<![CDATA[New rapid-acting and long-acting injectables help bridge hospital-to-community care, cutting post-discharge nonadherence and relapse risk.]]>

RutiSafeNet: a behavioral risk and nursing workload monitoring tool for open-door acute inpatient mental health units

IntroductionOpen-door policies for acute inpatient mental health units (AIMHU) have shown promising results in reducing coercive measures, but concerns remain among patients and staff regarding increased workload, constant surveillance, and potential safety risks associated with these policies. This study aims to develop a monitoring tool to facilitate safety management in AIMHUs by monitoring behavioral risks and nursing workload.MethodsThis study employed a qualitative approach using the content analysis method. Data were collected through three in-depth interviews and two focus groups involving staff (n=19) from the AIMHU of the hospital.Results34 items were identified to define behavioral risks related to self-harm and suicide, aggressiveness, and absconding, alongside factors affecting nursing workload. These items were categorized into three levels of risk: low, moderate, and high.DiscussionRutiSafeNet is a preliminary, observation-based monitoring prototype intended to support, rather than to predict, structured risk and workload monitoring in acute inpatient mental health units. As a qualitatively developed instrument, it requires psychometric validation, including inter-rater reliability, construct and criterion validity, predictive value, and clinical feasibility, before it can be implemented as a validated scale in clinical practice.

Closing the data loop in AI-driven drug discovery

Drug discovery is a high-cost, high-risk endeavor that is under growing pressure from a market increasingly defined by first-mover advantage.

Since the 1950s, the cost of developing new pharmaceuticals has roughly doubled every nine years—a phenomenon known as Eroom’s Law. Today, bringing a new drug to market takes an average of 10-15 years and costs anywhere from $1 billion to $2.5 billion, with failure rates upward of 90%.

AI has become the pharmaceutical industry’s biggest bet on bringing success rates up and timelines down. The faster drug companies can identify, test, and optimize new chemical compounds, the lower the risk of costly failures later in development.

“The main cost in drug discovery is still the clinical phase, so trying to reduce risk and increase your success rates there is obviously hugely beneficial,” says Paul Belcher, director of protein research strategy at global life sciences company Cytiva. “AI is one approach that drug companies hope will not only save time and compress timelines, but enable better quality candidates to reach the clinic.”

Early use of AI in drug discovery shows potential, but also highlights the need for robust and authentic data, as well as integration in lab systems.

AI brings efficiency to the lab

One of the most promising early-stage applications of AI in drug discovery is in hit identification. This involves screening libraries of molecular entities against a disease-related target, such as a protein, to find molecules that bind to it. A successful hit gives researchers a starting point for further testing and refinement, with the aim of eventually developing a viable drug.

Belcher has seen a shift from empirical screening to predictive design: Instead of physically screening libraries, drug companies are now using AI to design drug candidates from scratch and predict how they will interact with disease targets before committing anything to research and development (R&D).

This means companies are no longer limited by how much they can physically screen to identify starting points. “AI does away with that,” says Belcher. “And it can help eliminate low-quality candidates before you have to physically test them, saving time and resources.”

What AI can’t do yet is reliably predict kinetics or developability of new compounds, says Belcher. This means every AI-generated candidate still needs to be validated in the lab.

Traditional screening workflows were built to identify hits at scale, not to profile large numbers of complex candidates in detail. This is placing more pressure on lab teams, who now have to test, characterize, and purify a growing volume of more diverse, AI-generated compounds.

“The current techniques used in hit identification can screen hundreds of thousands, sometimes millions of compounds, using binary or threshold-based techniques producing low-fidelity data—yes-or-no responses,” Belcher explains. “AI can increase the number of hits you get and potentially give you better quality hits as well. That increases demand for higher-throughput, information-rich technologies to then validate and characterize those hits.”

Models need complete, quality data

As AI has accelerated demand for data-rich lab systems, it has also highlighted a fundamental need for better, more complete data.

Many earlier AI models were trained on publicly available datasets and are now hitting what Belcher calls a data wall. Because models have access to the same data, they all reach similar conclusions, with diminishing returns over time. Additionally, the datasets weren’t built with AI in mind, meaning they lack the structure, labeling, and diversity needed to keep models accurate and free of bias.

Publication bias reinforces the problem. “Most publicly available datasets and scientific publications focus exclusively on positive results,” says Belcher. “No one wants to share their failures. This bias is almost like having one hand tied behind your back. AI models can identify patterns associated with success, but they lack the comprehensive understanding of failures that would make predictions more reliable.”

The data Belcher believes would markedly improve models—the failed experiments, the compounds that don’t bind—remains frustratingly difficult to come by. “We often joke that there should be a journal of negative data,” he says. “It’s often buried in lab notebooks, and it’s never used to inform or guide future research.”

This lack of negative data creates a fundamental problem: Without access to a broad range of data, models can’t be adequately trained to avoid bias. “In all machine learning applications, the model’s performance relies heavily on the quality and scope of the training data,” notes Belcher.

Fabrication has also become much easier with AI, compounding concerns around data integrity. Take Western blots, for example. These are part of a standard technique for identifying proteins in blood or tissue samples, and they are among the most common targets for manipulation in biomedical research. Belcher cites research by Dutch microbiologist Elisabeth Bik, who found that almost 4% of biomedical papers contained duplicated or manipulated images. This was back in 2016, before generative AI made fabrication trivial.

“Manipulated or faked data has always been a problem in science, but in the AI world, especially when used to train models, it could have potentially disastrous consequences,” says Belcher. “There needs to be more tools to verify that data is not manipulated.”

Some vendors are starting to tackle this challenge. Belcher points to solutions like Cytiva’s Image Integrity Checker, for instance, which uses secure hash algorithms—the same technology used in blockchain—to detect whether scientific images have been tampered with. “We’re starting to see a lot of interest from publishing houses that want to adopt this as standard because it’s a quick way to ensure that what gets published in the literature is genuine,” he adds.

Autonomous labs could accelerate breakthroughs

Belcher describes the future state of drug discovery as fully autonomous labs that run with minimal human intervention. Foundational to this vision is consistency in data and infrastructure.

These AI-driven dark labs, or labs-in-the-loop, operate around the clock. They cycle through prediction, testing, and optimization, and then feed results back into AI models to guide the next round of experiments. This can improve the success rates of drug candidates entering clinical trials, says Belcher. Better starting points, combined with more rounds of optimization, should result in better candidates with fewer liabilities reaching the clinic.

But automating a lab depends heavily on integration. That means interoperable systems, highly structured and comprehensive datasets, and information flowing easily in and out. Most labs aren’t there yet. “Today, a lot of the instruments in labs are standalone,” Belcher notes. “You can have the best technology in the world, but if it’s a closed ecosystem—if the user can’t get the data out—it doesn’t do any good.”

An integrated infrastructure can enable labs to generate FAIR (findable, accessible, interoperable, and reusable) data at scale. This would not only inform individual lab reports, but could also train subsequent generations of AI models, effectively closing the loop between the computational, AI-driven dry lab and the physical wet lab.

“Our goal is to help scientists and researchers accelerate their breakthroughs and make that future state of autonomous labs a real possibility,” says Belcher. “We want to help them generate reliable data, simplify workflows in discovery, and hopefully enable what they’re working on to become tomorrow’s life-changing therapies, faster and with greater confidence.”

On costs and what comes next

AI-driven drug discovery is still in its early days. Notably, no drug discovered primarily through AI-driven design has yet received full FDA approval—although Belcher expects that to change in the next two to three years.

How big of an impact could AI eventually have on drug discovery? “The holy grail would be full in silico prediction of efficacy and toxicity, eliminating the need for the vast majority of physical wet lab work,” says Belcher. But there are many barriers to this beyond the maturity of the models, including regulatory hurdles and cost challenges.

A Stanford study found that the cost of training frontier AI models has more than doubled every year since 2016, adding more financial pressure to a sector already defined by exceptionally high R&D spend.

Belcher acknowledges the tension, but remains optimistic about what’s ahead. “I think we’ll get to a point where there’s a balance between AI and wet work, from a cost perspective and a risk perspective,” he says. “As long as the cost of compute doesn’t ever outweigh the cost of clinical development, I think AI is going to be an advantage.”

Learn more about how Cytiva is using faster discovery to reshape protein purification workflows.

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.

Lessons From Building a Large, Public HIV-Related Database in Support of the Ending the HIV Epidemic in the US Initiative

The HIV epidemic remains a national priority in the United States, and the Ending the HIV Epidemic initiative has renewed the call for expanded prevention and treatment strategies capable of reducing new HIV infections by 90% by 2030. Achieving this goal requires robust, integrated data for understanding HIV-related needs, barriers to care, and the effectiveness of interventions. However, despite the existence of numerous publicly available datasets, few integrate multiple domains such as HIV outcomes, social determinants of health, and community-level factors. The lack of unified data and difficulty linking datasets hampers efforts for meaningful cross-domain analyses to tailor HIV management and treatment strategies. The resulting fragmentation constitutes a methodological gap: implementation teams lack replicable guidance for constructing unified HIV and contextual databases from public sources. In this viewpoint, we describe our experience building a unified compilation of publicly available HIV and community data to identify factors influencing HIV outcomes and interventions. The completed database comprises 242 variables drawn from 8 public sources mapped across clinic, zip code, county, and state levels of geography. Rather than simply reporting what we built, we position four core decisions as transferable methodological advances: (1) treating source identification as a bounded phase before construction begins, (2) adopting automated data engineering tools from the outset rather than manual entry, (3) establishing a shared data dictionary before the first variable is entered, and (4) integrating quality control throughout the workflow rather than as a final phase. The build required approximately 350 total project hours and revealed an initial spot-check error rate of approximately 33%, which we attribute primarily to manual data entry. By sharing the approach used to develop this database and making the final resource publicly accessible through the Yale Center for Methods in Implementation and Prevention Science, we aim to reduce barriers to data access and encourage similar data integration efforts. The methodological framework described in this paper is intentionally designed to be replicable with modest resources, and we present it as a practical model for research teams operating without specialized infrastructure. Consolidating HIV, social determinants of health, and contextual variables into a unified data source is a critical step toward enabling deeper, more comprehensive analysis and supporting ongoing efforts to end the HIV epidemic in the US.
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Clinical warning signs preceding severe suicide attempts requiring pediatric intensive care in children and adolescents

BackgroundChildhood suicide attempts requiring pediatric intensive care unit (PICU) admission represent some of the most severe forms of self-harm and are associated with substantial morbidity and mortality. This study aimed to identify potential psychosocial factors and clinical warning signs preceding severe suicide attempts in children and adolescents.MethodsThis retrospective study was conducted in the PICU of Van Regional Training and Research Hospital between January 2017 and January 2025. Children aged 8–18 years admitted following intentional self-harm or suicide attempts were eligible. Survivors participated in structured face-to-face interviews. For deceased patients, information was obtained from at least three first-degree relatives and corroborated using medical records and reports from treating physicians.ResultsDuring the study period, 256 individual patients accounted for 289 suicide-related PICU admissions, of whom 116 met the inclusion criteria. The cohort included 81 females (69.8%) and 35 males (30.2%), with a mean age of 15.5 ± 2.1 years. Patients were classified according to the presence of documented healthcare encounters within the preceding year: Group 1 (80/116, 69.0%) had at least one prior healthcare contact for potential warning signs, whereas Group 2 (36/116, 31.0%) had none. Group 2 patients were younger, more frequently aged 8–13 years, and experienced significantly higher morbidity and mortality. Mortality was significantly higher among boys aged 8–13 years. The highest mortality rates were observed among patients with gender identity-related distress (3/3) and pregnant adolescents reporting violations of sexual consent (3/4), although these findings were based on very small subgroups.ConclusionsNearly 70% of children who attempted suicide had prior healthcare encounters for potentially recognizable warning signs, including psychosomatic complaints, humiliation or bullying, exposure to violence, and gynecological presentations. These findings highlight opportunities for earlier recognition of psychosocial distress during routine clinical encounters. Given the retrospective single-center design and absence of a non-suicidal comparison group, the results should be considered exploratory and hypothesis-generating rather than predictive.

Opinion: How midwives like me can help fight medical misinformation

In the dimmed light of a hospital room in Nevada, the placenta — blue and shining — has just delivered. I coaxed it gently, spinning the warm, bloody organ and twisting the trailing membranes into a compact coil, leaving nothing behind. Even a small fragment of placenta or membrane can prevent the uterus from contracting properly, failing to squeeze shut the great vessels that have spent 40 weeks surging with blood to feed a growing baby. If those vessels do not abruptly close, blood continues pumping into the empty uterus and a hemorrhage begins.

I am always vigilant for bleeding — but today I am also uneasy. My patient has made it clear that she does not consent to blood products, even in an emergency. She will not risk receiving blood from a donor who has been vaccinated against Covid-19. No hospital or blood bank tracks donor vaccine status, because it poses no known transfusion risk — but no fact will change her mind.

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From emotion regulation to suicide-specific coping: a qualitative study of self-regulatory processes in suicidal crises

IntroductionNegative affect is strongly associated with suicidal thoughts and behaviors (STBs). Accordingly, the ability to regulate intense negative affective states may be central to understanding the emergence and maintenance of STBs. However, very little is known about how individuals with lived experience regulate negative affect and cope with suicidal thoughts and urges. This study aimed to explore emotion-regulation strategies (ERS) and suicide-specific coping strategies (SCS) used during suicidal crises, their perceived effectiveness, and the situational and contextual factors influencing their selection.MethodsSemi-structured interviews were conducted with 12 individuals admitted to a psychiatric hospital due to an acute suicidal crisis. Data were analyzed using qualitative content analysis.ResultsBefore and during suicidal crises, participants predominantly used avoidance-oriented ERS that contributed to the maintenance of negative affect. With increasing distress, suicidal thoughts emerged as an additional ERS, providing short-term relief while contributing to the intensification of the suicidal crisis over time. A broad range of SCS was identified, differing in their motivational orientation toward suicidal behavior. Suicide-approach strategies (e.g., suppression, substance use, preparatory behaviors) often facilitated the escalation of the suicidal crisis, whereas suicide-avoidant strategies (e.g., seeking support, safety strategies) were context-dependent and not consistently effective. Strategy selection and effectiveness were shaped by situational and contextual factors.ConclusionSuicidal crises can be understood as dynamic, context-dependent self-regulatory processes characterized by escalating emotional distress, changes in strategy use, and dynamic regulatory resources. Interventions should focus on strengthening flexible coping repertoires and preserving self-regulatory capacity. Future research should further investigate these processes to improve prevention and intervention efforts.

Opinion: The U.S. pharmaceutical supply chain problem is not about China

In 2025, there were 216 active drug shortages in the U.S., impacting Americans’ access to lifesaving medications. The resilience of our pharmaceuticals supply chains has been increasingly framed as a national security issue, including by the White House — and rightly so, as Covid-19 magnified the massive costs of a health system ill-equipped to care for its population.

But this national security framing has heavily skewed toward a U.S.-China competition lens, distracting from the real root causes of our pharmaceuticals supply chain vulnerabilities: inadequate regulation of an industry that tends to prioritize profit over America’s health.

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3-Dimensional Optical Scanning to Assess and Monitor Malnutrition in Eating Disorders (3D-ED) Study

Conditions: Anorexia in Adolescence; Anorexia Nervosa; Anorexia Nervosa, Atypical; Anorexia Nervosa, Binge Eating/Purging Type; Anorexia Nervosa Restricting Type; Anorexia Nervosa With Significantly Low Body Weight; Body Composition Changes; Growth & Development; Malnutrition Severe; Malnutrition, Calorie

Sponsors: University of California, San Francisco; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); Denver Health and Hospital Authority; University of Hawaii

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