/michigan-primary-1147200d96f45858f06023416e64efaf">Michigan</a>.<div><blockquote class="twitter-tweet">Trump wins Cass County, Missouri. <a href="https://t.co/4P4XaTFw7K">pic.twitter.com/4P4XaTFw7K</a>&mdash; Mark Alford 🇺🇸🇺🇸🇺🇸🇺🇸 (@markalfordkc) <a href="https://twitter.com/markalfordkc/status/1763968076414886252?ref_src=twsrc%5Etfw">March 2, 2024</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></div>Trump earned every delegate at stake on Saturday, bringing his count to 244 compared to 24 for former U.N. Ambassador&nbsp;<a href="https://apnews.com/hub/nikki-haley">Nikki Haley</a>. A candidate needs to secure 1,215 delegates to clinch the Republican nomination.The next event on the Republican calendar is Sunday in&nbsp;<a href="https://apnews.com/article/washington-dc-republican-primary-trump-haley-4598c50642fe17c700f87f7858cea4a9">the District of Columbia</a>. Two days later is&nbsp;<a href="https://apnews.com/article/super-tuesday-presidential-primary-caucuses-biden-trump-haley-49585962c1bca87fe53b1f40c282b509">Super Tuesday</a>, when 16 states will hold primaries on what will be the largest day of voting of the year outside of the November election. Trump is on track to lock up the nomination days later.The steep odds facing Haley were on display in Columbia, Missouri, where Republicans gathered at a church to caucus.Seth Christensen stood on stage and called on them to vote for Haley. He wasn't well received.Another caucusgoer shouted out from the audience: “Are you a Republican?”An organizer quieted the crowd and Christensen finished his speech. Haley went on to win just 37 of the 263 Republicans in attendance in Boone County.Here's a look at Saturday's contests:MISSOURIVoters lined up outside a church in Columbia, home to the University of Missouri, before the doors opened for the caucuses. Once they got inside, they heard appeals from supporters of the candidates.“Every 100 days, we’re spending $1 trillion, with money going all over the world. Illegals are running across the border,” Tom Mendenall, an elector for Trump in 2016 and 2020, said to the crowd. He later added: “You know where Donald Trump stands on a lot of these issues.”Christensen, a 31-year-old from Columbia who came to the caucus with his wife and three children age 7, 5, and 2, then urged Republicans to go in a new direction.“I don’t need to hear about Mr. Trump’s dalliances with people of unsavory character, nor do my children,” Christensen said to the room. “And if we put that man in the office, that’s what we’re going to hear about all the time. And I’m through with it.”Supporters quickly moved to one side of the room or the other, depending on whether they favored Trump or Haley. There was little discussion between caucusgoers after they chose a side.This year was the first test of the new system, which is almost entirely run by volunteers on the Republican side.The&nbsp;<a href="https://apnews.com/article/presidential-caucus-primary-idaho-missouri-848804f822975481c69765e7b0f60878">caucuses were organized</a>&nbsp;after GOP Gov. Mike Parson&nbsp;<a href="https://apnews.com/article/2022-midterm-elections-voting-missouri-government-and-politics-342663e72a921cb9a5f55657d87a0910">signed a 2022 law</a>&nbsp;that, among other things, canceled the planned March 12 presidential primary.Lawmakers&nbsp;<a href="https://apnews.com/article/presidential-caucus-primary-idaho-missouri-848804f822975481c69765e7b0f60878?utm_source=copy&amp;utm_medium=share">failed to reinstate</a>&nbsp;the primary despite calls to do so by both state Republican and Democratic party leaders. Democrats will hold a party-run primary on March 23.Trump prevailed twice under Missouri's old presidential primary system.MICHIGANMichigan Republicans at their convention in Grand Rapids began allocating 39 of the state’s 55 GOP presidential delegates. Trump won all 39 delegates allocated.But a significant portion of the party’s grassroots force was skipping the gathering because of the lingering effects of a monthslong&nbsp;<a href="https://apnews.com/article/michigan-republican-party-rnc-trump-hoekstra-karamo-88d110d19ee2927a83844b9587b7148c">dispute</a>&nbsp;over the party's&nbsp;<a href="https://apnews.com/article/michigan-gop-presidential-convention-nominating-c39147c98073eea712611648b31345b8">leadership.</a>Trump handily won Michigan’s&nbsp;<a href="https://apnews.com/article/michigan-primary-apathy-voters-a92790de4fd55639a55ea0f18af988c6">primary</a>&nbsp;this past Tuesday with 68% of the vote compared with Haley’s 27%.Michigan Republicans were forced to split their delegate allocation into two parts after Democrats, who control the state government,&nbsp;<a href="https://apnews.com/article/politics-michigan-39eed7a1134a14a671de16487fec47a9">moved Michigan</a>&nbsp;into the early primary states, violating the national Republican Party’s rules.IDAHOLast year, Idaho lawmakers passed cost-cutting legislation that was intended to move all the state’s primaries to the same date in May. But the bill inadvertently eliminated the presidential primaries entirely.The Republican-led Legislature considered holding a special session to reinstate the presidential primaries but failed to agree on a proposal in time, leaving both parties with presidential caucuses as the only option."I think there’s been a lot of confusion because most people don’t realize that our Legislature actually voted in a flawed bill,” said Jessie Bryant, who volunteered at a caucus site near downtown Boise. “So the caucus is really just the best-case scenario to actually get an opportunity to vote for a presidential candidate and nominate them for the GOP.”One of those voters was John Graves, a fire protection engineer from Boise. He said the caucus was fast and easy, not much different from Idaho’s usual Republican primary. He anticipated the win would go to Trump.“It’s a very conservative state, so I would think that Trump will probably carry it quite easily,” Graves said. “And I like that.”The Democratic caucuses aren’t until May 23.The last GOP caucuses in Idaho were in 2012, when about 40,000 of the state’s nearly 200,000 registered Republican voters showed up to select their preferred candidate.___

🎥Trump wins caucuses in Missouri and Idaho and sweeps Michigan GOP convention

Kansas City hospitals say AI has the potential to reduce paperwork, save money and bring better care to patients, but regulators may not be doing enough to rein it in and keep patients safe

BY:&nbsp;<a href="https://missouriindependent.com/author/suzanneking/">SUZANNE KING</a>&nbsp;

In September, the mom of a 4-year-old boy made national news when she used ChatGPT to diagnose her son’s pain, teeth grinding and leg dragging, a diagnosis that had eluded 17 doctors over three years.

It’s an increasingly common scenario: Patients are looking to artificial intelligence for health care answers.

AI plays a growing role in health care encounters, whether or not a patient is actively typing symptoms into a chatbot.

At Kansas City-area hospitals, for example, AI predicts and manages the availability of hospital beds, charts staffing levels, reads mammograms, writes notes after a patient examination and helps respond to messages from patients.

But as AI’s tentacles reach deeper into medical practices every day, the fast-evolving technology faces almost no regulation. Arguably, the medical industry has little incentive to push for regulation on a trend that could transform the business of health care. And right now, nothing stands in its way. Hospitals aren’t even required to tell patients when they’re using AI.

“Because, unfortunately,” said Lindsey Jarrett, vice president of ethical AI at Kansas City’s&nbsp;<a target="_blank" href="https://www.practicalbioethics.org/">Center for Practical Bioethics</a>, “no one’s really telling them they have to.”

Experts worry that biases baked into AI could cause real harm to patients, and even as the industry gives a nod to helping write regulations, they are busy trying to exploit all the cost-saving and staff-trimming possibilities the technology has to offer. Meanwhile, patients remain largely skeptical that it’s a good thing.

Facing increasing costs, shrinking reimbursements from insurers and a growing shortage&nbsp; of nurses and doctors, hospitals see many reasons to roll out technology that has the potential to save time and, as a result, boost profits. Proponents also say AI brings the possibility of better care and could supercharge research into diseases and treatments.

Put simply, AI is a computer system imitating human behavior, only with vastly greater capacity for taking in and making sense of information. Potential uses, said Tony Jenkins, assistant director of IT initiatives at the&nbsp;<a target="_blank" href="https://www.kansashealthsystem.com/">University of Kansas Health System</a>, stretch from billing offices to human resource departments to patient care.

“It looks through and parses all that data, and helps us find patterns that are actually beyond human recognition,” Jenkins said.

Computer processing power only recently became robust enough to sift through years’ worth of hospital data or patient records and come up with something useful. Now that it can, possibilities for it could be vast, Jenkins said.

Hospitals and medical clinics constantly feel pressure to do more with less, he said. To cope with the problems of an aging population. And to make better use of the roughly 17% percent of the economy devoured by health care costs.

“There are a million problems that exist in the industry,” Jenkins said. “Using technology to augment (staff) is always going to be at the forefront of any sort of transformation.”

At the same time, hospitals must be vigilant with&nbsp;<a target="_blank" href="https://kcbeacon.org/stories/2024/01/25/how-ransomware-attacks-at-kansas-city-hospitals-threaten-your-privacy/">security</a>.

KU has been trying out AI in many parts of its business, including in patient exam rooms. About a year ago, a handful of providers began a trial of Abridge, technology that records patient visits and then transcribes notes based on the recordings. Almost a year in, the pilot program has grown to include several hundred doctors.

“That’s allowing our clinicians to remain more focused on the interaction with the patients in the room,” Jenkins said. “They’re no longer having to be heads down, fingers on a keyboard.”

In the end, chart notes can be more accurate, too, because they come directly from a recording rather than piecing them together hours after an exam when a doctor finally has time to sit down to do paperwork.

“The system is pulling out the medical things (to include) … and allowing the physician to confirm, validate that what the system provided was accurate and add anything extra if they would like,” Jenkins said.

It gives doctors back hours in their days, Jenkins said. Something other AI applications also can do.

At&nbsp;<a target="_blank" href="https://www.childrensmercy.org/">Children’s Mercy</a>, a NASA-like operations center that relies on AI and predictive analytics cuts the time spent on paperwork. The hospital’s&nbsp;<a target="_blank" href="https://news.childrensmercy.org/childrens-mercy-kansas-city-ge-healthcare-launch-nations-first-pediatric-hospital-operations-center-to-improve-patient-care/">Patient Progression Hub</a>&nbsp;helps anticipate bed capacity, speeds up patient discharges and monitors many aspects of patient care and hospital operations.

Jennifer Watts, who oversees the hospital hub, said referrals of children from other hospitals improved dramatically with AI help.

“It was a pen-and-paper game and multiple people were involved,” she said. “We had to tell our referral, ‘Let’s see if we have something available, and we’ll let you know as soon as we can.’ There were multiple phone calls in the background. … Nine times out of 10 we were still able to say yes. But the workload on our end was pretty big … Now we can say yes faster.”

Children’s Mercy’s hub has also reduced the wait time for patients ready to be discharged. Once a doctor has signed off on a patient going home, it used to take hours or even days to complete the process. But now, Watts said, most areas of the hospital have cut that to well under two hours, largely because the AI-driven system can pinpoint where the holdups are and nudge staff to clear the path.

“This was a big accomplishment,” Watts said.

Now hospital workers get less buried in paperwork or tied to the telephone, she said.

“The goal is for our front-line staff is to do our front-line care,” Watts said. “That’s what they’re trained to do — our nurses, our doctors, our techs.”

And by removing some of the administrative burdens from doctors’ and nurses’ to-do lists, Watts said she’s noticing fewer symptoms of burnout.

While the health care industry is quick to tout the potential advantages of using AI, patients are generally skeptical. A Pew Research Center&nbsp;<a target="_blank" href="https://www.pewresearch.org/short-reads/2023/11/21/what-the-data-says-about-americans-views-of-artificial-intelligence/">survey</a>&nbsp;last November found that 60% of Americans said they would feel uncomfortable if their health care provider relied on AI when providing care. Meanwhile, 33% said AI would lead to worse health outcomes, 38% said it could lead to better outcomes and 27% doubted it would make any difference.

Some aspects of AI used in health care are obvious to patients. For example, when a KU doctor uses Abridge to record patient visits, the patient is informed and gives verbal consent before it’s turned on. But other AI uses in health care aren’t so transparent.

Medical technology companies embed AI into systems that providers already use to treat patients. The technology may be so seamless, a doctor may not even realize AI is involved. Neither would patients.

“They don’t have full awareness of how AI is actually embedded already so deeply into our decision-making,” Jarrett said.

That’s a major problem when it comes to AI in health care, because so many factors that could affect care are in play, she said. Patients, and importantly doctors, should know when AI is being used so they can dig deeper and find out how the AI was developed and if there are potential biases that could affect care.

If AI-enabled products are “trained” with information that is biased in some way, it has the potential of doing real harm in a health care setting. If a tool was built with data gathered from white patients, for example, it might not accurately inform doctors how to treat Black or Asian patients.

Jarrett said the pandemic, which became so entwined with discussions about embedded discrimination in the country, has broadened the conversations people are having about AI in health care. It’s made people think more about how the populations involved in training models could affect care.

“Had the pandemic not happened,” Jarrett said, “we would have continued to have conversations about AI in regards to privacy and security … but we wouldn’t have started to have conversations around bias and patient impact.”

In the absence of governmental regulation, health care providers have no reason to assume that technology was developed with patient safety or medical ethics in mind. Increasingly the industry is taking on the role of establishing standards for how the health care industry can safely and ethically use AI.

Since 2021, the Center for Practical Bioethics, through its Ethical AI Advisory Council, has been mapping out AI standards it hopes all Kansas City-area health care providers will adopt. The council includes leaders from major health systems in the area, representatives from health care technology companies; community advocates; leaders in diversity, equity and inclusion; social workers; and nurses and doctors.

The Center for Practical Bioethics is also involved in directly helping implement AI at KU and Children’s Mercy, with hopes of working with other hospitals. The group helps hospitals develop standards for when AI is appropriate, and it teaches both technical and clinical staff to understand the ethics behind using the technology.

The group also wants health care providers to know what questions to ask when they consider using AI technology. For example, doctors need to ask, what has the technology developer done to mitigate bias? What algorithms were used to create it? At the same time, Jarrett said, patients need to ask who the technology was developed for and whether it would work on people of their age, race or gender.

“Developers creating these things in health care should be able to answer those questions,” Jarrett said. “But they’re not required to answer them today.”

Eventually, Jarrett wants a rating system that would easily tell patients whether a hospital has put the right guardrails around its use of AI.

“We have to be able to have these organizational policies where providers can say, ‘Oh, yeah, that is an AI product. And I know how to explain that to you and why I’m using it,’” Jarrett said.

As recognition grows about the potential dangers of AI, government agencies, Congress and state legislators are starting to look at how to regulate it.

Late last year, the White House issued an&nbsp;<a target="_blank" href="https://www.whitehouse.gov/briefing-room/presidential-actions/2023/10/30/executive-order-on-the-safe-secure-and-trustworthy-development-and-use-of-artificial-intelligence/">executive order</a>&nbsp;about AI, which began by saying that the technology “holds extraordinary potential for both promise and peril.” The order specifically called out health care as an area “where mistakes could harm patients.”

Late last year, the U.S. Food and Drug Administration updated its&nbsp;<a target="_blank" href="https://www.fda.gov/medical-devices/software-medical-device-samd/artificial-intelligence-and-machine-learning-aiml-enabled-medical-devices">list</a>&nbsp;of approved AI medical devices to include 692, adding 170 over the previous year. The list includes machine learning devices, which have the potential to gain insight from vast amounts of data accumulated in hospitals and doctors’ offices every day.

The vast majority of approved devices — 87% — involve radiology, while 7% involve cardiology, and a&nbsp; tiny percentage of approved devices are used in neurology, hematology, gastroenterology/urology, ophthalmology, clinical chemistry and ear, nose and throat medicine.

The agency has not approved any devices yet that rely on generative AI, like the technology used in ChatGPT. But that doesn’t mean the technology isn’t in use in health care. Many trials of AI are still unapproved because regulations are still nascent.

The U.S. Department of Health and Human Services established an AI office in 2021, and the agency has both encouraged the adoption of AI and called for establishing the HHS AI Council to work on governing it.

Meanwhile, a branch of HHS that regulates health IT published a&nbsp;<a target="_blank" href="https://www.healthit.gov/topic/laws-regulation-and-policy/health-data-technology-and-interoperability-certification-program">rule</a>&nbsp;last year that would require electronic health vendors to display basic information about how a model was trained or developed.

“What were the patients that the model was trained on?” said Brian Anderson, a founder of the Coalition for Health AI (CHAI). “That would inform its accuracy on how it might perform on patients once it’s deployed.”

<figure>
 <img src="https://media.eaglewebservices.com/public/2024/2/1709050400076.png" alt="At Children’s Mercy Hospital, an AI-powered Patient Progression Hub is helping reduce paperwork and curb employee burnout (Courtesy photo/Children’s Mercy)." />
 <figcaption>At Children’s Mercy Hospital, an AI-powered Patient Progression Hub is helping reduce paperwork and curb employee burnout (Courtesy photo/Children’s Mercy).</figcaption>
 </figure><h2>Kansas City hospitals say AI has the potential to reduce paperwork, save money and bring better care to patients, but regulators may not be doing enough to rein it in and keep patients safe</h2>BY:&nbsp;<a href="https://missouriindependent.com/author/suzanneking/">SUZANNE KING</a>&nbsp;In September, the mom of a 4-year-old boy made national news when she used ChatGPT to diagnose her son’s pain, teeth grinding and leg dragging, a diagnosis that had eluded 17 doctors over three years.It’s an increasingly common scenario: Patients are looking to artificial intelligence for health care answers.And so are medical pros.AI plays a growing role in health care encounters, whether or not a patient is actively typing symptoms into a chatbot.At Kansas City-area hospitals, for example, AI predicts and manages the availability of hospital beds, charts staffing levels, reads mammograms, writes notes after a patient examination and helps respond to messages from patients.But as AI’s tentacles reach deeper into medical practices every day, the fast-evolving technology faces almost no regulation. Arguably, the medical industry has little incentive to push for regulation on a trend that could transform the business of health care. And right now, nothing stands in its way. Hospitals aren’t even required to tell patients when they’re using AI.“Because, unfortunately,” said Lindsey Jarrett, vice president of ethical AI at Kansas City’s&nbsp;<a target="_blank" href="https://www.practicalbioethics.org/">Center for Practical Bioethics</a>, “no one’s really telling them they have to.”Experts worry that biases baked into AI could cause real harm to patients, and even as the industry gives a nod to helping write regulations, they are busy trying to exploit all the cost-saving and staff-trimming possibilities the technology has to offer. Meanwhile, patients remain largely skeptical that it’s a good thing.<h2>Why AI?</h2>Facing increasing costs, shrinking reimbursements from insurers and a growing shortage&nbsp; of nurses and doctors, hospitals see many reasons to roll out technology that has the potential to save time and, as a result, boost profits. Proponents also say AI brings the possibility of better care and could supercharge research into diseases and treatments.Put simply, AI is a computer system imitating human behavior, only with vastly greater capacity for taking in and making sense of information. Potential uses, said Tony Jenkins, assistant director of IT initiatives at the&nbsp;<a target="_blank" href="https://www.kansashealthsystem.com/">University of Kansas Health System</a>, stretch from billing offices to human resource departments to patient care.“It looks through and parses all that data, and helps us find patterns that are actually beyond human recognition,” Jenkins said.Computer processing power only recently became robust enough to sift through years’ worth of hospital data or patient records and come up with something useful. Now that it can, possibilities for it could be vast, Jenkins said.Hospitals and medical clinics constantly feel pressure to do more with less, he said. To cope with the problems of an aging population. And to make better use of the roughly 17% percent of the economy devoured by health care costs.“There are a million problems that exist in the industry,” Jenkins said. “Using technology to augment (staff) is always going to be at the forefront of any sort of transformation.”At the same time, hospitals must be vigilant with&nbsp;<a target="_blank" href="https://kcbeacon.org/stories/2024/01/25/how-ransomware-attacks-at-kansas-city-hospitals-threaten-your-privacy/">security</a>.<h2>How Kansas City hospitals are using it</h2>KU has been trying out AI in many parts of its business, including in patient exam rooms. About a year ago, a handful of providers began a trial of Abridge, technology that records patient visits and then transcribes notes based on the recordings. Almost a year in, the pilot program has grown to include several hundred doctors.“That’s allowing our clinicians to remain more focused on the interaction with the patients in the room,” Jenkins said. “They’re no longer having to be heads down, fingers on a keyboard.”In the end, chart notes can be more accurate, too, because they come directly from a recording rather than piecing them together hours after an exam when a doctor finally has time to sit down to do paperwork.“The system is pulling out the medical things (to include) … and allowing the physician to confirm, validate that what the system provided was accurate and add anything extra if they would like,” Jenkins said.It gives doctors back hours in their days, Jenkins said. Something other AI applications also can do.At&nbsp;<a target="_blank" href="https://www.childrensmercy.org/">Children’s Mercy</a>, a NASA-like operations center that relies on AI and predictive analytics cuts the time spent on paperwork. The hospital’s&nbsp;<a target="_blank" href="https://news.childrensmercy.org/childrens-mercy-kansas-city-ge-healthcare-launch-nations-first-pediatric-hospital-operations-center-to-improve-patient-care/">Patient Progression Hub</a>&nbsp;helps anticipate bed capacity, speeds up patient discharges and monitors many aspects of patient care and hospital operations.Jennifer Watts, who oversees the hospital hub, said referrals of children from other hospitals improved dramatically with AI help.“It was a pen-and-paper game and multiple people were involved,” she said. “We had to tell our referral, ‘Let’s see if we have something available, and we’ll let you know as soon as we can.’ There were multiple phone calls in the background. … Nine times out of 10 we were still able to say yes. But the workload on our end was pretty big … Now we can say yes faster.”Children’s Mercy’s hub has also reduced the wait time for patients ready to be discharged. Once a doctor has signed off on a patient going home, it used to take hours or even days to complete the process. But now, Watts said, most areas of the hospital have cut that to well under two hours, largely because the AI-driven system can pinpoint where the holdups are and nudge staff to clear the path.“This was a big accomplishment,” Watts said.Now hospital workers get less buried in paperwork or tied to the telephone, she said.“The goal is for our front-line staff is to do our front-line care,” Watts said. “That’s what they’re trained to do — our nurses, our doctors, our techs.”And by removing some of the administrative burdens from doctors’ and nurses’ to-do lists, Watts said she’s noticing fewer symptoms of burnout.<h2>Working behind the scenes</h2>While the health care industry is quick to tout the potential advantages of using AI, patients are generally skeptical. A Pew Research Center&nbsp;<a target="_blank" href="https://www.pewresearch.org/short-reads/2023/11/21/what-the-data-says-about-americans-views-of-artificial-intelligence/">survey</a>&nbsp;last November found that 60% of Americans said they would feel uncomfortable if their health care provider relied on AI when providing care. Meanwhile, 33% said AI would lead to worse health outcomes, 38% said it could lead to better outcomes and 27% doubted it would make any difference.Some aspects of AI used in health care are obvious to patients. For example, when a KU doctor uses Abridge to record patient visits, the patient is informed and gives verbal consent before it’s turned on. But other AI uses in health care aren’t so transparent.Medical technology companies embed AI into systems that providers already use to treat patients. The technology may be so seamless, a doctor may not even realize AI is involved. Neither would patients.“They don’t have full awareness of how AI is actually embedded already so deeply into our decision-making,” Jarrett said.That’s a major problem when it comes to AI in health care, because so many factors that could affect care are in play, she said. Patients, and importantly doctors, should know when AI is being used so they can dig deeper and find out how the AI was developed and if there are potential biases that could affect care.If AI-enabled products are “trained” with information that is biased in some way, it has the potential of doing real harm in a health care setting. If a tool was built with data gathered from white patients, for example, it might not accurately inform doctors how to treat Black or Asian patients.Jarrett said the pandemic, which became so entwined with discussions about embedded discrimination in the country, has broadened the conversations people are having about AI in health care. It’s made people think more about how the populations involved in training models could affect care.“Had the pandemic not happened,” Jarrett said, “we would have continued to have conversations about AI in regards to privacy and security … but we wouldn’t have started to have conversations around bias and patient impact.”<h2>Industry stepping in to set standards</h2>In the absence of governmental regulation, health care providers have no reason to assume that technology was developed with patient safety or medical ethics in mind. Increasingly the industry is taking on the role of establishing standards for how the health care industry can safely and ethically use AI.Since 2021, the Center for Practical Bioethics, through its Ethical AI Advisory Council, has been mapping out AI standards it hopes all Kansas City-area health care providers will adopt. The council includes leaders from major health systems in the area, representatives from health care technology companies; community advocates; leaders in diversity, equity and inclusion; social workers; and nurses and doctors.The Center for Practical Bioethics is also involved in directly helping implement AI at KU and Children’s Mercy, with hopes of working with other hospitals. The group helps hospitals develop standards for when AI is appropriate, and it teaches both technical and clinical staff to understand the ethics behind using the technology.The group also wants health care providers to know what questions to ask when they consider using AI technology. For example, doctors need to ask, what has the technology developer done to mitigate bias? What algorithms were used to create it? At the same time, Jarrett said, patients need to ask who the technology was developed for and whether it would work on people of their age, race or gender.“Developers creating these things in health care should be able to answer those questions,” Jarrett said. “But they’re not required to answer them today.”Eventually, Jarrett wants a rating system that would easily tell patients whether a hospital has put the right guardrails around its use of AI.“We have to be able to have these organizational policies where providers can say, ‘Oh, yeah, that is an AI product. And I know how to explain that to you and why I’m using it,’” Jarrett said.<h2>Beginnings of regulations</h2>As recognition grows about the potential dangers of AI, government agencies, Congress and state legislators are starting to look at how to regulate it.Late last year, the White House issued an&nbsp;<a target="_blank" href="https://www.whitehouse.gov/briefing-room/presidential-actions/2023/10/30/executive-order-on-the-safe-secure-and-trustworthy-development-and-use-of-artificial-intelligence/">executive order</a>&nbsp;about AI, which began by saying that the technology “holds extraordinary potential for both promise and peril.” The order specifically called out health care as an area “where mistakes could harm patients.”Late last year, the U.S. Food and Drug Administration updated its&nbsp;<a target="_blank" href="https://www.fda.gov/medical-devices/software-medical-device-samd/artificial-intelligence-and-machine-learning-aiml-enabled-medical-devices">list</a>&nbsp;of approved AI medical devices to include 692, adding 170 over the previous year. The list includes machine learning devices, which have the potential to gain insight from vast amounts of data accumulated in hospitals and doctors’ offices every day.The vast majority of approved devices — 87% — involve radiology, while 7% involve cardiology, and a&nbsp; tiny percentage of approved devices are used in neurology, hematology, gastroenterology/urology, ophthalmology, clinical chemistry and ear, nose and throat medicine.The agency has not approved any devices yet that rely on generative AI, like the technology used in ChatGPT. But that doesn’t mean the technology isn’t in use in health care. Many trials of AI are still unapproved because regulations are still nascent.The U.S. Department of Health and Human Services established an AI office in 2021, and the agency has both encouraged the adoption of AI and called for establishing the HHS AI Council to work on governing it.Meanwhile, a branch of HHS that regulates health IT published a&nbsp;<a target="_blank" href="https://www.healthit.gov/topic/laws-regulation-and-policy/health-data-technology-and-interoperability-certification-program">rule</a>&nbsp;last year that would require electronic health vendors to display basic information about how a model was trained or developed.“What were the patients that the model was trained on?” said Brian Anderson, a founder of the Coalition for Health AI (CHAI). “That would inform its accuracy on how it might perform on patients once it’s deployed.”But while the rule calls for transparency, it does not specify standards. The rule defers to the industry on what the specific standards should be. And, while many in the industry see a need for regulations, it also wants a part in creating them.That’s something CHAI is working on. The group, which includes industry leaders and regulators, last year issued a&nbsp;<a target="_blank" href="https://coalitionforhealthai.org/updates/april-4th-2023">Blueprint for Trustworthy AI in Healthcare</a>&nbsp;and is working on developing industry standards for the responsible use of AI.“It’s gonna be a hard needle to thread,” Anderson said. “Part of the hope is that bringing the regulators and the innovators together, that whatever approach the regulators take, it’s not going to stifle the innovation that’s already happening.”Right now, industry is making progress establishing guardrails. But ultimately that won’t be enough, Anderson said.“Guardrails by their very nature are voluntary,” he said. “You could crash into the guardrails or jump over them if you wanted to.”This&nbsp;<a target="_blank" href="https://kcbeacon.org/stories/2024/02/22/hospitals-ai-kansas-city-little-regulation/">article</a>&nbsp;first appeared on&nbsp;<a target="_blank" href="https://kcbeacon.org/">The Beacon</a>&nbsp;and is republished here under a Creative Commons license.<figure>
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