Background: Since their introduction with the Digital Care Act in 2019, DiGA are a part of the German statutory healthcare system. In order to become a DiGA, mHealth apps have to complete a certification process covering both technical and evidence related aspects. After completion, DiGA are added to the DiGA-directory, containing a list of all reimbursable DiGA within German statutory health insurance (SHI). The first apps were added at the end of 2020 with the number steadily increasing. The novelty of the introduction leads to problems and barriers to optimal use along the way, which is studied from different stakeholder perspectives in this research article. Objective: The aim of the survey was to identify problems and barriers in the context of certification, financing and use of DiGA in Germany. Methods: We used semi-structured expert interviews to evaluate the perspective of stakeholders of the German healthcare system on DiGA. The interview guide was developed according to Helfferich, the interviews were transcribed and analyzed using the qualitative content approach by Mayring and Kuckartz. Results: We identified problems from stakeholder perspectives regarding the certification/admission, financing and service distribution regarding DiGA. The interviewed stakeholders reported problems with authorization of DiGA and the corresponding process. DiGA prices and the different negotiation positions were criticized, as well as financial challenges for smaller DiGA-manufacturers. Within service provision, technical problems, e. g., with activation codes or software surrounding DiGA-prescription were mentioned. Problems were also seen in insufficient knowledge and skills on the side of the patients as well as the medical providers. Conclusions: mHealth applications provide potentially disruptive innovations within the healthcare sector. Nevertheless, since the evidence-based and regulated use of this technology is relatively new there are still problems and barriers limiting the optimized, patient-centered use. This study provides an overview of problems in the context of DiGA in Germany from the stakeholder perspective. Since other countries showed interest in potentially adopting the German system, valuable implications can be drawn from this survey.

arXiv:2601.18226v2 Announce Type: replace Abstract: Conventional agent systems often struggle in open-ended environments where task distributions continuously drift and external supervision is scarce. Their reliance on static toolsets or offline training lags behind these dynamics, leaving the system's capability boundaries rigid and unknown. To address this, we propose the In-Situ Self-Evolving paradigm. This approach treats sequential task interactions as a continuous stream of experience, enabling the system to distill short-term execution feedback into long-term, reusable capabilities without access to ground-truth labels. Within this framework, we identify tool evolution as the critical pathway for capability expansion, which provides verifiable, binary feedback signals. Within this framework, we develop Yunjue Agent, a system that iteratively synthesizes, optimizes, and reuses tools to navigate emerging challenges. To optimize evolutionary efficiency, we further introduce a Parallel Batch Evolution strategy. Empirical evaluations across five diverse benchmarks under a zero-start setting demonstrate significant performance gains over proprietary baselines. Additionally, complementary warm-start evaluations confirm that the accumulated general knowledge can be seamlessly transferred to novel domains. Finally, we propose a novel metric to monitor evolution convergence, serving as a function analogous to training loss in conventional optimization. We open-source our codebase, system traces, and evolved tools to facilitate future research in resilient, self-evolving intelligence.

Nature Medicine, Published online: 09 February 2026; doi:10.1038/s41591-025-04074-y

In a randomized controlled study involving 1,298 participants from a general sample, performance of humans when assisted by a large language model (LLM) was sensibly inferior to that of the LLM alone when assessing ten medical scenarios leading to disease identification and recommendations for treatment.

Extrachromosomal DNA (ecDNA) is a major source of oncogenic fusions across cancer types, generating tissue-specific fusion landscapes with diagnostic potential. EcDNA-borne PVT1 5′-end fusions stabilize partner RNAs and boost oncogene output.