RecoverEsupport—A Digital Health Intervention for Recovery After Breast Cancer Surgery: Feasibility and Acceptability Outcomes from a Pilot Randomized Controlled Trial

Background: Optimizing recovery following breast cancer surgery is critical for restoring usual function, minimizing complications, and enabling timely initiation of adjuvant therapies. Enhanced Recovery After Surgery protocols are internationally endorsed recommendations and include patient-led behaviors such as early mobilization, early oral intake of fluids and food, postoperative rehabilitation exercises, and multimodal pain management. However, adherence to these behaviors is often suboptimal, and strategies to support patients are limited. Digital health interventions (DHIs) may offer scalable solutions. Objective: The aim of the study is to assess the acceptability of the RecoverEsupport Breast DHI, designed to increase adherence to patient-led Enhanced Recovery After Surgery recommendations across the perioperative period for breast cancer surgery, and to assess the feasibility of conducting a randomized controlled trial to evaluate it. Methods: In this single-site, 2-arm randomized pilot trial, conducted at a major cancer hospital in New South Wales, Australia, between July 2024 and October 2025, participants were consecutively recruited from the surgical list at the study site, supplemented by referrals from surgeons’ private rooms, and included individuals having a mastectomy with or without implant-based reconstruction. Participants were allocated to usual care (control) or usual care plus the RecoverEsupport DHI (intervention). Trial feasibility outcomes included participant recruitment, retention, data completeness, and postoperative safety (adverse events). Intervention acceptability was assessed via the System Usability Scale, participant engagement rates, and willingness to recommend the intervention to others undergoing surgery. Descriptive analyses were conducted, and outcomes were compared to prespecified targets and progression criteria. Results: In total, 23 participants were recruited (control: n=12, intervention: n=11), which was below the target of 70, while participant retention and data completeness were 100% (23/23), both exceeding the targets. No grade 3+ adverse events occurred; minor grade 2 events occurred in both groups. Acceptability outcomes exceeded targets: usability was high (mean System Usability Scale score 83.2, SD 17.7; target >68), 100% (11/11; target >75%) of participants logged in to the DHI at least once, and 88% (10/11; target >75%) would recommend the program to others undergoing surgery. According to prespecified progression criteria, 3 of 4 feasibility targets were met, indicating that a revised recruitment strategy would be required before proceeding. The restrictive eligibility criteria may have contributed to the lower than expected recruitment rate. All 3 acceptability targets were met. Conclusions: The RecoverEsupport intervention was acceptable and safe and had high participant engagement. The trial processes were feasible; however, recruitment barriers, including restrictive eligibility criteria, highlight the need for more robust and integrated recruitment strategies to enable progression to a fully powered randomized controlled trial. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12624000417583; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386404 International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2024-093869

Teaching AI to run with the turbines

Artificial intelligence may have captured the public imagination through chatbots and image generators, but some of its most consequential use cases are unfolding far from consumer-facing tools. In industries where physical infrastructure, operational continuity, and safety are paramount, AI is becoming a core operating layer. With its sprawling industrial systems and constant stream of operational data, the energy sector offers a glimpse into what that future could look like.

At Woodside Energy, AI adoption did not begin with generative models or enterprise copilots. The company has spent years building predictive analytics, optimization systems, and machine learning tools across exploration, drilling, maintenance, and plant operations. “We’ve always had very large volumes of operational data coming from the equipment and the plants and the assets that we operate,” says the company’s vice president for digital Andrew Melouney. “Those have created really clear, quite high-value use cases for us.”

That long-term investment in infrastructure and governance is now enabling a broader shift toward agentic AI systems that can support complex industrial workflows. Rather than replace human operators, Woodside designs AI systems to augment expertise in high-stakes environments. A prime example is its “Startup Advisor,” an AI copilot that helps operators manage the complex process of starting liquefied natural gas (LNG) plants. “We’re really thinking about, how does it support the people in the organization in terms of empowering them to make better decisions, to make faster decisions,” Melouney explains.

The company’s approach reflects a wider evolution taking place across industrial AI: graduating from isolated experiments to enterprise-wide systems built on standardized platforms, governed data, and repeatable deployment patterns. That transition, Melouney argues, requires organizations to rethink both their technology stacks and how work itself gets done. “We’re not just bolting AI onto an existing process,” he says. “We’re deeply thinking about how that work needs to be reimagined.”

Melouney’s motto has become: “Think big, prototype small, and scale fast.”

As AI systems become more autonomous and interconnected, the companies poised to succeed may be those that spent years building the operational foundations beneath the hype.

“Our ambition is really for an autonomous enterprise, where we have agents with agency that are able to really deeply interact with our core workflows,” says Melouney.

This episode of Business Lab is produced in partnership with Infosys.

Full Transcript:

Megan Tatum: From MIT Technology Review, I’m Megan Tatum, and this is Business Lab, the show that helps business leaders make sense of new technologies coming out of the lab and into the marketplace.

This episode is produced in partnership with Infosys.

Now, when people think about artificial intelligence, they often picture chatbots or productivity tools, but some of the most sophisticated and high impact uses of AI are actually happening far from consumer apps, inside complex industrial environments where safety, reliability, and physical systems matter. The global energy sector is a prime example.

Companies like Woodside Energy, a global energy producer headquartered in Western Australia, have been applying AI for more than a decade now, from advanced analytics and operations, to remote decision support, to smarter maintenance, and energy efficiency across large scale assets. Today, Woodside is scaling that experience, embedding AI more deeply across its operations and the enterprise with a strong focus on governance, data quality, and human accountability.

Two words for you: technological fuel.

My guest today is Andrew Melouney, vice president for digital at Woodside Energy. Welcome, Andrew.

Andrew Melouney: Thanks, Megan. It’s great to be here.

Megan: Lovely to have you. Now, Andrew, as I said there, the energy sector has approached AI quite differently from technology or consumer businesses. Early value has emerged in operational and industrial environments, rather than consumer-facing generative AI tools. Why is that? And what differentiates the energy sector’s AI journey?

Andrew: Megan, I think it really comes down to the nature of the work we do. Energy operations and what Woodside does is very asset intensive, it’s very safety critical, and it’s highly physical. And when you think about how Woodside operates, we operate across the full value chain. We do exploration through to drilling and subsurface work, to project development, all the way through to operating assets, which are often operated in harsh and remote locations, and then global energy portfolio marketing and trading as well.

We’ve always had very large volumes of operational data coming from the equipment and the plants and the assets that we operate, and those have created really clear, quite high-value use cases for us. When you think about reliability, when you think about safety and efficiency, those are really critical things for a company like Woodside. We’ve been doing traditional AI for many years now. If you think about analytics, if you think about optimization, if you think about things like predictive models, those techniques we’ve been applying to our data sets and to our business since around 2015.

And more recently with the advent of generative AI, we’ve really found that we’ve got a pretty strong and awesome foundation to build on top of and to really solve problems in the service of improving the business. And again, whether that is keeping people safe, keeping the environments we operate in safe, or improving returns for the organization.

Megan: Fantastic. I mean you touched on it there, but how has this reality shaped your own AI strategy at Woodside? Where did you start, and where did the technology prove most impactful in those early days?

Andrew: Well, like I said, we’ve had a very long journey, in terms of understanding our operational data, recognizing the value of it, and collecting it at scale so that we can use it. And we’ve been very deliberate in that approach, Megan. We’ve really thought about where the value is and where the risks were manageable. And we’ve started looking at, in today’s world from an agentic AI perspective, we’ve started looking at the problems that were solved with traditional AI and machine learning and data science in the past. And we’ve started to think about, where can we then layer agentic AI over the top to provide an even better outcome?

For our asset intensive industry and organization, we’re looking at areas such as maintenance optimization. We’re looking at areas such as, how do we ensure our LNG plants start up reliably, consistently, and safely? And we’re considering really our frontline workforce and making sure that we’re giving people on the frontline the tools required to do their jobs. When we think about AI, we’re really thinking about, how does it support the people in the organization in terms of empowering them to make better decisions, to make faster decisions? I think over time, this has just evolved from what has been traditional analytics to now artificial intelligence and generative AI. And we’ve learned along the way that the technology is important, but it’s about aligning people, processes, and the technology together.

We’ve spent a long time not only in collecting the data and having a well-curated data set that we can build on top of, but we’ve also spent a lot of time teaching people how to work in agile ways, how to do design thinking, how to problem solve, and how to really make sure that the technology that, say, my team can bring to bear to the organization is adopted effectively and purposefully. And I think once we had that solid foundation in place from a technology perspective, from a data perspective, once we got strong trust built between our digital teams and the organization, we really saw quite a material uptick and the scaling of technology occur more broadly across the enterprise.

Megan: Fantastic. That people piece so important, isn’t it? It’s just a tool, technology, that needs to be in the right hands. And you touched on data there; industrial AI obviously depends on vast amounts of data. Can you walk us through how you’ve approached data at Woodside in a little more detail? How it’s structured and governed, and how tools like maintenance intelligence as well fit into that.

Andrew: Well, data is really foundational and fundamental to everything we do, particularly from a technology perspective. It gives us the ability to innovate at pace when we are building over the top of a strong foundation. As I said before, we’ve had the benefit of a long-term investment in our underlying operational data. I think the way we think about data is that it’s an asset for us.

And when you think about operating a facility where you’ve got sensors everywhere, you’ve got data streaming in real time, you’ve got operators needing to make decisions in real time, we have consciously made a decision over many, many years to invest in that enterprise scale data platform to make sure that it’s secure. We’ve got well-structured data assets, and we’ve got strong governance over the top of that data so that when it is used, when it’s built in a data science application or an AI agent, that we’ve got a level of trust in it that it’s going to be used responsibly. And that when it’s used, it can be trusted to give the outcome that we expect.

We have developed platforms that continuously ingest really high frequency data from the assets and from our enterprise systems. Once we’ve been able to develop solutions on top of that, parts of the business that might own the systems that collect that data, they see the value in it.

When you look at something like maintenance intelligence is a really good example of how we’ve been able to take something that we’ve been working on for a long time. Woodside does a lot of maintenance, it’s a very important part of our business, and it occurs across all of our operating assets. But we have been looking at how we do predictive analytics and predictive maintenance for a long time across that data set that we own. And something like maintenance intelligence is a solution that gives us the ability to optimize how we do that maintenance. And what it does is it analyzes historical maintenance records, alongside the performance of the equipment. And again, by having that data set well-governed and in one place, we get the ability to correlate different data sets, such as maintenance records out of SAP, alongside say equipment and performance coming from our time series data lake.

And when we build over the top of that, something like maintenance intelligence gives us the opportunity to recommend to the assets what the optimal timing for maintenance activities might be, and really give what is quite a simple aim, which is do the right work at the right time. And with something like maintenance intelligence, we have seen the opportunity, and we have the opportunity to reduce maintenance hours by up to 15% over five years on one of the assets that we’ve piloted this on. And as we’ve built out that underlying analytical model, we’re now able to put agentic AI over the top of that and provide better insights and optimize that solution more.

It really comes down to providing our asset teams and our operational teams with the right decision support capability that ensures they’re still accountable to make the decision and to ensure the right work is being done, but we are giving them the best possible opportunity to use their judgment and experience with the data that we provide to make the right decision.

Megan: Sounds like a really impactful change. Last year also marked a milestone in moving from early AI learnings to scale, using AI more deliberately as a force multiplier. What transition were you trying to make and how did you approach it?

Andrew: Well, Megan, we’ve had a philosophy for a long time in Woodside from an innovation perspective, where we really want to think big, we want to prototype small, and we want to scale fast. We want to find big opportunities that we can go after, but we want to ensure that we look at how we deploy those on a small scale first, and then provide the right learning and insight that then can scale it everywhere. Something like maintenance intelligence is a good example of that, or our Startup Advisor, where we know that we’ve got multiple plants that we need to start up. We know that we’ve got multiple assets that need to do maintenance, so we have a big, bold ambition about how we can improve and optimize that. We start with a small prototype; it might be one subsystem, it might be just a part of an asset, and then we scale it out, we learn, and we scale faster.

I think from an AI learning perspective, one of the key things we’ve learned is really the transition from moving from isolated AI solutions to a more coordinated enterprise-wide capability. If you look back maybe 18 months, two years, in our generative AI journey, we rarely started by deploying AI as broadly as we could in the organization from a personal productivity perspective. And probably being quite open in terms of the problems that we will solve, the business problems that we’ll solve with AI. That had a lot of benefits for us in terms of allowing our organization to get to know AI, get to know the capabilities, to build the trust in it.

What we’ve learned though is that we’ve needed to pivot from that to being a little bit tighter in terms of where we are going to invest our time and resources and more higher value solutions. How do we then enable and empower the rest of the organization so that they can actually effectively problem solve with technology in their domain or in their personal productivity without having to come to a central team?

When we think about that, think big, prototype small, scale fast, has been something really important for us. The transition from a more broader approach to use case development and solution development to now a narrower focus on the high value priorities. We’ve seen that paying dividends to us and allowing us to go after solutions and opportunities, things like Startup Advisor.

And so our Startup Advisor is a agentic AI solution that really aims to optimize and empower and better support our operators that sit in front of a panel and have to start up LNG plants, which are incredibly technical facilities and require really specialist skills to start up. And so our Startup Advisor is almost like a copilot that sits alongside those operators, and it gives them the ability to be able to play back previous startups. It gives them the ability to look at how the current startup is progressing, and it provides them better insights to optimize how they start up that facility. And again, starting up an LNG facility is incredibly complex.

Megan: I can imagine.

Andrew: When we think about opportunities like Startup Advisor, again, it goes back to that think big, prototype small, and scale fast. We started with a very bold vision of, how do we start up all of our LNG plants in a much more structured and optimized fashion? How do we better support our panel operators? How do we make, say, a more junior panel operator have a copilot that can help them almost like an experienced panel operator sitting next to them? And when we think about that vision and the ability then to prototype on a small scale and then scale fast, I think it’s been really successful for us.

As we scale, we’ve just naturally expanded into more agent-based solutions. Today, we’ve got around 50 AI agents in production, supporting both our operating assets and our enterprise workflows. These tools have been proven in live environments, and we have really seen the benefit of being able to shift from point solutions that maybe solve small scale problems in specific areas, to AI and agentic solutions with agency that can really work across our workflows.

We’re able to do this because we’ve standardized on the platform that we build on and we’ve got repeatable patterns. That’s been another really important learning for us, is that we don’t want to build 50 solutions in 50 different ways. We really want to be empowering our organization and our technical teams and the users of our solutions to roll them out quickly, to roll them out safely, and to do it in a patternized and platform manner.

But the last point I’ll make, Megan, from a learning perspective is that we’ve really understood that a strong governance around how AI is deployed and developed is critical for us, and it’s critical for us to go fast as well. The traditional ways of governing how we roll out different solutions or digital systems isn’t going to scale to the breadth that we need when we are thinking about AI. Being able to have a clear philosophy around how we innovate, transitioning from isolated solutions to that enterprise-wide capability, and making sure that we’ve got strong platforms with strong patterns and clear governance are the three really critical things that we’ve learned.

Megan: Such important pillars, all of them. And you’ve been working with Infosys on this journey. How has that partnership helped accelerate scaling and embedding AI across the business?

Andrew: Well, Infosys is our managed service provider, and so they play a really critical role in the operations of our core business. One of the things that I like to say is that our license to innovate is based on our license to operate. And so, for my team to be able to turn up to an operating asset or a corporate function and have the trust that’s needed to be able to innovate and reimagine and redesign how work gets done, to be able to do that, we need to make sure that our core platforms, our core systems, our applications are running really reliably, safely, and consistently every day. Having an experienced partner like Infosys looking after those core operations in partnership with our internal teams is really, really important to us.

As we move from pilots to enterprise-wide deployment, the ability to partner with someone like Infosys also gives us the ability to scale. And so being from Perth and Western Australia, while we’ve got a really strong local team in Western Australia, and we’ve also got a very strong team in some of our other operating locations, like everyone, we’re struggling to find people that can fill AI roles. Being able to partner with Infosys and have a number of different operating models at our disposal becomes really important for us. Having co-mingled teams where they are staff, they are Infosys staff, Woodside staff, and some of our other partners, really just brings diversity of thought and experience to how we solve problems.

Fundamentally, the partnership has allowed us to operate and innovate with more confidence. While Woodside always retains ownership of the strategy and where we’re going and the governance and my teams remain accountable for the outcomes, we can’t do what we do without strong partnerships like the one we have with Infosys.

Megan: Fantastic. And as AI adoption scales, you mentioned yourself, governance becomes increasingly important. How challenging has that been, and what guardrails have you put in place at Woodside?

Andrew: So, Megan, governance is really important to us, and we operate in a well-regulated environment. That means we’ve got to make really deliberate and well-reasoned decisions when we’re thinking about how we deploy technology into our organization, whether it’s artificial intelligence or anything else, for that matter. And so, governance is really central to how we approach the execution of our AI strategy at Woodside.

We’ve got maybe two or three really key things that we’ve put in place. The first one is just making sure that every AI use case goes through a structured assessment, and that’s making sure it meets our privacy controls, our cyber controls. We’re also asking the question, not just, could we do this, but should we do this? We’ve really got to bring together safety, ethics, transparency, accountability, and make sure that we make an informed decision. When an AI solution is going through that structured assessment, if there are concerns about how we might use that solution, it then goes to an AI council that’s made up of senior leaders across the organization. That council and that group really oversee some of the prioritization and risk management. That’s where we can have really strong, robust debates around, again, could we do something, should we do it, and how do we mitigate any of the risks that we might introduce here?

I think the last one, Megan, is really around lifecycle management. When you start thinking about, we’ve got 50 at the moment, but if we had 500 agents working in our organization, really amplifying the experience and the decision-making and the value creation of our staff, we really want to have an ability to manage the lifecycle of how those agents operate. We want to know, how many people are using them? What’s the efficacy and the outcome? Is there model drift? Do we need to retune or retrain? I think that’s an area where many organizations, including Woodside, are still leaning into and still figuring out the best way to do this. We can do it quite easily with 50 agents, but 500, 5,000, 50,000 becomes an opportunity for us. Again, thinking about how we partner with others, solving problems like that really present an opportunity to co-create and to co-solve with some of our partners, like with Infosys.

Megan: Fantastic. Just to close, what’s your long-term vision for AI at Woodside? How do you see this evolving over the years ahead, and what could it unlock for the sector in your view?

Andrew: So Megan, I think our ambition is really for an autonomous enterprise, where we have agents with agency that are able to really deeply interact with our core workflows. The outcome that we want to get from that is to protect our people, to protect the environments we operate in, and to be able to provide energy at a lower cost to the world. When we think about that ambition, we can really see that being applied to almost all of the areas that Woodside work in. Whether that’s from exploration through to project developments, through to operations or marketing, the scale of the opportunity in front of us and the ability for us to really change the way that work flows through the organization is really exciting.

For us, there’s three things that we have to get right in terms of being able to execute on that ambition. The first one is really thinking about how the work gets done in the organization so that we’re not just bolting AI onto an existing process, but we’re deeply thinking about how that work needs to be reimagined. We’ve also got to think about how we enable our workforce to work differently. Providing them with the skills and the tools and the ability to really harness the power of the technology that we provide.

Secondly, we’ve got to continue to move from and restrain ourselves from deploying point solutions that solve very narrow problems, to having more connected, agentic systems of systems that can interact with each other. To do that, and if we do that successfully, that’s where we really get the high value unlock from agents being able to interact with workflows and really change how the work gets done.

And lastly, Megan, it’s about how we must continue our philosophy of thinking big, prototyping small, and scaling fast.

Megan: Which is a fantastic lens to which to make all these decisions. Thank you so much, Andrew. That was Andrew Melouney, vice president for digital at Woodside Energy, whom I spoke with from Brighton in England.

That’s it for this episode of Business Lab. I’m your host, Megan Tatum. I’m a contributing editor and host for Insights, the custom publishing division of MIT Technology Review. We were founded in 1899 at the Massachusetts Institute of Technology, and you can find us in print, on the web, and at events each year around the world. For more information about us and the show, please check out our website at technologyreview.com.

This show is available wherever you get your podcasts. And if you enjoyed this episode, we hope you’ll take a moment to rate and review us. Business Lab is a production of MIT Technology Review, and this episode was produced by Giro Studios. Thanks ever so much for listening. Goodbye.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

The Download: a startup has a solution for AI’s groupthink problem

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

LLMs are stuck in a groupthink groove. This startup is trying to get them out.

Open up your chatbot of choice—Claude, ChatGPT, Gemini—and type “Give me a random number between 1 and 10.” You’re going to get 7. Almost always. 

That won’t work every time—but if it did for you, you may wonder if I have superpowers. I don’t.

The truth is that most large language models are stuck in a rut. They are far more predictable and far less creative in their responses than you might expect. That’s fine for tasks like coding or research, but groupthink is a problem when you’re brainstorming or planning your next vacation.

The Australian startup Springboards has a solution. It built an LLM called Flint, which has been trained to come up with a wider variety of responses than mainstream LLMs to open-ended questions such as “Where should I go in Europe?”

Meet the company pushing chatbots away from the obvious.

—Will Douglas Heaven

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 Scientists say they have built a cell from scratch for the first time
Built with lab-made DNA, it can feed, grow, and multiply. (CNN)
+ It brings us closer to creating synthetic life. (Quanta)
+ And is arguably the greatest feat of bioengineering yet. (New Scientist $)
+ But also raises concerns over the dangers of synthetic biology. (NYT $)
+ Mirror organisms could threaten life on Earth. (MIT Technology Review)

2 OpenAI has proposed giving the Trump administration a 5% stake
Talks over a public ownership deal come amid rising political pressure.(FT $)
+ OpenAI also proposed other US AI giants providing a 5% stake. (CNBC)
+ That could include Anthropic, Google, and Meta. (Bloomberg $)
+ President Trump says he wants the public to have a stake in AI. (BBC)

3 Singapore has seized a $42 million mansion tied to Nvidia chip smuggling
It was seized as part of an investigation into alleged illegal trading. (BBC)
+ Days earlier, Supermicro’s Taiwan offices were raided in the probe. (FT $)

4 Anthropic’s Fable 5 is back online
But queries posing security risks may be routed to less powerful models. (Axios)
+ Anthropic restored access yesterday after the US lifted an export ban. (BBC)
+ But the battle over how to tame AI has just begun. (WSJ $)
+ Anthropic has launched a new AI science product. (MIT Technology Review)

5 Meta is building its own cloud infrastructure business
It’s exploring two ways of monetizing AI compute and models. (Bloomberg $)
+ One is selling access to models hosted on Meta’s infrastructure. (CNBC)
+ The other is selling “raw” computing power. (TechCrunch)

6 PlayStation will stop releasing games on discs in 2028
Future PS5 games will be digital-only releases. (Verge)
+ The news comes days after reports that GTA VI will have no disc. (BBC)
+ It’s put a nail in physical media’s coffin. (Wired $)

7 A low-cost Chinese AI model is catching up with US giants on their home turf
Western customers are drawn to GLM-5.2’s cheap but powerful model. (Reuters $)
+ Chinese open-source models are spreading fast. (MIT Technology Review)

8 Google has lost its fight against a record €4.1 billion EU antitrust fine
It was charged in 2018 for using Android to ‌block rivals. (CNBC)

9 The UN has launched an “AI for Good” commission
Salesforce CEO Benioff and Rwandan President Kagame will co-chair it. (Axios)

10 People prefer AI impersonators over politicians
The study’s findings raise alarm bells around potential public deception. (404 Media)

Quote of the day

“If AI overdelivers, it will impact financial stability. If AI underdelivers, it will impact financial stability.”

—Torsten Slok from Apollo Global Management shares common concerns about AI at the European Central Bank’s annual conference, Reuters reports.

One More Thing


America was winning the race to find Martian life. Then China jumped in.

In July 2024, after more than three years on Mars, the Perseverance rover came across a peculiar rocky outcrop. Instead of the usual crystals or sedimentary layers, this one had spots. Those specks were the best hint yet of alien life.  

NASA began a new mission to bring the rocks back to Earth to study. But now, just over a year and a half later, the project is on life support. As a result, those oh-so-promising rocks may be stuck out there forever. 

This also means that, in the race to find evidence of alien life, America has effectively ceded its pole position to its greatest geopolitical rival: China. Beijing is now moving full steam ahead with its own version of NASA’s mission. 

Here’s how the search for Martian life has become a contest between two superpowers.

—Robin George Andrews

We can still have nice things

A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ The classic arcade game Crazy Taxi is returning.
+ Thom Yorke’s live set from the Sydney Opera House is a reminder of what an extraordinary performer he is.
+ Peer into 1,000 gloriously illuminated New York apartment windows at night in this generative photography project.
+ The Orion constellation dazzlingly displays every stage of star formation in this image from the James Webb Space Telescope.

Top image credit: Sarah Rogers/MITTR | Photos Getty

Please send gloriously illuminated New York apartments to hi@technologyreview.com

You can follow me on LinkedIn. Thanks for reading!

—Thomas

A Recap of the Inaugural Youth Mental Health Hub at SXSW London

In early June, SXSW London returned for its second year, gathering thousands of creatives, enthusiasts, entrepreneurs, and investors into the city to celebrate film, music, tech, and culture. As part of this year’s festival, the Child Mind Institute, in partnership with Wellcome, proudly presented the inaugural Youth Mental Health Hub – a week of programming dedicated to advancing solutions to one of the defining challenges of our time: the global youth mental health crisis. Through six thought-provoking sessions, leaders in clinical care, science, technology, policy, and media came together to explore how to strengthen prevention, improve early identification, reduce stigma, and build systems that meet young people where they are.

Here’s a look back at the inspiring conversations that took place throughout the week.

Beyond the Average: Understanding Vulnerability in the Digital Childhood Era

Beyond the Average: Understanding Vulnerability in the Digital Childhood Era

As artificial intelligence rapidly transforms the experience of childhood, experts explored how AI can both support and challenge young people’s mental health. The panelists discussed when and under what conditions young people may be most vulnerable as well as what systems we need to support them.

Moderator

Gary Wilson, Director of Research, Huo Family Foundation

Speakers
Catherine Sebastian, PhD, Head of Evidence for Mental Health, Wellcome
John Pickavance, PhD, Principal Data Scientist, Born in Bradford
Georgia Turner, Postdoctoral Research Associate, University of Cambridge
Michael Milham, MD, PhD, Chief Science Officer, Child Mind Institute

AI Is Already Shaping Childhood. Who Is Shaping AI? Balancing Innovation, Evidence, and Safety in Youth Mental Health

AI Is Already Shaping Childhood. Who Is Shaping AI? Balancing Innovation, Evidence, and Safety in Youth Mental Health

Youth are experiencing the impacts of AI earlier and more intensely than any previous generation has. This session explored the role of public leadership in anticipating harm before it becomes systemic — establishing guardrails, fostering digital resilience, and ensuring that innovation advances hand in hand with youth mental health and well-being.

Moderator
Sarah Aguiar-Borges, PhD, University of Cambridge

Speakers
Julia Gillard, former Prime Minister of Australia; Chair, Wellcome
Kanishka Narayan, UK Minister for AI and Online Safety
Giovanni Salum, MD, PhD, SVP, Global Programs, Child Mind Institute.

Youth Mental Health After Conflict: Healing, Resilience, and Rebuilding Systems

Experts shared insights on the unique mental health challenges facing children affected by war, displacement, and humanitarian crises. This session explored how societies can implement youth-centered systems grounded in prevention and use early identification to position youth mental health as a cornerstone of long-term recovery and resilience.

Moderator
Krupa Padhy, BBC Radio 4

Speakers
Dr. Mark Jordans, professor, Centre for Global Mental Health, King’s College London; Director of Research & Development, War Child
Emma Ferguson, mental health policy and advocacy specialist, UNICEF
Mohamed Ali, Director, Iftin Global

Dyslexia: Changing the Story

In a timely discussion, experts explored how dyslexia is currently understood in society, challenging current language and misperceptions that can impact a child’s confidence and mental health. Through a blend of personal experience and clinical expertise, the conversation focused on the need for evidence-based support and strengths-based approaches to help children and their families thrive.

Moderator
Kate Griggs, Founder, Made By Dyslexia

Speakers
Maggie Aderin, PhD, space scientist & educator; dyslexia advocate
Harold S. Koplewicz, MD, President and Medical Director, Child Mind Institute

Connection Continuum: Preventing Suicide and Combating Loneliness

Suicide is one of the leading causes of death among young people globally. This session gathered community, clinical, and digital leaders to explore what a more connected system of support looks like in practice. The panelists also discussed the important of recognizing warning signs, expanding access to evidence-based care, and prioritizing early intervention to help prevent youth suicide.

Moderator
Krupa Padhy, BBC Radio 4

Speakers
Victoria Hornby, CEO, Mental Health Innovations
Dean Perryman, Empty Chairs
Michael Milham, MD, PhD, Chief Science Officer, Child Mind Institute

Does Mental Health Science Funding Need a New Paradigm in the Age of AI?

With technology evolving faster than the science designed to understand it, experts examined how research, philanthropy, and clinical leaders can work together to build the evidence, safeguards, and infrastructure needed to protect children’s mental health in the digital age.

Moderator
Chelsea Clinton, Vice Chair, Clinton Global Initiative

Speakers
Miranda Wolpert, Director of Mental Health, Wellcome
Margaret Laws, President & CEO, HopeLab
Daria Bukhman, Co-Founder and Chair, Bukhman Philanthropies
Harold S. Koplewicz, MD, President & Medical Director, Child Mind Institute

The post A Recap of the Inaugural Youth Mental Health Hub at SXSW London appeared first on Child Mind Institute.

Boys, Masculinity, and the Looksmaxxing Trend  

By now, you’ve probably heard of the term looksmaxxing. Think pieces about the trend have popped up all over the internet. And in a recent episode of Saturday Night Live, comedians poked fun at lookmaxxing influencers obsessed with having the perfect male physique.

While this new social media craze may seem silly, it’s impacting more boys than you might think. In a study conducted last year that surveyed over 3,000 young men (ages 16–25) from the United States, United Kingdom, and Australia, nearly two-thirds of participants were regularly engaging with masculinity influencers.

Teen boys are being encouraged to change the way they look in order to fit a certain standard of attraction. The growing amount of looksmaxxing content they see online can have real effects on their self-esteem and mental health.   

What is looksmaxxing?  

Looksmaxxing originated nearly a decade ago in incel forums where men blamed their lack of romantic partners on the belief that female sexual selection is primarily based on physical qualities. So men who aren’t born with traits desirable to women are doomed to fail romantically. While traditional incels wallow in this fate, looksmaxxers seek to enhance their appearance to become more attractive. Their community claims that there is a universal standard for what the ideal man (and woman) should look like.

This is determined by a rating system called the PSL scale — the name being an amalgamation of three prominent misogynistic incel forums of the 2010s. There are many factors that go into the scaling, such as eye shape, jaw size, nose angle, and body fat percentage. Along this scale, you can land in four categories: subhuman, normie, Chadlite, and Chad (the ultimate catch).

During the pandemic, looksmaxxing went mainstream, merging with “manosphere” content on social media platforms like TikTok and Instagram. The trend became less about the ability to attract women and more of a competition among boys and men as they engaged in mog-offs — online contests where people have their faces analyzed and compared by facial recognition software to determine who’s better looking.

Self-improvement practices have gained popularity among boys. Some are considered to be softmaxxing, like developing skincare routines or eating high-protein diets, and others to be hardmaxxing, like using growth hormones or getting cosmetic surgery.

Prominent young influencers like Clavicular represent the extreme side of looksmaxxing. He practices bonesmashing (using a hammer on facial bones to try to form more angular features), injects himself with testosterone, and takes meth to maintain a low body fat percentage while still having a muscular physique.

Looksmaxxing and new beauty standards

The rise of looksmaxxing seems to have a caused a ripple effect among teen boys. While the ideal look has centered on big muscles and washboard abs for decades, there’s now an added pressure on facial beauty that’s typically been reserved for girls.

“With some of the teen boys I work with, most of whom already have self-esteem issues, I think there is a lot more concern about how they look,” observes Alnardo Martinez, LMHC, director of the Pediatric OCD Intensive Program and a mental health counselor at the Child Mind Institute. “They want to have the strong jaw, really big muscles, clear skin, and a perfect haircut.”

However, Martinez notes that it sometimes take a while for boys  to admit that they feel this pressure. They may insist that they don’t really care about that stuff. “But then, maybe a few months later, it comes out that there is a lot of comparison. They’re spending a lot of time in front of the mirror or in the bathroom trying to create this perfect image,” he observes.

What teen boys think about looksmaxxing and self-improvement

We talked to young men who were critical of Clavicular and the impact looksmaxxing can have on teens but were positive about engaging in some form of physical self-improvement.

Wyatt, now 19, remembers comparing his jawline to his peers’ when he was in 7th grade. “I just felt like they had really sharp jawlines. And I was just like, ‘Oh, I want to get closer to that.’” He would also come across TikToks advertising rubber chewing blocks and chin exercises meant to strengthen the jawline.

And so, Wyatt began to do jaw exercises he’d found online, reciting the alphabet while stretching out the muscles. “I would go through my Zoom classes throughout the day and then after that was done, I’d just go into the bathroom and go through the whole exercise. It would take like an hour sometimes,” he recalls. “It turned into more like a self-care, self-improvement session. I would do that every day after my classes. I didn’t feel like I was done with school until I finished my jawline routine.” He took photos to document his progress.  

Wyatt feels like the routine had a positive effect, because he was able to see an improvement. “I felt more satisfied with myself, a little more confident.”

Lev, now 19, remembers wanting to have some control over his body when going through puberty in high school. “Puberty is not a straightforward process. It’s not all peaches and cream. Your body changes, and it can be uncomfortable,” he explains. “But with lifting and strength training, it was very exciting to see this, you know, man energy that came out of it. I wanted to harness that and really take it by the reins. Have some agency as a man.”

And while he rejects the extreme parts of looksmaxxing, Lev does regularly practice self-improvement through weight lifting, skin care routines, and taking GLP-1 weight loss medication.

How looksmaxxing can impact boys’ mental health

Since looksmaxxing places such a strong emphasis on achieving a very specific look, clinicians are concerned about its influence on teens. “Self-esteem is pretty fragile during puberty,” Martinez says. “There’s already a ton of comparison and perceived flaws that teens don’t love about themselves.”

These insecurities can be exacerbated by the type of content teens engage with online, Martinez explains. Along with ChatGPT bots specifically designed to judge aesthetics, Reddit threads such as r/Mewing and websites like Looksmaxxing Forum encourage boys to post pictures of their faces and bodies to get rated by their peers. Boys as young as 13 visit these forums, posting pictures and asking for tips on how to improve their looks.

“These are generally places where people are already pretty harsh and critical. These boys are receiving a lot more ‘confirmation’ around the perceived things that are wrong with them or that they need to change,” Martinez says. “And it just feeds into the already present negative self-image and self-talk.”

He explains that this type of social media engagement can also compound underlying mental health issues like depression and social anxiety. “They might be less likely to go out and talk to people because they’re thinking, ‘Everyone is going to see this one thing that everyone else has told me is wrong with me. So now I can’t go out,’”he says.

Martinez is also concerned that online content can negatively affect teens with body dysmorphic disorder (BDD). “If they think they have a big nose, for example, they might go on these Reddits and ask, ‘What does my nose look like? Is it too big?’ There are trolls out there. Someone is going to say yes and then that’s going to make the BDD symptoms even worse.”

When behaviors might be concerning

In some ways, teen boys taking part in more self-improvement practices could be seen as a good thing. They’re exercising, taking care of their skin, and eating more balanced diets. The issues begin when these types of practices turn into obsession. And given the underlying ideology of looksmaxxing and the nature of social media, things can become unhealthy.

According to Martinez, there are some changes in behavior to look out for that indicate you might want to step in.

One clear change, he says, is a noticeable shift in the amount of time they’re spending on grooming themselves. “Maybe they were someone who would typically just get up and run out the door without washing their face,” he says. “But now they’re spending a lot more time in the bathroom and asking a lot of questions about how they look.”

Another warning sign can be a big change in personality. “Irritability is a big one that we’ll see a lot,” he says. “They’re unhappy with how they look, so this increases a general level of irritation.”

These behaviors paired with an unusual uptick in time spent on social media, Martinez explains, can be a sign that something’s wrong and support is needed.

How to support your child

If you’re worried that your child might be engaging in looksmaxxing-related behaviors to an unhealthy degree, says Martinez, there are a few things you can do:

  • Open communication. Martinez suggests approaching your child with curiosity. “You could start the conversation by saying something like, ‘So have you heard about this? What do you think about it? Have you ever had any thoughts yourself about how you look or desires to change your body or face?’ And then give them some space to be open and vulnerable about it. Validate their experience.” 
  • Find out where your child is getting their information. “Read it together, talk about it, and see what your child thinks about it,” Martinez advises. “And if it’s promoting something dangerous, then you can talk to them about how those practices can be harmful and what could actually happen if they do some of those things.”
  • Encourage male role models. “There’s a patient I work with now who doesn’t have a present dad,” Martinez explains. “His mom tries to talk to him about things like body image, but he feels like she doesn’t understand and can’t relate. So having someone that he can talk to and be open about this stuff with, especially someone who can also share their own struggles, can be really helpful.”
  • Seek help from a mental health professional. This is especially important if you find out that your child has been engaging in extreme forms of looksmaxxing such as bonesmashing or starvemaxxing. Martinez recommends looking for a clinician who specializes in body image or body dysmorphic disorder.

A lot of parenting comes down to open communication around what your kids are seeing and what they’re feeling. We all have things about our bodies that we might not like and wish we could change, says Martinez, and it can help to normalize those feelings. “And then you can discuss how they can make changes in healthy ways,” he suggests. “Go over what’s a realistic change and what’s a dangerous change.”

The post Boys, Masculinity, and the Looksmaxxing Trend   appeared first on Child Mind Institute.

LLMs are stuck in a groupthink groove. This startup is trying to get them out.

Let’s start with a game. Open up your chatbot of choice—Claude, ChatGPT, Gemini—and type “Give me a random number between 1 and 10.” You’re going to get 7. Almost always. Now type “Another” and you’ll get 3 or 4. Type “Another” again and you’ll get 8 or 9.

That won’t work every time—but if it did for you, you may wonder if I have superpowers. I don’t.

The truth is that most large language models are stuck in a rut. They are far more predictable and far less creative in their responses than you might expect. That’s fine for tasks like coding or research, but groupthink is a problem when you’re brainstorming or planning your next vacation.

The Australian startup Springboards has a solution. It built an LLM called Flint, which has been trained to come up with a wider variety of responses than mainstream LLMs to open-ended questions such as “Where should I go in Europe?”

“Most language models are fighting hallucinations,” says Springboards cofounder and CEO Pip Bingemann. “We welcome them.”

Bingemann introduced me to the random number game when he first showed me his company’s new model. It felt like watching an illusionist with a deck of cards. “This is our sales trick, and it works every single time,” he says.

After ChatGPT and Claude both gave their 7s, Bingemann turned to Flint. It too came back with 7: “Aha, of course that was going to happen, but it’s okay—7 is a legitimate answer.” He restarted the session and prompted again: ChatGPT gave 7, Claude gave 7, Flint gave 3.7916.

Run your way

It’s not just numbers. When Bingemann asked ChatGPT and Claude to name a type of car, he predicted that it would be a Toyota or a Honda—and he was right. Flint came up with a Ford F-150. “There’s all this lost information that doesn’t get served up in these models,” he says. “They’re just as capable of saying a Buick or a Tesla. They just don’t—they’re biased.”

Bingemann sent one last prompt to each of the three models: “Give me a tagline for a campaign for New Balance running shoes. Just the tagline.” Claude: “Run your way.” ChatGPT: “Run your way.” Flint: “Built to last, run to win.” It won’t win any awards, but at least it’s different.

This weird limitation of LLMs is starting to get more attention. In November a team of researchers put out a paper, titled “Artificial Hivemind: The Open-Ended Homogeneity of Language Models (and Beyond),” that exposed a remarkable degree of repetition not only in the answers from individual LLMs but between them as well. They found that different LLMs converged on very similar answers when prompted with open-ended questions.

It’s not clear exactly why this happens, but the researchers speculate it’s because most LLMs today are trained in similar ways on similar data to do similar tasks. The team won the best paper award at NeurIPS, a major AI conference.

When the researchers asked 25 different LLMs (including models from the top US firms as well as open-source models from China and elsewhere) 50 times each to write a metaphor about time, most of the 1,250 responses were a version of “Time is a river” or “Time is a weaver.”

(I asked some of my colleagues the same question and six people gave me six different answers. My highlight: “Time is a favorite sweatshirt, shaped by a lifetime of wear.”)

When you look for it, you see repetition everywhere, says Kieran Browne, cofounder and CTO at Springboards. “The way that most chat interfaces are designed, it makes it feel like you’re having a personal conversation,” he says. “I think most people don’t really realize the extent to which they are getting the same stuff as everybody else.”

Take another example: “What should I name my band?” Most models will say something involving “glass,” “neon,” “velvet,” or “static,” says Browne.  

When I tried it, ChatGPT spat out a list of 56 band names. At the top was “Glass Harbor.” Skimming through, I found “Static Empire,” “Neon Hearts,” and “Velvet Echo.” I asked Gemini; it gave me 15 suggestions, including “Static Horizon.”

Some of the suggestions looked pretty cool, though. ChatGPT’s “Sofa Astronauts” caught my eye, so I googled it—and found that a band called Sofa Astronauts already exists. 

(OpenAI says that training models to give reliable and coherent answers can lead them to converge around familiar, high-probability responses and that pushing harder for novelty can lead to weaker or less reliable responses. It also notes that the “Artificial Hivemind” paper studied models from 2024 that have since been updated.)

Creative catapult

Springboards has developed a tool backed by a selection of LLMs, including ChatGPT and Claude, that creative professionals in advertising or marketing can use to brainstorm ideas. The tool lets you drag around text produced by different models, picking the bits that you like and combining them into something new—in theory. Springboards is pitching Flint as an alternative model that users of its tool can select when looking for more variety.

Zoe Scaman, founder of the business strategy startup Bodacious and chief strategy officer at 77X, a direct-to-fan marketing platform set up by Luka Dončić of the LA Lakers, has been trying it out. “I find it really useful for throwing me in completely different directions,” she says. “I use it if I want to catapult myself all over the place.”

In one test, Scaman pitted Flint against Claude, Gemini, and ChatGPT by giving each of the models a classic MBA case study: How would you reinvent a finance company for today’s youth? The three mainstream models all went down the same path, she says: “You know, we need to teach financial literacy in a fun and funky way—well, that’s nothing new.”

But Flint came up with something different, suggesting that the whole concept of wealth accumulation should get a rebrand. “That was really interesting,” says Scaman.

She notes that Flint is still a prototype and doesn’t work all the time. “It sometimes falls over when you start pushing it too far,” she says. “But I think that the premise behind it is really powerful.”

Taking the temperature

Springboards built Flint on top of Qwen 3, an open-source model from the Chinese tech giant Alibaba. “We’re a small team,” says Browne. “Training a foundation model is not on the table for us. It’s just too expensive.”

Most LLMs have settings that let you adjust the level of randomness in their output. The most common is called temperature. “Obviously, that was one of the first things we explored, because that’s what people tell you: If you want more creativity, you turn up the temperature,” says Browne.

But changing those settings can also make models incoherent. Dialing up the temperature on one of OpenAI’s models to its maximum setting made it produce responses that switched from English into code halfway through a sentence, says Browne.

Springboards realized that parameters were blunt instruments for what it wanted to do. It does not make sense to dial up the randomness across the board; you only want to boost it at specific points in its output, he says.

For example, when you ask a chatbot “Where should I go in Europe?” the model only needs to tweak the randomness just before it names a destination, not for every word in its response.

To make Flint do this, Springboards trained its version of Qwen 3 to identify the points in its output where more variety was possible and fill those spots with words or phrases that were a little more random.

“Flint’s programmed to throw an oddball in. It’s more of an invitation to think wider,” says Maximilian Weigl, cofounder and chief strategy officer at Uncommon, a marketing firm. “That’s super interesting.”

Weigl’s team uses Flint alongside ChatGPT, Claude, and Gemini. “You can’t really create something boundary-breaking with tools that pull you back to the average,” he says. 

And yet Weigl notes that nine times out of 10 the average is fine. You don’t always need to reach for extremes with something like Flint, he says: “Most people are fine with good enough. They want to see mass-market familiar things.”

Weigl also cautions against using any LLM too much. “I have a big problem when people rely on the output from any AI, including Flint,” he says. “If I saw people on my team copy-pasting something from AI, I’d be like, ‘That’s not your job! Think, talk to other people, use your own voice.’”

For now, Flint is aimed at advertisers and marketers because those are Springboards’s customers. But Bingemann and Browne insist that a lack of variety is a problem for anyone using chatbots.

The idea is to give people the choice and leave it to them to decide if the result is good or not, says Bingemann. “Variety is great when you’re trying to spark ideas,” he says. “Let’s go down this route instead of letting the machines do it all and ending up in a gray, boring world.”

CCRM Ireland Would Be Established to Hasten Translation of Advanced Therapies Into Patient Treatments

Rinn Advanced Therapies, Ireland’s national research center for personalized immune cell therapies, signed a Memorandum of Understanding (MOU) with CCRM, which focuses on cell and gene therapy development and commercialization. The agreement outlines a strategic collaboration to explore establishing a CCRM-affiliated advanced therapies hub in Ireland.

The proposed initiative, referred to as CCRM Ireland, is designed to position Ireland as a key node within CCRM’s global network of advanced therapies hubs and further strengthen Ireland’s expertise in next-generation biomedicine. CCRM’s global network comprises CCRM in Canada, CCRM Australia, and CCRM Nordic in Sweden.

“The idea of collaborating with CCRM to establish CCRM Ireland is very attractive because of our shared commitment to improving patient outcomes,” said Sakis Mantalaris, PhD, director of Rinn Advanced Therapies. “By combining Rinn Advanced Therapies’ focus on novel personalized immune cell therapeutics with CCRM’s global platform, CCRM Ireland can accelerate the translation of cutting-edge science into accessible, high-quality treatments.”

Through this collaboration, Rinn Advanced Therapies will lead the evaluation of how Ireland’s integrated ecosystem—spanning academia, health care, biomanufacturing and research—can be aligned with CCRM’s model for accelerating the development of advanced therapies. The partnership will explore how to advance the design and clinical translation and delivery of personalized immune cell therapies, while also leveraging Ireland’s biopharmaceutical manufacturing skills.

CCRM Ireland would potentially support investment, venture creation and commercialization pathways, following CCRM Canada’s proven model.

“As cell and gene therapies move from scientific promise to clinical reality, no single organization, region or country can build this industry alone,” says Michael May, president and CEO, CCRM. “CCRM’s global hubs are designed to connect world-class research, manufacturing expertise, capital and talent into a coordinated network that accelerates the development and commercialization of advanced therapies.

By creating hubs around the world, and in the spirit of the Prime Minister of Canada’s call for middle-power countries to work together, with CCRM Ireland, we can help innovators overcome barriers to scale, strengthen local ecosystems and, most importantly, bring life-changing treatments to patients faster.”

Rinn Advanced Therapies brings together a network that includes universities, hospitals, and national organizations with a shared mission to develop and deliver personalized immune cell therapies that are more effective, accessible and affordable for patients.

CCRM will contribute its expertise in establishing and operating advanced therapies hubs, drawing on its experience in Canada and its growing international network. This includes proven frameworks in governance, GMP manufacturing, quality systems and commercialization.

 

The post CCRM Ireland Would Be Established to Hasten Translation of Advanced Therapies Into Patient Treatments appeared first on GEN – Genetic Engineering and Biotechnology News.

Adherence to a Digital Knee Rehabilitation Platform Among Patients With Knee Osteoarthritis and Anterior Cruciate Ligament Reconstruction in Hong Kong: Qualitative Study

Background: Exercise therapy is fundamental to rehabilitation for knee osteoarthritis and anterior cruciate ligament (ACL) reconstruction, yet adherence to prescribed exercise typically declines once clinical supervision ends. Digital rehabilitation platforms offer a promising means of supporting sustained exercise adherence, but qualitative evidence on how patients experience these platforms in real-world clinical practice remains limited, particularly in non-Western health care contexts. Objective: This study aimed to explore how patients with different knee conditions experienced the Healthy Knees digital rehabilitation platform in Hong Kong and to identify the factors shaping their platform engagement and exercise adherence. Methods: A qualitative design was adopted using reflexive thematic analysis. Fifteen adults (9 with ACL, 6 with osteoarthritis) who had been prescribed the Healthy Knees web-based platform at Prince of Wales Hospital participated in semistructured, in-person interviews (30‐45 min). Interviews were conducted in Cantonese or Mandarin, transcribed verbatim, translated into English, and analyzed inductively. Ethics approval was obtained from the Chinese University of Hong Kong and the University of New South Wales. Results: Participants were aged 21 to 79 years, with most being male (11/15). Younger participants were predominantly patients with postoperative ACL, while older participants were predominantly patients with preoperative osteoarthritis. Three interrelated themes were identified, collectively describing the fit between the platform and participants’ contexts. Content fit captured the alignment between exercise content and rehabilitation needs; participants across both groups perceived substantial overlap with existing physiotherapy, and content was often mismatched to their recovery stage. Motivational fit captured the alignment between platform support features and motivational needs; pain functioned as both a driver and a deterrent to exercise, and participants ranged from highly self-directed to reliant on external scaffolding, not following a simple age pattern. Access fit captured the alignment between the platform’s delivery mechanism and participants’ technological circumstances; QR code–dependent access, absence of a dedicated mobile app, and display issues created friction that led several participants to migrate to alternative resources, maintaining exercise adherence while abandoning platform engagement. Conclusions: Adherence to digital knee rehabilitation was shaped by the degree of fit between the platform and users’ contexts across content, motivational, and access dimensions. When access fit failed, participants often substituted alternative exercise resources rather than ceasing exercise entirely, highlighting a distinction between platform engagement and exercise adherence. As the sample’s clinical and demographic characteristics were closely linked, these findings should not be interpreted as diagnostic comparisons between ACL and osteoarthritis populations but as patterns shaped by the recovery phase and age. These findings suggest that digital rehabilitation platforms should incorporate adaptive content aligned with the recovery stage, integrated feedback mechanisms, and reduced access friction to sustain platform engagement within an ecosystem of competing alternatives.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/7a14e974f70af5794765b21582feb228" />

Sleep Habits Can Influence Effects of Alzheimer’s Disease Risk Genes

Research led by Edith Cowan University in Australia suggests the impact of genetic mutations that impact Alzheimer’s disease risk are influenced by a person’s sleep habits.

As reported in the journal Alzheimer’s & Dementia, the researchers confirmed links with aquaporin-4 gene (AQP4) variants and changes in brain volume, atrophy and cognition linked to Alzheimer’s disease.

The investigators also showed how long people sleep, how long it takes them to fall asleep, how often their sleep is disturbed, and how good or poor their sleep is overall contributed to the effect of these mutations.

“Our study shows that individuals carrying certain AQP4 variants showed faster grey matter loss when they reported shorter sleep,” said study co-author Ayeisha Milligan Armstrong, PhD, a researcher at Edith Cowan University, in a press statement.

“It’s not just which genes you carry—it’s how those genes interact with the world around you. The same variant can look protective or detrimental depending on how someone is sleeping. That’s important, because sleep is one of the few modifiable factors people can actually act on.”

Researchers now think the brain gets rid of amyloid‑beta using a kind of plumbing system that washes waste away along the outside of blood vessels. In this system, fluid moves through the spaces around blood vessels, helped by tiny water channels called aquaporin‑4, encoded by AQP4, which sit on the parts of astrocyte cells that wrap tightly around those vessels.

“Given that AQP4 has been identified as an important mediator of brain amyloid beta clearance, variation within the AQP4 gene has been investigated in relation to neurodegenerative diseases and their associated phenotypes,” write the authors.

“A bi-directional relationship has been observed between suboptimal sleep and increasing brain amyloid beta accumulation…Importantly, a previous study utilizing data from the Australian Imaging, Biomarker and Lifestyle cohort reported that the relationship between sleep and cross-sectional brain amyloid beta burden was moderated by genetic variants in AQP4.”

To investigate this link further, the researchers studied 351 cognitively normal people already showing ongoing build‑up of brain amyloid‑beta on positron emission tomography (PET) imaging. They genotyped the group for 13 mutations in the AQP4 gene and also assessed sleep duration and quality, brain volume, amyloid burden and cognition scores.

Several AQP4 variants interacted with sleep measures to predict gray‑matter atrophy, brain ventricular volume, white‑matter volume, and cognitive decline. For example, people carrying certain variants who also had shorter sleep duration were more likely to have faster grey‑matter loss, and other variants magnified the impact of poorer global sleep quality on ventricular enlargement in the brain.

One variant showed a direct association with better global cognitive performance and two other variants seemed to be linked to less cognitive decline as sleep disturbances increased.

“We’ve known for a while that poor sleep and Alzheimer’s risk are linked,” said first author Tenielle Porter, PhD, also a researcher at Edith Cowan University.

“What this shows is that rather than assuming everyone at risk follows the same pathway, a more targeted and personalized approach to Alzheimer’s prevention may be needed. But we’re not at the point of recommending genetic testing; our findings need replication in larger and more diverse cohorts.”

The post Sleep Habits Can Influence Effects of Alzheimer’s Disease Risk Genes appeared first on Inside Precision Medicine.

StockWatch: Positive Phase III Data Sells Investors on Intellia

A second positive Phase III data readout in two months is a major reason why Intellia Therapeutics (Nasdaq: NTLA) shares have soared more than 76% over the past six months—including a 29% surge this past week that followed the CRISPR gene editing therapy developer’s lead pipeline candidate lonvoguran ziclumeran (lonvo-z) meeting three key secondary endpoints in a pivotal study in patients with hereditary angioedema (HAE).

Lonvo-z met the Phase III HAELO trial’s (NCT06634420) primary endpoint, Intellia announced back in April, by showing an 87% reduction (p<0.0001) in mean monthly attacks in the lonvo-z arm vs. the placebo arm during the efficacy evaluation period (weeks 5-28). Lonvo-z also aced the trial’s key secondary endpoint by showing that 62% of the 52 patients in the lonvo-z arm were entirely attack-free and therapy-free for the six-month efficacy evaluation period, vs. just 11% of the 28 patients in the placebo arm (p<0.0001).

On June 13, Intellia presented and published additional data showing lonvo-z to have achieved positive results on three other key secondary endpoints:

  • Monthly rate of attacks requiring on-demand treatment, Weeks 5–28, mean (0.19 vs. 1.79, 95% CI).
  • Monthly rate of moderate/severe attacks, Weeks 5–28, mean (0.11 vs. 1.23, 95% CI).
  • Change from baseline to Week 28 in AE-QoL total score, mean ( — 23.51 vs. — 6.47, 95% CI).

Intellia presented the data at the European Academy of Allergy & Clinical Immunology (EAACI) Annual Congress 2026 in Istanbul, Türkiye, and published the results in The New England Journal of Medicine.

The data was strong enough for Intellia to continue the rolling Biologics License Application (BLA) submission that it began in April. The company expects to complete the BLA filing by year’s end and hopes to gain FDA approval and launch lonvo-z in the first half of 2027.

“Super pleased”

“We were super pleased with the results that we saw,” John Leonard, MD, Intellia’s president and CEO, told GEN. “We’re essentially replicating what we’ve seen throughout the program, where most of the patients reached a status of no attacks, no therapies over the course of this extended observation period. For those patients who didn’t, they appeared to be on their way to reaching that kind of a state. And critically important was that every single patient who got the drug was off long-term prophylaxis.”

“Across the board, and across all subgroups, the drug performed extremely well. So, we think it speaks to physicians, it’s going to speak to payers in terms of how they think about the drug and its ultimate, excellent utility,” Leonard said.

Investors and analysts appeared to share that enthusiasm this past week, as Intellia’s stock price rose over three of the four trading sessions following the release of data on the secondary endpoints. Intellia shares jumped 23% on June 15, the first trading day since the news, rising from $12.11 to $14.92. After a day of profit-taking that saw shares dip 2.5%, to $14.55, Intellia’s stock resumed its upward trajectory, rising nearly 4.5% to $15.20 on Wednesday, then another 3% Thursday, closing the week at $15.67. Markets were closed on Friday for the Juneteenth holiday.

Since December 18, 2025, when Intellia shares closed at $8.88, the stock has soared nearly 76.5%, accounting for most of its one-year gain of 62%. Lonvo-z accounted for three of Intellia’s four stock price peaks in 2026: The dosing of the first patient in HAELO, announced January 22, led the stock to climb 13%, from $14.03 to $15.90.

Shares surged 12% March 2, from $13.78 to $15.44, when the FDA lifted a clinical hold on the company’s Phase III MAGNITUDE trial (NCT06128629) assessing nexiguran ziclumeran (nex-z) in transthyretin amyloidosis with cardiomyopathy (ATTR-CM). The FDA imposed the hold after an elderly patient died during a study of Nex-z, an in vivo CRISPR-based therapy developed in partnership with Regeneron Pharmaceuticals (Nasdaq: REGN) to treat ATTR-CM by inactivating the TTR gene.

The third peak, an 8% gain from $15.31 to $16.57 on April 22, followed Intellia reporting positive data for lonvo-z, showing that it met HAELO’s primary endpoint, while the fourth peak followed the secondary endpoint announcement.

Misperceived market

“Hereditary angioedema has, in the last 10 to 15 years, had a variety of therapies arrive that are better than the ones that were there 20 years ago. Twenty years ago, circumstances were pretty grim for patients with HAE,” Leonard recalled. “I think some investors have looked at this incorrectly as a satisfied market, only because there are other therapies available.”

Among those therapies are three that won FDA approval last year. Last August, the agency approved Dawnzera® (donidalorsen), a prekallikrein-directed antisense oligonucleotide designed to prevent HAE attacks in patients ages 12+, marketed by Ionis Pharmaceuticals (Nasdaq: IONS). A month earlier, the FDA authorized Ekterly® (sebetralstat), a plasma kallikrein inhibitor indicated for the treatment of acute attacks of HAE in patients ages 12+, marketed in the United States by KalVista Pharmaceuticals (Nasdaq: KALV).

And in June 2025, the FDA approved Andembry® (garadacimab-gxii), an activated Factor XII (FXIIa) inhibitor (monoclonal antibody) and the first long-term prophylactic HAE treatment designed to target Factor XIIa, administered as a once-monthly subcutaneous injection for patients ages 12+, marketed by CSL Behring, the largest business unit of Australian-owned CSL (ASX: CSL).

“What we’re showing is that a lot of efficacy and a lot of utility has been left on the table, and that it’s possible for patients to get pretty close to something resembling a normal person who does not have HAE and all of the things, benefits that come with that,” Leonard said. “As people have looked at the data more completely, I think they’re seeing more and more that that’s the case, and maybe some of those original premises that they had are not quite correct.”

In research notes, three analysts said Intellia’s latest data strengthened the company’s future case to regulators for pursuing approval of lonvo-z as a one-time HAE treatment.

“We view these data as furthering Intellia’s case for regulatory approval following its expected completion of a rolling BLA,” Myles R. Minter, PhD, a partner and biotechnology analyst with William Blair, wrote June 15.

A day earlier, Jefferies equity analyst Maury Raycroft, PhD, commented that Intellia’s latest data will help lonvo-z gain more than a foothold in the HAE market.

“Positive implications”

“Big picture, we believe total HAE data have positive implications for commercial positioning” of lonvo-z, Raycroft wrote. “Editing is expected to be durable (we have seen longer term ph.I/II data out to 3-yrs); therefore, NTLA’s approach could eliminate need for lifelong chronic tx [therapy], justifying the value proposition of a 1X tx, despite competition in a crowded HAE space.”

Raycroft cited market research from Intellia showing that 64% of surveyed patients on LTPs [long-term prophylaxis drugs] are extremely likely to transition to a one-time therapy, while 54% surveyed docs expressed intent to prescribe such a treatment.

Mani Foroohar, MD, senior managing director, genetic medicines, and a senior research analyst with Leerink Partners, said Intellia’s latest results “again demonstrate lonvo-z’s clean safety and best-in-class efficacy and convenience.”

Writing in NEJM, the team of HAELO investigators reported no serious adverse events in patients treated with lonvo-z: “The most common adverse reactions were infusion-related reactions, which were generally transient and resolved without intervention. Elevated levels of serum aspartate aminotransferase and alanine aminotransferase, which occurred in approximately 10 to 15% of patients treated with lonvo-z, were transient, asymptomatic, and resolved without intervention.”

Foroohar sided with optimistic investors over their pessimistic counterparts in arguing that patients will warm up to a one-time treatment, though it will likely be costlier than current therapies.

Bears and bulls

“Bears argue limited patient demand to move up the innovation curve in a market with several approved treatments. We take the other side of this and see onetime therapy (vs lifetime chronic dosing) and patient desire to be attack-free as potent tailwinds to adoption,” Foroohar wrote. “Longer follow-up and crossover data (caveat – small n [number of patients studied]) provide an early glimpse at the improving profile of lonvo-z over time. We look to more data ahead of 1H27 launch to further educate physicians/patients.

“Subgroup analyses demonstrate clear benefit across all patient populations (prior LTP use, historical attack severity/frequency, etc.), supporting broad uptake as SoC [standard of care] across HAE—recognizing this will take time to play out as physicians gain comfort with this (likely) first approved in vivo gene editing therapy,” Foroohar added.

Intellia has not set a price for lonvo-z.

“We have said publicly we’re not going to set any new records beyond prices that have been precedented,” Leonard said.

HAE patients, he continued, “are some of the most costly patients that payers have. They’re small in number, but high in cost, with the therapies they take and their healthcare resource utilization exceeding $1 million a year.

“When you consider that these are patients that are oftentimes treated, or first diagnosed in adolescence or young adulthood, the lifetime costs are frighteningly high,” Leonard explained. “We are confident that, and we have this as an intended outcome, that we will save lifetime health, resources in very, very substantial terms, in a way that payers see and can recognize. We want to make it easy for patients to get onto the therapy, and we want to make it very competitive, cost-competitive for physicians taking care of them.”

Leaders and laggards

  • Elicio Therapeutics (Nasdaq: ELTX) shares plunged 72.5% from $14.85 to $4.08 on June 15 after the developer of immunotherapies to treat high-prevalence cancers said it was evaluating multiple strategic financing and partnership opportunities to advance its planned Phase III adjuvant pancreatic cancer immunotherapies program and broader AMP platform. The action came after ELI-002 7P, a 7-peptide formulation of its lead candidate ELI-002, failed the Phase II AMPLIFY-7P trial (NCT05726864) in patients with mKRAS-driven pancreatic ductal adenocarcinoma (PDAC). ELI-002 7P missed the pre-specified primary endpoint of disease-free survival (DFS) in the intent-to-treat population. Elicio said the ELI-002 7P arm had a higher proportion of R1 resected (higher residual disease) patients vs. the observation arm (19% vs. 10%), and that post-hoc analyses showed significant DFS improvement (R0: HR 0.65, p=0.048) in the 121 lower residual disease (R0 completely resected) patients, a subgroup representing approximately 84% of enrolled patients. Elicio said the trial results will shape a Phase III strategy focused on a defined R0 resected population and additional ELI-002 7P dosing.
  • Neumora Therapeutics (Nasdaq: NMRA) shares plummeted 49% from $1.78 to 91 cents on June 15 after the brain disease drug developer said it was chopping its workforce by approximately 35% or about 34 jobs, ending development of its major depressive disorder (MDD) candidate navacaprant, and refocusing on advancing the rest of its pipeline. The actions came after navacaprant missed statistical significance on the primary and key secondary endpoints of the Phase III KOASTAL-2 trial (NCT06058013) and KOASTAL-3 trial (NCT06058039) in MDD. The primary endpoint was the change from baseline to week 6 on the Montgomery-Åsberg Depression Rating Scale (MADRS).  Neumora projected the job cuts would save it approximately $10 million annually, to be partially offset this year by approximately $2 million in one-time restructuring costs. Neumora said current cash and cash equivalents are expected to provide runway into Q3 2027, including multiple expected key clinical milestones. Neumora’s pipeline includes NMRA-511 in Alzheimer’s disease agitation, NMRA-898 in schizophrenia, and NMRA-215 in cardiometabolic disease.
  • uniQure (Nasdaq: QURE) shares zoomed 78% from $26.99 to $48.16 Wednesday after the gene therapy developer announced the FDA’s revised position that a three-year analysis from its two-trial, Phase I/II study (United States, NCT04120493, and Europe (NCT05243017) of AMT-130 in Huntington’s disease was now acceptable as the primary basis of a Biologics License Application (BLA) for accelerated approval of the gene therapy. Researchers hailed “game-changing” data last year showing significant slowing of Huntington’s disease (HD) progression, but the FDA disagreed while its Center for Biologics Evaluation and Research (CBER) was headed by Vinayak (Vinay) Prasad, MD, who resigned in April. uniQure said the FDA seeks to align on the confirmatory study design prior to the BLA submission, including considering allowing concurrent control on standard-of-care therapy instead of a sham procedure. “FDA communicated that they would work as expeditiously as possible with uniQure on this effort. The company is committed to conducting the confirmatory study without delay and expects to further align with the FDA on the details of such a study prior to BLA submission,” uniQure stated.

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