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Nov. 27, 2025, 6:00 AM ESTBy Akshay Syal, M.D.For decades, doctors have been puzzled by why women develop Alzheimer’s disease at nearly twice the rate of men. There are an estimated 7 million people in the U.S. living with Alzheimer’s, with that number expected to reach nearly 13 million by 2050. A majority of cases, or about 2 out of every 3, are in women. An emerging body of research is suggesting that estrogen, the predominant female sex hormone, may play a critical role, specifically in the perimenopausal transition to menopause, when the body’s hormone levels naturally begin to decline. Estrogen is thought to perform a variety of functions in the body, such as improving cardiovascular health and maintaining bone density. Estrogen is very important to the brain and is considered neuroprotective, helping shield brain cells from inflammation, stress and other forms of cellular damage. Alzheimer’s researchers are focused on the early period of perimenopause, which typically occurs in a woman’s early- to mid-40s, as a target for hormone replacement therapy to maintain estrogen levels and possibly protect some women against developing dementia decades later. “This interest comes primarily from decades of pre-clinical research, animal models, and basic science research showing that menopause is a tipping point for Alzheimer’s pathology,” said Lisa Mosconi, director of the Alzheimer’s Prevention Program at Weill Cornell Medicine. Mosconi is leading a new $50 million global women’s health research initiative called CARE, or Cutting women’s Alzheimer’s risk through endocrinology. Looking at biomarkers from nearly 100 million women, it’s expected to be the largest analysis of why women are at greater risk of Alzheimer’s disease. The link between estrogen and dementia has gained renewed focus after the Food and Drug Administration recently lifted the decades-old black-box warning on hormone replacement therapy, a move that may lead to many more women in their 40s and 50s being prescribed treatment. Doctors say loosened restrictions could reduce stigma around hormone therapy. The FDA’s move could also pave the way for broader research into whether hormone replacement therapy might offer additional benefits, including protection against dementia. Declining reproductive hormonesMenopause occurs when the ovaries gradually produce less estrogen and progesterone, hormones that help regulate the menstrual cycle. Estrogen and progesterone are sex hormones that are present in females and to a lesser extent in males that play an important role in sexual and reproductive development. Most women reach menopause between the ages of 45 and 55, said Dr. Monica Christmas, a gynecologist and director of the menopause program at UChicago Medicine. The transition can begin years earlier during perimenopause, which usually starts when women are in their mid-40s. That’s when symptoms such as hot flashes, night sweats, mood changes and sleep disturbances often appear. It’s thought that menopause symptoms are caused by decreased levels of estrogen and progesterone in the body. For example, when estrogen levels drop, the body’s internal thermostat, controlled by the hypothalamus in the brain, begins to not work properly. The brain might interpret the body as too hot and tell it to start sweating to cool off, leading to symptoms of hot flashes. Hormone therapy can replenish those levels and help the body regulate its temperature. What role does estrogen play?Receptors for this sex hormone are found throughout our brains, said Rachel Buckley, an associate professor of neurology at Massachusetts General Hospital whose research focuses on sex differences in Alzheimer’s disease. “Estrogen is actually a really powerful hormone,” she said. “It’s found in the hippocampus which is an area [in the brain] that we know is very closely associated with memory and learning.” Estrogen also helps to build and maintain healthy blood flow in the brain, she added, and can even help the brain use energy more efficiently. During menopause, however, the levels of estrogen begin to decline, potentially leaving the brain more vulnerable to damage. “Once the brain loses the protective effects of estrogen and other sex hormones, it’s a turning point for Alzheimer’s pathology accumulation in the brain,” said Mosconi. Can hormone replacement therapy fight dementia?Hormone replacement therapy is available in many forms, including a wearable patch, cream and pills, and can include either estrogen, progesterone, or both. If estrogen helps protect our brain, it would make sense that replacing levels through hormone therapy might confer some sort of benefit. It turns out, however, the answer is much more complicated than that, experts say, as the research behind hormone replacement therapy is mixed and ongoing.However, data suggests that the perimenopause transition might represent a critical window of opportunity where treatment could help some patients ward off dementia, said Dr. Kellyann Niotis, a preventive neurologist in Florida and faculty member at Weill Cornell Medicine. “One leading belief is that during this perimenopausal window hormones are fluctuating rapidly and you can have steep declines in [estrogen] which can be harmful for the brain,” said Niotis.“The idea is that using hormones at a steady state or consistent level kind of helps even out those fluctuations.” A large analysis from Mosconi and her team in 2023 published in Frontiers in Aging Neuroscience found that there may be a sweet spot for initiation of HRT for helping women fight cognitive decline.Her team analyzed over 50 studies and found that people using estrogen therapy in midlife, or within 10 years of their final menstrual period, had a significantly lower risk of dementia. Conversely, when combination hormone therapy was initiated after 65, there was an increased risk of dementia. Another large-scale analysis of 50 studies presented this fall at the American Neurological Association annual meeting found that the risk of Alzheimer’s was up to 32% lower among women who started HRT within five years of menopause than in those who received a placebo or no treatment. The paper is not yet peer-reviewed or published in a journal. The research, which was done by scientists based in India, also found that among women who waited until they were 65 or older to start therapy, there was a 38% increase in Alzheimer’s risk. However, many of the studies performed to date have been observational, said Christmas, and do not directly prove a cause and effect relationship. More rigorous research including large scale trials are needed, she added. Hormone therapy that is prescribed may also not behave exactly like estrogen that is produced naturally by the body, she added, and also requires further study.Why timing of hormone therapy mattersThe theory of a critical window to initiate hormone replacement therapy may be related to estrogen receptors in the brain, said Mosconi. During the transition to menopause, there becomes a progressively higher density of estrogen receptors on brain cells, her research has found. This is because, as estrogen levels naturally decline, the brain increases the amount of available receptors as a compensatory mechanism to try and grab every little bit of estrogen that’s still available to be used up, she said. But at some point, when estrogen is permanently low, the brain ultimately stops trying and gives up, and the estrogen receptors disappear, she added. “That is the end of the window of opportunity because once the estrogen receptors are gone, there’s no point putting estrogen back in the system because it has nothing to bind to,” said Mosconi.Some outstanding questions remain, including how long women would need to stay on hormone replacement therapy or whether estrogen would be more protective for women with a genetic predisposition to Alzheimer’s. It’s also unclear if the brain responds differently to estrogen the body makes compared to hormone replacement. Men, on the other hand, have biologically different brains than women, said Buckley, as they have significantly less estrogen receptors and thus have a lower requirement of the hormone. It’s also unclear if testosterone replacement therapy for men confer any potential benefit for Alzheimer’s prevention, said Niotis. While some studies have suggested an association between men with lower testosterone and dementia, much more research is needed before any definitive conclusions can be made. Experts say it’s still too early to recommend hormone replacement therapy to prevent Alzheimer’s disease.“We do not use hormone therapy for Alzheimer’s prevention right now,” said Mosconi. “Clinical guidelines currently do not endorse using hormone therapy only for Alzheimer’s prevention.” Instead, HRT should be prescribed primarily to treat moderate to severe menopausal symptoms that can affect quality of life, such as hot flashes, night sweats, sleep disturbances or mood changes. Niotis said relieving these symptoms may help improve cognition, as people who sleep better have improved mood and tend to think more clearly. Still, she is optimistic that future research may bring more definitive answers. “The hope is that with the removal of this black-box warning that we’ll have more women that are starting therapies and are less afraid of using them, and more doctors that are less afraid of prescribing them,” said Niotis. Akshay Syal, M.D.Dr. Akshay Syal is a board-certified internal medicine physician at UCLA Health and instructor of medicine at the David Geffen School of Medicine at UCLA. He also is a member of the NBC News Health Unit, reporting for both NBC News Digital and on air for NBC News NOW and MSNBC.  

New evidence suggests there may be a critical window for hormone replacement therapy use in women to maintain estrogen levels and protect against cognitive decline.

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Nov. 27, 2025, 5:00 AM ESTBy Alicia Victoria LozanoLOS ANGELES — This time last year, Jon Cherkas and his wife were busy preparing to host relatives, friends and neighbors for Thanksgiving in their Southern California home of more than 20 years.This year, the couple is planning to dine out with friends in Scottsdale, Arizona. “We had such great community and fun with neighbors,” he said. “That’s the one thing that’s really missing now.”Cherkas’ home was one of roughly 16,000 structures destroyed in the deadly Jan. 7 wildfires that consumed entire swaths of Los Angeles County. At least 31 people were killed, and more than 57,000 acres were scorched in densely populated communities including Altadena, Pacific Palisades, Malibu and Sunset Mesa, where Cherkas’ house overlooked the Pacific Ocean. Thousands of empty lots now dot neighborhoods that would otherwise be brimming with holiday decorations. Survivors say those inescapable reminders of what was lost gives them a renewed appreciation of Thanksgiving.“I’m optimistic and try not to dwell on it,” Cherkas said. He’s seen wildfires disrupt the lives of plenty of other people. But now, he said, “I am that other person.”So instead of getting ready for his annual party, Cherkas and his wife chose to spend Thanksgiving this year with old neighbors from Sunset Mesa who relocated to Arizona before the fire hit. Being with old friends, he said, “makes it feel a little bit like being home.” Cherkas intends to rebuild but says permitting is taking much longer than expected. Like all natural disasters, rebuilding is an onerous process. Fewer than 2,000 permits have been issued in burn zones out of 5,000 applications received to date, according to the state’s dashboard. About 3,100 are under review and thousands more have yet to be submitted. Tom Reed, who also lost his home in the Palisades Fire, said this year has been a study in creative problem-solving. For Easter, rather than hosting the annual egg hunt for his grandchildren in the backyard, he and wife threw a party in the courtyard of their rental condo. The adults wore T-shirts with eggs attached via velcro. Instead of hunting for eggs, grandchildren hunted for grandparents. “Things have changed, but I gotta find amusement,” he saidWhen the question of where to host Thanksgiving came around, Reed decided one day was simply not enough. Instead of cramming everyone into the condo, Reed, his wife and the rest of the family will spend the weekend at Lake Arrowhead in the San Bernardino Mountains. “You can’t look back because it will mess with your head,” he said. Across the county, in Altadena, Freddy Sayegh is back in his smoke-damaged house. It has been remediated, but his wife and two children remained at their rental for several months. Before the fire, Thanksgiving Day festivities with Freddy Sayegh’s large extended family could number anywhere between 50 and 60 people all in one house. This year, the family is splitting up because many relatives were displaced by the Eaton Fire.Courtesy Freddy SayeghTucked in the foothills of the San Gabriel Mountains, Altadena felt like a small village nestled within a megapolis. It was filled with mom-and-pops stores and multigenerational families who purchased homes when other parts of the county were out of reach.Sayegh and his extended family lost seven properties in the Eaton Fire, homes and businesses included. He has spent much of this year jumping from one rental to another waiting to be able to move back into his house. Before the fire, Thanksgiving with the Sayeghs could mean celebrating with up to 60 people spread throughout “one big home cooking and sleeping and drinking and partying for 48 hours,” he said.This year won’t be like that. Some relatives have decided to vacation out of state, and others made reservations to dine out. “It’s all been broken up into pieces,” he said. But a strong sense of community defined Altadena, and many are determined to nurture its essence. Some residents have thrown block parties on their otherwise vacant streets, and others meet for weekly game nights or other gatherings throughout the area. Next week, Sayegh is hosting a 1980s-themed extravaganza called Back to Altadena that will take over a small block in the western side of the neighborhood near the worst of the destruction. “I want to give them a party and a reason to smile,” Sayegh said. “It’s really magical when you’re around other survivors in the same situation.”Altadena resident Keni “Arts” Davis plans to spend this Thanksgiving Day at the home of one of his daughters outside Los Angeles who not affected by the Eaton Fire. He is most grateful this year that everyone is safe and happy.Courtesy Keni “Arts” DavisAltadena resident Keni “Arts” Davis, whose home of 45 years was destroyed, said he and his family will focus this Thanksgiving on being grateful for what they do have. One of his daughters, who also lost her house in the fire, recently secured a grant to plant gardens at dozens of Altadena homes that were destroyed. Each site will feature a bench where people can gather or just enjoy the silence.Davis said he has also been involved in beautifying Altadena during its recovery. An accomplished artist, Davis spent much of the last year painting the rebuild and visiting places he once frequented. He and his wife will move into his daughter’s new guest house once it’s completed and then begin rebuilding their own home.“I just can’t get over how thankful I am that my family is safe,” he said.Alicia Victoria LozanoAlicia Victoria Lozano is a California-based reporter for NBC News focusing on climate change, wildfires and the changing politics of drug laws.

LOS ANGELES — This time last year, Jon Cherkas and his wife were busy preparing to host relatives, friends and neighbors for Thanksgiving in their Southern California home of more.

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Nov. 27, 2025, 5:04 AM ESTBy Kathy Park and Jackie MontalvoOn Thanksgiving, turkeys are usually a comfort food and the main attraction at the dinner table. But on one farm just outside Nashville, Tennessee, the birds offer a different kind of comfort — cuddle therapy. “You can get on the ground in front of them, and you can scootch up real close so they’re right here,” Ellie Laks, founder of the Gentle Barn, said as she sat down in front of a turkey named Serena. “Then you can kiss their fuzzy pink heads and just pet them and talk to them.”The act of cuddling a turkey is just like it sounds: It’s a chance to slow down, sit with a turkey and gobble up a connection you might not expect.“The majority of people who come to the Gentle Barn and cuddle a turkey for the first time burst into tears because they’re so surprised at their unexpected show of affection,” Laks said. She founded the original Gentle Barn in 1999 in California’s San Fernando Valley, a lifelong dream come true. In 2015, she opened a second location in Tennessee with her husband.“It was all because of a cow named Dudley. He was here in Nashville, lost a foot because of an accident, hobbling around in tremendous pain, and the rancher could only do so much,” Laks said. On Thursday, the Gentle Barn is hosting a “Gentle Thanksgiving,” a day dedicated to connecting and cuddling with turkeys.NBC News“A friend of his reached out to 200 sanctuaries to see if someone could take him in, and no one was able to, so she called us all the way in California and said, ‘I know you’re far away. I don’t know what to do. Can you at least give me advice?’”Instead, Laks and her husband flew to Dudley and helped find him a bovine surgeon and a prosthetic foot.They brought him to UT Knoxville for amputations, surgeries, acupuncture and underwater treadmill therapy. When it was time for him to be discharged, Laks said, “we didn’t want to drive him all the way to California, so we opened a location here.”Now, the Gentle Barn has more than 200 rescue animals from turkeys and chickens to sheep, cows, and goats. Over the last 26 years, it has welcomed more 1 million visitors, many coming for turkey cuddle therapy.In addition to school field trips and private tours, the barn offers therapeutic sessions. “It was always my dream to be able to help animals and then partner with them to heal and help hurting humans,” Laks said.Volunteer Nicole Downs had never been on a farm before visiting the Gentle Barn. “My first experiences here were with chicken cuddling, and I fell in love with the chickens,” said Downs. “It was a natural progression then to want to cuddle with the turkeys.” Laks hopes visitors will see that underneath it all, we’re all the same.NBC NewsThe volunteer is now a weekly visitor and says these cuddle sessions have been a game-changer in helping her manage her anxiety.“It has become my kind of go-to grounding space for if I’m having an anxiety attack,” said Downs. “We have so many things available to us now that we can put in our toolkit, but this is by far the best.”“It’s therapy that you didn’t know you needed until you do it, and then you’re like, Where was this all fof my life?” she said.Laks said the farm is a sanctuary for animals and people alike. “As depression and anxiety come to an all time rise, I would invite people to come out to the gentle barn and find the love and nurturing here,” she said. “We need each other, and we need the animals, and they’re here for us.”On Thursday, the Gentle Barn is hosting a “Gentle Thanksgiving,” a day dedicated to connecting and cuddling with turkeys.Laks hopes visitors will see that underneath it all, we’re all the same. “There’s just so much unconditional love and gentleness, and I don’t know, there’s not a lot of that in the world today, so sometimes you have to get it from a turkey.”Kathy ParkKathy Park is a correspondent for NBC News.Jackie MontalvoJackie Montalvo is a producer-editor for NBC News.

On Thanksgiving, turkeys are usually a comfort food and the main attraction at the dinner table.

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Nov. 26, 2025, 7:48 PM EST / Updated Nov. 26, 2025, 11:38 PM ESTBy Marlene Lenthang and Tom WinterTwo National Guard members were shot in broad daylight in Washington, D.C., on Wednesday afternoon, just one day before Thanksgiving, in what officials described as a “targeted” attack.The guard members are in critical condition, authorities said. They were shot in the head, according to a U.S. official and a senior official directly briefed on the investigation. The suspect was also shot and taken to a hospital. He has been identified as Rahmanullah Lakanwal, four senior law enforcement sources briefed on the investigation said.Follow live updatesNational Guard members have been based in Washington since August following President Donald Trump’s highly contested directive to curb crime in the nation’s capital. The shootingThe shooting happened at 2:15 p.m. Wednesday near the Farragut Square Metro Station in the area of 17th and High streets NW, just a few minutes’ walk from the White House.At the time, National Guard members were on “high visibility patrols,” said Jeff Carroll, executive assistant chief of the Metropolitan Police Department.The two National Guard members were “ambushed” by a person who “came around the corner, raised his arm with a firearm and discharged at the National Guard members,” Carroll said at a news conference. Law enforcement officials at the scene of the shooting in downtown Washington on Wednesday.Drew Angerer / AFP – Getty ImagesThe suspect was shot “during the interaction,” Carroll said, though it’s not clear who shot him, and was taken to a hospital for treatment. Other National Guard members were in the area and intervened by holding the suspect down after he had been shot until he was taken into custody. Officials said there no other suspects. Carroll said both guard members are being treated at a local hospital. Flight tracking data showed a medical helicopter landed on the National Mall, then flew to MedStar Washington Hospital Center following the shooting. Mayor Muriel Bowser called the shooting “targeted,” saying the suspect who was taken into custody “appeared to target these guardsmen.”What we know about the victimsThe two National Guard members were from the West Virginia National Guard. West Virginia Gov. Patrick Morrisey initially posted on X that both died from their injuries, but he later backtracked and clarified that his office has received “conflicting reports” about their conditions. Police: No motive identified in D.C. shooting; National Guardsmen in ‘critical condition’01:25Around 2,100 National Guard troops were serving in Washington as of Wednesday morning, including 181 West Virginia National Guard members, the joint task force operating in the city said.What we know about the suspectLakanwal, the man law enforcement sources said has been identified as the suspect, is 29, the four senior law enforcement sources told NBC News.He has been initially identified as an Afghan national who used a handgun, according to two senior U.S. law enforcement officials.Lakanwal, who grew up in Khost province, was living in Bellingham, Washington, with his wife and five children, a relative of Lakanwal’s said.The relative said Lakanwal’s said he arrived in the U.S. in September 2021 after having served in the Afghan army for 10 years alongside U.S. Special Forces troops. A source familiar with the case and a separate law enforcement source told NBC News that the alleged shooter was granted asylum this year.What is the status of the investigation?FBI Director Kash Patel called the attack “a horrendous act of violence.”He promised at a news conference Wednesday that the perpetrator “will be brought to justice” and said the matter will be treated as an assault on a federal law enforcement officer. The FBI will initially investigate the shooting as possible act of terrorism, two senior U.S. law enforcement officials said.President Donald Trump said on Truth Social that the shooter was “severely wounded” and will “pay a very steep price.”Marlene LenthangMarlene Lenthang is a breaking news reporter for NBC News Digital.Tom WinterTom Winter is NBC’s National Law Enforcement and Intelligence Correspondent. Kelly O’Donnell, Ted Oberg, NBC Washington, Mosheh Gains, Gordon Lubold, Gary Grumbach , Laura Strickler, Courtney Kube and Rich Schapiro contributed.

Two National Guard members were shot in broad daylight in Washington, D.C., on Wednesday afternoon, just one day before Thanksgiving, in what officials described as a “targeted” attack

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Nov. 27, 2025, 12:32 AM ESTBy Phil Helsel and Jennifer JettPresident Donald Trump called for a “re-examination” of all Afghan nationals who came to the U.S. during the Biden administration, hours after an Afghan man was named as the suspect in the shooting of two National Guard members in Washington, D.C.Homeland Security Secretary Kristi Noem said on X that the suspect came to the U.S. in September 2021 under Operation Allies Welcome, a Biden-era program designed to help Afghans who assisted U.S. forces and were facing a Taliban takeover.“We must now re-examine every single alien who has entered our country from Afghanistan under Biden,” Trump said in an address Wednesday night in which he called the shooting an “act of terror.”Shortly after his remarks, U.S. Citizenship and Immigration Services said it was halting the processing of immigration from Afghanistan to the U.S.“Effective immediately, processing of all immigration requests relating to Afghan nationals is stopped indefinitely pending further review of security and vetting protocols,” the agency, known as USCIS, said on X.The two National Guard members, who are from West Virginia and deployed to Washington, were shot by a gunman around 2:15 p.m. They were in critical condition Wednesday, officials said. The suspect was also shot — by whom was still under investigation — and was hospitalized, according to police.Authorities have not detailed a motive, if one is known, but D.C. Mayor Muriel Bowser said that “this is a targeted shooting” and that the suspect appeared to target the guard members.The suspect has been identified as Rahmanullah Lakanwal, 29, of Bellingham, Washington, four senior law enforcement officials briefed on the investigation told NBC News.A relative of Lakanwal’s told NBC News on Wednesday that Lakanwal arrived in the U.S. in September 2021 after having served in the Afghan Army for 10 years, alongside U.S. Special Forces.Lakanwal was stationed at a base in Kandahar for part of that time, the relative said. He came to the U.S. after the Taliban returned to power following the August 2021 withdrawal of U.S.-led forces and eventually settled in Washington state.“We were the ones that were targeted by the Taliban in Afghanistan,” the relative said. “I cannot believe it that he might do this.”A source familiar with the case and a separate law enforcement source told NBC News that the suspect was granted asylum this year.Details of what a re-examination of Afghans already in the U.S. would look like, and who arrived during the Biden administration, were not immediately clear Wednesday night.A Trump administration memo on Friday, seen by NBC News on Tuesday, called for a review of all refugees admitted to the U.S. during the Biden administration — which could affect 200,000 people.The memo calls for a “comprehensive review and a re-interview of all refugees admitted from January 20, 2021, to February 20, 2025,” including U.S. green card holders. It cites a finding by USCIS that the Biden administration “potentially prioritized expediency, quantity, and admissions over quality interviews and detailed screening and vetting.”The San Diego-based Afghan advocacy group #AfghanEvac, which works to ensure that Afghans who helped the U.S. are not abandoned in the wake of the Taliban takeover, said Wednesday’s shooting should not be used to punish Afghans in the U.S.“Afghan immigrants and wartime allies who resettle in the United States undergo some of the most extensive security vetting of any population entering the country,” Shawn VanDiver, the group’s president, said in a statement.“This individual’s isolated and violent act should not be used as an excuse to define or diminish an entire community,” he added.The Department of Homeland Security resettled more than 80,000 Afghan refugees to the U.S. before or immediately after the U.S. withdrawal from Afghanistan and the subsequent takeover by the Taliban. But many others who wanted to leave were left behind.The State Department’s inspector general’s office said in a June 2023 report that as of March of that year, 152,091 Afghan “Special Immigrant Visa” applicants in Afghanistan were waiting on processing. The visa is for Afghans who were employed by or on behalf of the U.S.Afghan immigrants and refugees, including those who aided the American military during 20 years of war, have been all but barred from entering the U.S. during Trump’s second term.On his first day in office, Trump signed an executive order suspending all refugee resettlement in the U.S. until admissions align “with the interests of the United States.” Thousands of Afghan refugees, including many who had already been approved for U.S. resettlement, are stranded in Afghanistan, Pakistan and other countries, and in some cases they have been forcibly repatriated.The Trump administration has also terminated protections that allowed Afghans to live and work in the U.S. temporarily because of dangerous conditions at home. The White House says the protections are no longer needed because it is now safe to return to Afghanistan, which is experiencing multiple humanitarian crises and which Trump described as a “hellhole” in Wednesday’s address.Advocates say that Afghans who worked with the U.S. are at risk of persecution, torture or death if they return to Taliban-ruled Afghanistan and that they undergo extensive vetting before they arrive in the U.S.Trump has said he is committed to helping Afghans who worked with the U.S. military, saying in August that “we know the good ones and we know the ones that maybe aren’t so good.”Phil HelselPhil Helsel is a reporter for NBC News.Jennifer JettJennifer Jett is the Asia Digital Editor for NBC News, based in Hong Kong.Courtney Kube, Rich Schapiro, Abigail Williams, Laura Strickler and Tom Winter contributed.

U.S. Citizenship and Immigration Services said it was halting the processing of immigration requests for Afghan nationals after the National Guard shooting.

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