Identifying clinical features associated with electroconvulsive therapy response in adolescents with major depressive disorder using machine learning

BackgroundElectroconvulsive therapy (ECT) is an effective treatment for adolescent major depressive disorder (MDD), but its efficacy varies. This study utilized machine learning (ML) to identify baseline clinical factors associated with poor ECT response.MethodsWe retrospectively enrolled 503 adolescent MDD patients. A poor response was defined as a <50% reduction on the Hamilton Depression Scale (HAMD-24). The optimal ML algorithm (Random Forest, RF) was selected from nine candidates and then simplified using recursive feature elimination (RFE) and interpreted via Shapley Additive Explanations (SHAP).ResultsA simplified model using two baseline features—the neutrophil-to-platelet ratio (NPR) and pre-treatment HAMD score—achieved an AUC of 0.731 on the testing set, comparable to the full-feature model (AUC: 0.751). SHAP analysis revealed that a lower baseline NPR and a lower pre-treatment HAMD score were associated with a poor response. Furthermore, retrospective statistical comparisons revealed that patients in the poor response group completed significantly fewer ECT sessions than those in the good response group.ConclusionsWe developed a concise explanatory model demonstrating that routine clinical data available at admission (blood NPR and HAMD score) can effectively stratify the risk of poor ECT efficacy. Crucially, identifying these high-risk patients early empowers clinicians to implement targeted management, ensuring they complete a full and adequate course of ECT to maximize therapeutic benefits and prevent premature termination.

A two-decade bibliometric analysis (2004–2024) of parental factors in the context of internet gaming disorder research

ObjectiveThis is the first targeted bibliometric analysis which explores the development of scientific production on the relationship between parenting and Internet Gaming Disorder (IGD) over twenty years, emphasizing the central role of the family context in the etiology and maintenance of IGD.MethodsPapers indexed in Scopus and Web of Science databases from 2004 to December 31, 2024, were analyzed using the PRISMA guidelines, the R package Bibliometrix, and VOSviewer. A comprehensive search strategy was developed using Boolean operators to capture variations of parental and gaming-related terminology. Records were exported in BibTeX format and were merged and cleaned to remove duplicates before the analysis. A descriptive bibliometric analysis, bibliometric mapping, and content analysis were conducted to identify trends and thematic clusters. The analysis included 389 publications.ResultsThe most cited papers confirm the association of low parental warmth, family dysfunction, and comorbid psychiatric symptoms with a higher risk of IGD. Thematic mapping reveals six dominant clusters covering the conceptualization and diagnosis of IGD, parental mediation and virtual environment, psychological vulnerability and mental health, parenting and attachment, parenting styles and self-control, and problematic screen-related behaviors, and a strong concentration of publications in China, Germany, and the USA. The analysis also revealed an increase in publication output after 2013, with a notable acceleration following the inclusion of gaming disorder in the International Classification of Diseases 11th Revision (ICD-11).ConclusionThe bibliometric analysis reveals the rapid growth of research on parenting and IGD, highlighting the multifactorial nature of the disorder where dysfunctional family relationships increase risk, while supportive ones reduce it. Despite progress, longitudinal studies are needed for better understanding of causality and interventions.

Trends of incident stimulant use disorder diagnoses before and after the COVID-19 pandemic in British Columbia (2013-2024): a population-based study

BackgroundThere is rising detection of unregulated stimulants (e.g. cocaine and methamphetamine) in toxicology results among people who died of unregulated drug poisoning. Nevertheless, little research describes the population-level trends of incident (new) stimulant use disorder (StUD) diagnoses. This study reports on trends of incident StUD diagnoses pre- and post-Covid-19 public health emergency in British Columbia (BC), Canada.MethodsInterrupted time series analyses were conducted with BC’s COVID-19 public health emergency declaration on March 16, 2020 as the interruption point. Descriptive statistics on demographic and health service contact were conducted for the population diagnosed before (January 1, 2013 – March 16, 2020) and after (March 17, 2020 – December 31, 2024) the COVID-19 pandemic emergency declaration. Seasonal autoregressive integrated moving average (sARIMA) models were used to .estimate changes to incident StuD diagnoses rates before and after the COVID-19 pandemic declaration.Results38, 217 people were identified with incident StUD diagnoses between January 1, 2013 and March 31, 2024. The average diagnosis rate of incident StUD was 5.18 per 100, 000 in the pre-pandemic period and increased by 19.9% to 6.21 per 100, 000 in the post-pandemic period. The estimated increase in slope (ramp) of incident StUD was 0.0315 cases per 100, 000 population per month (95% CI: -0.00182, 0.06482).ConclusionsWe identified a rate of increase in incident StUD diagnoses since the COVID-19 pandemic declaration in BC that was not statistically significant. Our study highlights the need for more comprehensive linked data -including, administrative health data, surveys, and other services/program data (e.g., community services, private sector) to better disentangle StUD incidence and prevalence to inform services to meet the needs of people with StUD. Stimulant use, Stimulant use disorder, pandemic, Covid-19, methamphetamines, cocaine, interrupted time series.

STAT+: FDA to reconsider treatment for rare cancer after its surprise rejection

Two companies developing a therapy for a rare blood cancer have reached an agreement with the Food and Drug Administration that walked back the agency’s main reason for rejecting the drug in January. 

Pierre Fabre Pharmaceuticals and Atara Biotherapeutics, makers of the drug called Ebvallo, said Thursday that a meeting held in late April with FDA officials ended with the agency agreeing that their already completed, single-arm clinical trial was sufficient to support a review and potential approval. 

When the FDA rejected Ebvallo, the agency said the same study was flawed and the data produced from it was “insufficient” to support the drug’s approval. The drug’s review was conducted by the FDA’s Center for Biologics Evaluation and Research, led at the time by Vinay Prasad. He departed the agency at the end of April. 

Continue to STAT+ to read the full story…

STAT+: Next-gen Duchenne drug from Entrada disappoints

Entrada Therapeutics’ next-generation drug for Duchenne muscular dystrophy disappointed in an early trial, raising questions about the company’s competitiveness in an increasingly crowded field.

Entrada is one of a group of companies developing new exon-skipping drugs. These medicines are designed to help patients with certain mutations produce shortened but still functional forms of dystrophin, the protein missing in Duchenne. 

The first such drug, from Sarepta Therapeutics, had only marginal effects on protein production but was approved in 2016 under immense pressure from patient advocates. Since then, scientists have devised ways of redesigning these molecules to better infiltrate muscle cells, leading to vastly higher dystrophin levels. 

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Noise, air pollution exposure and attention-deficit/hyperactivity disorder: a meta-analysis

ObjectiveThis meta-analysis evaluated the associations between noise exposure, air pollutants, and attention-deficit/hyperactivity disorder (ADHD) in children, aiming to inform future prevention strategies.MethodsStudies were systematically retrieved from CNKI, Wanfang, PubMed, Web of Science, Embase, and the Cochrane Library, covering publications from inception to November 2025. Heterogeneity was assessed using Cochran’s Q test and the I² statistic. Subgroup analyses, meta-regression, and sensitivity analyses were performed to evaluate the robustness of the findings.ResultsNoise exposure was associated with a small increase in ADHD risk (odds ratio [OR] = 1.03, 95% confidence interval [CI]: 1.01–1.05), with stronger associations for childhood exposure, whereas prenatal exposure showed no significant effect. Given the modest effect size, this finding should be interpreted cautiously. Particulate matter (PM2.5 and PM10) was significantly associated with ADHD in continuous-exposure models—PM2.5 (OR = 1.32, 95% CI: 1.16–1.50) and PM10 (OR = 1.47, 95% CI: 1.15–1.87). In dichotomous models, PM2.5 was not significant, while PM10 remained positively associated (OR = 1.58, 95% CI: 1.11–2.26). Elevated nitrogen dioxide (NO2) exposure was also associated with a modest increase in ADHD risk (OR = 1.11, 95% CI: 1.02–1.20), whereas nitrogen oxides (NOx), ozone (O3), and sulfur dioxide (SO2) did not show significant associations.ConclusionsNoise and several air pollutants (PM2.5, PM10, and NO2) were significantly associated with increased ADHD risk, particularly during childhood exposure. Other pollutants, including O3 and SO2, did not demonstrate significant effects. These findings suggest that environmental noise and several air pollutants may be associated with ADHD; however, some observed associations, particularly for noise and NO2, were modest in magnitude and should be interpreted cautiously. These results reflect observational associations rather than evidence of a strong or causal effect, while the evidence for some pollutants remains limited or inconclusive. Further research is needed to clarify pollutant-specific associations and the role of exposure timing.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024593274, identifier CRD42024593274; https://www.crd.york.ac.uk/PROSPERO/view/CRD42025632899, identifier CRD42025632899.

Top takeaways from a new study of an AI-integrated capsule gastroscopy (ACG) system

Dr. Baoyi Huang, Southern Medical University Upper gastrointestinal abnormalities are one of the more common medical conditions, but there is a huge unmet need in the diagnosis due to a shortage of endoscopists, endoscopy equipment and venues to cater for the entire population. Our study looks into an innovative solution — an AI-integrated capsule gastroscopy…

The post Top takeaways from a new study of an AI-integrated capsule gastroscopy (ACG) system appeared first on Medical Design and Outsourcing.

Microproteins and Peptideins Expand Boundaries of the Human Proteome

A research team led by scientists at the Princess Máxima Center for Pediatric Oncology, the University of Michigan Medical School, EMBL European Bioinformatics Institute, and the Institute for Systems Biology, has uncovered more than 1,700 new proteins that could have implications for human diseases, including cancer.

Mostly very small, these proteins have been discovered in what’s known as the “dark proteome,” which covers gene products from previously overlooked sections of DNA. These proteins have unusual properties, motivating scientists to coin a new concept, peptideins, to help understand their potentially unique biology. Research co-lead Sebastiaan van Heesch, PhD, a group leader at the Princess Máxima Center, commented, “We know that the current overview of recognized proteins doesn’t capture the full picture. With this study, we show that thousands of overlooked genetic sequences contribute to the dark proteome by producing a new class of protein-like molecules, microproteins, that had been missed before now. But for most of them, we don’t yet know what they do.”

Research co-lead and co-corresponding author Robert Moritz, PhD, professor and head of proteomics at the Institute for Systems Biology, further noted, “Biology has long relied on a relatively small cast of well-characterized proteins to explain the regulatory logic of the cell, but peptideins suggest that beneath that familiar layer lies an entire untapped layer of molecular actors whose functional roles in gene regulation, signaling, and cytopersistence, many we are only beginning to imagine. Given their smaller size and the diversity of cellular contexts in which they appear, I believe peptideins may prove to be among the most versatile and consequential regulatory molecules we have yet encountered in human biology. This is not the end of a search—it is the opening of a vast and fertile new territory for the entire scientific community to explore and exploit, and I look forward to seeing what the broader scientific community uncovers as these molecules, and many more that are yet to be confirmed, are brought into the light.”

Research co-lead John Prensner, MD, pediatric neurooncologist at the University of Michigan Medical School, together with Van Heesch and Moritz, are co-senior and co-corresponding authors of the researchers’ published paper in Nature titled “Expanding the human proteome with microproteins and peptideins.” The team is sharing its discoveries with scientists worldwide in an open-source format to stimulate further research.

Van Heesch added, “With growing interest in industry and academia, peptideins are at the center of multiple drug development initiatives. Similarly, we see them increasingly turning up as important players in diseases, including childhood cancers. We hope to inspire a new wave of research into peptideins and to unlock new insights and drug targets across human biology, particularly for the development of cellular immunotherapies and cancer vaccines.”

The study is the work of the TransCODE Consortium, an international collaboration of more than 60 researchers at over 30 institutions worldwide, co-led by the Princess Máxima Center for Pediatric Oncology in the Netherlands, the University of Michigan Medical School, the EMBL European Bioinformatics Institute in Hinxton, and the Institute for Systems Biology in Seattle.

Genes in DNA provide the recipe for cells to produce peptides. Historically, peptides have been called proteins if they are long enough and have existing evidence for a biological role, such as the appearance of the same protein across species in evolution. “Protein-coding genes are the bedrock of biomedical investigations, including the overwhelming majority of drug development programs,” the authors wrote. A large, curated international database of proteins contains some 19,500 entities.

But increasingly, scientists believe the traditional definition of a protein needs to be broadened. “Whether the human genome encodes substantially more than the approximately 19,500 canonical protein-coding genes has sparked a spirited debate in recent years,” the scientist continued. “Therefore, any wholesale addition of protein-coding genes creates ripple effects across human bioscience.”

Through their newly reported study the team looked at more than 7,200 previously understudied sections of the DNA called non-canonical open reading frames (ncORFs). They found that some 25% of these sections—more than 1,700—generated detectable protein-like molecules. These proteins, smaller than traditional proteins, are referred to as “microproteins.”

Generating their results involved looking at 3.7 billion individual bits of raw data that may support known and previously unknown proteins—drawing upon 95,520 experiments. “We show that about 25% of a set of 7,264 ncORFs gives rise to detectable peptides in a large-scale analysis of 95,520 proteomics experiments,” they wrote. The process took around 20,000 hours for computers to complete, working non-stop. They found 1,785 microproteins, a number that at first glance would increase the protein databases by nearly 10%.

Predicted binding between a non-canonical open reading frame (blue) and traditional protein (yellow). [Leron Kok/Princess Máxima Center for pediatric oncology]
Predicted binding between a non-canonical open reading frame (blue) and traditional protein (yellow). [Leron Kok/Princess Máxima Center for Pediatric Oncology]

Moritz further explained, “By deploying our battle-hardened Trans Proteomic Pipeline across nearly 100,000 mass spectrometry experiments encompassing 3.7 billion spectra—derived from the world’s collective publicly available mass spectrometry data, with the results housed within PeptideAtlas at ISB for the scientific community to view and share—we were able to confirm, with high confidence, the existence of more than 1,700 of these newly identified peptideins that would otherwise have largely remained invisible to science.”

But most of these 1,785 microproteins didn’t resemble the other 19,500 traditional proteins. For example, they were very small: 65% were fewer than 50 amino acids in length, compared to less than 1% of the 19,500 previously catalogued. Looking more closely at the microproteins the investigators saw that only a few—perhaps a dozen—resembled the traditional proteins. The team then spent more than a year trying to make sense out of the remaining bulk.

Working with protein experts from across the globe in the TransCODE consortium, the scientists coined a new biological concept, which they coined peptidein. For decades, the research community has had a binary view of the relationship between human DNA and human proteins.  A given piece of DNA either does or does not produce a protein. In their new study, the scientists propose a third choice, which is that DNA could make a protein, a peptidein, or neither.

The team defined a peptidein as existing in cells as a protein-like molecule, meaning that it is made of amino acids, as are proteins. But the role of a peptidein is ambiguous. Perhaps it has a function in normal human biology, or perhaps not; this is the key distinction with traditional proteins, where all are believed to have a function in normal human biology even if the details of that function are not fully known yet. “To advance these ncORFs in biological inquiry, we invoke the emerging umbrella term of peptidein, which we define as an ORF with experimentally confirmed RNA translation and protein synthesis, but for which the data are currently insufficient to claim conventional protein-coding gene status,” the investigators stated in their report.

Importantly, this definition of peptidein leaves the door open for it to become a ‘protein’ in the future—that is, if scientists gather more evidence on it.  To start exploring this idea, the team searched for peptideins without which cells cannot survive. These so-called pan-essential peptideins can be important candidate drug targets in cancer and other diseases.

Using large-scale CRISPR gene editing, the scientists found six peptideins that looked promising. For example, one of these was a peptidein produced from OLMALINC, a genetic sequence previously thought not to produce proteins. When the researchers switched this gene off, 85% of more than 485 cancer cell lines showed impaired survival. The researchers confirmed that this effect comes from the peptidein itself, not the RNA molecule it sits on, and found that it plays a role in cell division and DNA damage response. “Our work here highlights c10riboseqorf92 (in the OLMALINC transcript),” they commented. “… while we do not yet have sufficient evidence that this ncORF encodes a bona fide protein, its CRISPR-based phenotypes in the context of cancer cells are intriguing.”

Many of the newly detected peptideins are presented on cell surfaces for recognition by the immune system, making them potential targets for cancer immunotherapy. A number of such molecules presented to the immune system are already under development as drug targets, and there is growing interest from both academia and industry in exploiting this new class of cancer antigens. Peptideins could also shed light on genetic diseases that conventional gene analysis has been unable to explain, simply because genetic diagnostics were unaware that these molecules were encoded by the human genome.

Members of the consortium had previously uncovered an essential role for a microprotein, ASNSD1-uORF, in children with a high-risk form of the brain cancer, medulloblastoma. Scientists at the Princess Máxima Center are now carrying out further research to determine its role in additional pediatric cancers with the activated MYC oncogene, such as neuroblastoma.

van Heesch commented, “It felt really special to discuss and decide what to do with this new class of molecules, as we had gathered enough early evidence to suspect that they might be widespread across cell types and tissues. By classifying these molecules of unknown functionality as peptideins, we’ve given them a formal place in reference databases so the wider community can study them.”

In their paper the researchers concluded, “The extent of the undiscovered proteome is one of the central questions in human biomedicine. This work reflects the multi-consortium collaboration between the TransCODE Consortium, the HUPO-HPP/PeptideAtlas project, the HIPP immunopeptidomics project and the GENCODE gene annotation group to coalesce a generalizable approach towards understanding which ncORFs can be understood as encoding proteins … Through our efforts, we bring microproteins and alternative protein molecules into reference gene annotation by defining them as either a protein-coding gene or a peptidein, a new concept referring to confirmed protein molecules of indeterminate consequence.”

Prensner added, “We’re just beginning to see what this ‘dark proteome’ has to offer.  It’s like the trailer to a movie. We see the outline of a game-changing view of human biology.  We’re incredibly excited that the coming years will open new doors to help solve and treat human diseases such as cancer.”

Moritz further stated, “Our collaborative work represents a culmination of decades of investment from federal funding agencies in building the computational and data infrastructure needed to interrogate the proteome at truly unprecedented scale at the Institute for Systems Biology … What excites me most is not simply that these molecules exist, but what their existence implies.”

The researchers are making we make all ncORFs, peptides and spectra publicly available through PeptideAtlas.

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