KHON KAEN —  A 28-year-old man from Chiang Rai province died after being bitten by a cobra he had been filming himself playing with at a hotel in Khon Kaen’s Chum Phae district in the early hours of Thursday.

Police from Chum Phae Station in northeastern Thailand’s Khon Kaen province investigated the death of Suprachya Sangratcha, 28, whose body was found on a bed in a ground-floor hotel room in Chum Phae municipality after midnight.

The victim, originally from Village 16, Pa-o Don Chai subdistrict in Chiang Rai’s Mueang district, was found wearing a T-shirt, jeans, and sneakers. Investigators discovered bite marks resembling those from a venomous snake on his right upper arm.

There were no signs of struggle in the room, the door was locked from inside, and lights were left on. Near the entrance, police found a white cloth bag tied shut containing a live cobra.

Police Colonel Rakchart Ruengcharoen, chief of Chum Phae Police Station, said video clips found on the victim’s mobile phone showed him handling and playing with the cobra at close range. Investigators believe Suprachya died from the cobra bite while keeping the snake.

Medical staff from Chum Phae Hospital conducted a preliminary autopsy to confirm the cause of death.

Cobras are highly adaptable and can be found in urban communities across Thailand. The monocled cobra (N. kaouthia) is most frequently encountered, followed by the Siamese spitting cobra (N. siamensis) and the golden spitting cobra (N. samarensis).

Cobra venom contains powerful neurotoxins that can cause death, while spitting cobras can cause blindness if venom contacts the eyes. The danger of cobras has been illustrated since ancient times, including in Aesop’s fable “The Farmer and the Viper.”

In Thai politics, the term “cobra” is used to describe MPs who defect from their original parties to join opposing sides in exchange for benefit.

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If you were looking for some motivation to follow your doctor's advice or remember to take your medicine, look no further than this grisly tale.

A 64-year-old man went to the emergency department of Brigham and Women’s Hospital in Boston with a painful festering ulcer spreading on his left, very swollen ankle. It was a gruesome sight; the open sore was about 8 by 5 centimeters (about 3 by 2 inches) and was rimmed by black, ashen, and dark purple tissue. Inside, it oozed with streaks and fringes of yellow pus around pink and red inflamed flesh. It was 2 cm deep (nearly an inch). And it smelled.

The man told doctors it had all started two years prior, when dark, itchy lesions appeared in the area on his ankle—the doctors noted that there were multiple patches of these lesions on both his legs. But about five months before his visit to the emergency department, one of the lesions on his left ankle had progressed to an ulcer. It was circular, red, tender, and deep. He sought treatment and was prescribed antibiotics, which he took. But they didn't help.

You can view pictures of the ulcer and its progression here, but be warned, it is graphic. (Panel A shows the ulcer five months prior to the emergency department visit. Panel B shows the ulcer one month prior. Panel C shows the wound on the day of presentation at the emergency department. Panel D shows the area three months after hospital discharge.)

Gory riddle

The ulcer grew. In fact, it seemed as though his leg was caving in as the flesh around it began rotting away. A month before the emergency room visit, the ulcer was a gaping wound that was already turning gray and black at the edges. It was now well into the category of being a chronic ulcer.

In a Clinical Problem-Solving article published in the New England Journal of Medicine this week, doctors laid out what they did and thought as they worked to figure out what was causing the man's horrid sore.

With the realm of possibilities large, they started with the man's medical history. The man had immigrated to the US from Korea 20 years ago. He owned and worked at a laundromat, which involved standing for more than eight hours a day. He had a history of eczema on his legs, high cholesterol, high blood pressure, and Type 2 diabetes. For these, he was prescribed a statin for his cholesterol, two blood pressure medications (hydrochlorothiazide and losartan), and metformin for his diabetes. He told doctors he was not good at taking the regimen of medicine.

His diabetes was considered "poorly controlled." A month prior, he had a glycated hemoglobin (A1C or HbA1C) test—which indicates a person's average blood sugar level over the past two or three months. His result was 11 percent, while the normal range is between 4.2 and 5.6 percent.

His blood pressure, meanwhile, was 215/100 mm Hg at the emergency department. For reference, readings higher than 130/80 mm Hg on either number are considered the first stage of high blood pressure. Over the past three years, the man's blood pressure had systolic readings (top number, pressure as heart beats) ranging from 160 to 230 mm Hg and diastolic readings (bottom number, pressure as heart relaxes) ranging from 95 to 120 mm Hg.

Clinical clues

Given the patient's poorly controlled diabetes, a diabetic ulcer was initially suspected. But the patient didn't have any typical signs of diabetic neuropathy that are linked to ulcers. These would include numbness, unusual sensations, or weakness. His responses on a sensory exam were all normal. Diabetic ulcers also typically form on the foot, not the lower leg.

X-rays of the ankle showed swelling in the soft tissue but without some signs of infection. The doctors wondered if the man had osteomyelitis, an infection in the bone, which can be a complication in people with diabetic ulcers. The large size and duration of the ulcer matched with a bone infection, as well as some elevated inflammatory markers he had on his blood tests.

To investigate the bone infection further, they admitted the man to the hospital and ordered magnetic resonance imaging (MRI). But the MRI showed only a soft-tissue defect and a normal bone, ruling out a bone infection. Another MRI was done with a contrast agent. That showed that the man's large arteries were normal and there were no large blood clots deep in his veins—which is sometimes linked to prolonged standing, as the man did at his laundromat job.

As the doctors were still working to root out the cause, they had started him on a heavy-duty regimen of antibiotics. This was done with the assumption that on top of whatever caused the ulcer, there was now also a potentially aggressive secondary infection—one not knocked out by the previous round of antibiotics the man had been given.

With a bunch of diagnostic dead ends piling up, the doctors broadened their view of possibilities, newly considering cancers, rare inflammatory conditions, and less common conditions affecting small blood vessels (as the MRI has shown the larger vessels were normal). This led them to the possibility of a Martorell's ulcer.

These ulcers, first described in 1945 by a Spanish doctor named Fernando Martorell, form when prolonged, uncontrolled high blood pressure causes the teeny arteries below the skin to stiffen and narrow, which blocks the blood supply, leading to tissue death and then ulcers. The ulcers in these cases tend to start as red blisters and evolve to frank ulcers. They are excruciatingly painful. And they tend to form on the lower legs, often over the Achilles’ tendon, though it's unclear why this location is common.

What the doctor ordered

The doctors performed a punch biopsy of the man's ulcer, but it was inconclusive—which is common with Martorell's ulcers. The doctors turned to a "deep wedge biopsy" instead, which is exactly what it sounds like.

A pathology exam of the tissue slices from the wedge biopsy showed blood vessels that had thickened and narrowed. It also revealed extensive inflammation and necrosis. With the pathology results as well as the clinical presentation, the doctors diagnosed the man with a Martorell's ulcer.

They also got back culture results from deep-tissue testing, finding that the man's ulcer had also become infected with two common and opportunistic bacteria—Serratia marcescens and Enterococcus faecalis. Luckily, these are generally easy to treat, so the doctors scaled back his antibiotic regimen to target just those germs.

The man underwent three surgical procedures to clean out the dead tissue from the ulcer, then a skin graft to repair the damage. Ultimately, he made a full recovery. The doctors at first set him on an aggressive regimen to control his blood pressure, one that used four drugs instead of the two he was supposed to be taking. But the four-drug regimen caused his blood pressure to drop too low, and he was ultimately moved back to his original two-drug treatment.

The finding suggests that if he had just taken his original medications as prescribed, he would have kept his blood pressure in check and avoided the ulcer altogether.

In the end, "the good outcome in this patient with a Martorell’s ulcer underscores the importance of blood-pressure control in the management of this condition," the doctors concluded.

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E Ink has developed a new touchpad for laptops featuring the same electronic paper technology found in e-readers. It’s not the first company to look at the ever-growing size of laptop touchpads and see the potential of additional functionality, but instead of serving as a second smaller screen for the computer’s OS, E Ink is positioning its touchpad as a dedicated home for AI applications and assistants.

A mockup image shared by the company features a laptop with a touchpad upgraded with a color E Ink screen similar to what’s in use by devices like the Amazon Kindle Colorsoft. Instead of it being an extension of a laptop’s main screen, E Ink envisions its new touchpad as being a separate place where AI-generated text summaries could appear under your hands while working on a document, or you could maintain a constant conversation with an AI chatbot without having to juggle desktop windows.

The idea is reminiscent of laptops that companies like Asus have already released featuring upgraded touchpads that double as secondary displays, but they typically feature  smartphone-sized LCD screens that are often too small to effectively use applications designed for larger computer screens. A full color screen under your hands can also be a distraction and potentially reduce a laptop’s battery life. The use of E Ink screens has expanded outside e-readers to include colorful signage and digital notepads, but the technology is still best suited to displaying text.

Similar to Apple’s now discontinued Touch Bar, E Ink also says the touchpad display could provide quick access to frequently used shortcuts, display notifications or the weather, or provide temporary playback controls without having to sacrifice a laptop keyboard’s row of function keys. It would also help reduce battery anxiety, because unlike LCD or OLED panels, E Ink’s display technology only consumes power when it’s being updated. That’s a big benefit given the higher demands of AI tools on a laptop’s battery life.

What’s not currently known are more in-depth technical specifications. Aside from the touchpad potentially using color e-paper displays, E Ink hasn’t revealed if it will adapt one of its current panels, or if it’s developed an entirely new one with increased resolutions. Today’s announcement specifically references compatibility with Intel-based AI PCs, but E Ink didn’t go into details about whether the touchpad display would be powered by a laptop’s primary OS, or if it would feature its own. The company also didn’t provide a timeline for when these touchpads might start showing up in laptops or which hardware makers may be interested.

In mid-June, a federal judge issued a stinging rebuke to the Trump administration, declaring that its decision to cancel the funding for many grants issued by the National Institutes of Health was illegal, and suggesting that the policy was likely animated by racism. But the detailed reasoning behind his decision wasn't released at the time. The written portion of the decision was finally issued on Wednesday, and it has a number of notable features.

For starters, it's more limited in scope due to a pair of Supreme Court decisions that were issued in the intervening weeks. As a consequence, far fewer grants will see their funding restored. Regardless, the court continues to find that the government's actions were arbitrary and capricious, in part because the government never bothered to define the problems that would get a grant canceled. As a result, officials within the NIH simply canceled lists of grants they received from DOGE without bothering to examine their scientific merit, and then struggled to retroactively describe a policy that justified the actions afterward—a process that led several of them to resign.

A more limited verdict

The issue before Judge William Young of the District of Massachusetts was whether the government had followed the law in terminating grants funded by the National Institutes of Health. After a short trial, Young issued a verbal ruling that the government hadn't, and that he had concluded that its actions were the product of "racial discrimination and discrimination against America’s LGBTQ. community." But the details of his decisions and the evidence that motivated them had to wait for a written ruling, which is now available.

In the meantime, however, the Supreme Court had shifted the ground on a couple of issues. For example, while Young still feels that policy decisions were motivated by discrimination against the LGBTQ community, the United States v. Skrmetti decision limits what he can do about it. Young writes that the decision "leads this Court to conclude that, while here there is federal government discrimination based on a person’s status, not all discrimination is pejorative."

Separately, Trump v. Casa blocked the use of a national injunction against illegal activity. So, while the government's actions have been determined to be illegal, Young can only protect the people who were parties to this suit. Anyone who lost a grant but wasn't a member of any of the parties involved, or based in any of the states that sued, remains on their own.

Those issues aside, the ruling largely focuses on whether the termination of grants violates the Administrative Procedures Act, which governs how the executive branch handles decision- and rule-making. Specifically, it requires that any decisions of this sort cannot be "arbitrary and capricious." And, Young concludes that the government hasn't cleared that bar.

Arbitrary and capricious

The grant cancellations, Young concludes, "Arise from the NIH’s newly minted war against undefined concepts of diversity, equity, and inclusion and gender identity, that has expanded to include vaccine hesitancy, COVID, influencing public opinion and climate change." The "undefined" aspect plays a key part in his reasoning. Referring to DEI, he writes, "No one has ever defined it to this Court—and this Court has asked multiple times." It's not defined in Trump's executive order that launched the "newly minted war," and Young found that administrators within the NIH issued multiple documents that attempted to define it, not all of which were consistent with each other, and in some cases seemed to use circular reasoning.

He also noted that the officials who sent these memos had a tendency to resign shortly afterward, writing, "it is not lost on the Court that oftentimes people vote with their feet."

As a result, the NIH staff had no solid guidance for determining whether a given grant violated the new anti-DEI policy, or how that might be weighed against the scientific merit of the grant. So, how were they to identify which grants needed to be terminated? The evidence revealed at trial indicates that they didn't need to make those decisions; DOGE made them for the NIH. In one case, an NIH official approved a list of grants to terminate received from DOGE only two minutes after it showed up in his inbox.

"There is no reasoned decision-making at all with respect to the NIH’s 'abruptness' in the 'robotic rollout' of this grant-termination action," Young concludes. "Based upon a fair preponderance of the evidence and on the sparse administrative record, the Court finds and rules that HHS and, in turn, NIH, are being force-fed unworkable 'policy' supported with sparse pseudo-reasoning, and wholly unsupported statements."

Young also noted that the termination of grants to Columbia University was equally arbitrary. "How the scientific and research activities had any connection with unrest issues on Columbia’s campus is conspicuously never explained," Young noted. "The record evidence certainly reveals none."

A small win against a larger loss

Given all that, it's little surprise that the ruling declares the grant terminations to be arbitrary and capricious. "The Public Officials [at the NIH] in their haste to appease the Executive, simply moved too fast and broke things," Young concluded, "including the law." That provides the legal reasoning behind his earlier decision to restore the cancelled grants, although as noted, this has now been limited to only those grants held by researchers who are covered by one of the organizations or governments that filed the suit.

But Young also appears to lament the fact that he had to intervene here, writing:

The American people have enjoyed a historical norm of a largely apolitical scientific research agency supporting research in an elegant, merit-based approach that benefits everyone. That historical norm changed on January 20, 2025. The new Administration began weaponizing what should not be weaponized—the health of all Americans through its abuse of HHS and the NIH systems, creating chaos and promoting an unreasonable and unreasoned agenda of blacklisting certain topics, that on this Administrative Record, has absolutely nothing to do with the promotion of science or research.

So, while the decision restores money to individual research programs, it does nothing to reverse the larger damage caused by the politicization of funding decisions.

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The El Rancho Unified School District is calling for a federal investigation after video shows ICE agents as they appear to pee on school grounds in public view.