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Prevalence of Dropout and Influencing Factors in Digital Psychosocial Intervention Trials for Adult Illicit Substance Users: Systematic Review and Meta-Analysis

Background: Globally, the number of illegal drug users is rising, posing mental and physical health challenges and increasing societal burdens. Despite a significant need for treatment, only about 10% of these individuals receive it worldwide, often with poor adherence. Traditional treatments, while effective, suffer from high dropout rates due to limitations. The COVID-19 pandemic has spurred the growth of digital interventions like apps and online platforms, offering flexibility and cost-effectiveness that better meet patient needs and improve engagement. However, addressing the persistently high dropout rates in these online treatments is crucial and necessitates further research. Objective: This study aimed to estimate dropout rates among adults with illicit drug use participating in digital psychosocial intervention trials, and to identify factors associated with attrition. Methods: We conducted a systematic search of five major databases for English-language randomized trials published up to January 27, 2025. A total of 40 studies (80 arms; 9,563 participants) reporting 46 dropout rate estimates were included. A random-effects model was used to calculate pooled dropout rates, with meta-regression and subgroup analyses exploring potential moderators. The study was registered on PROSPERO (CRD42024534389). Results: At post-test, the pooled dropout rate in the intervention group across 17 studies was 22.4% (95% CI: 12.4%–37.2%). Dropout was significantly associated with education level, employment status, baseline clinical diagnosis, intervention frequency, and initial medication use. During the longest follow-up (29 studies), the dropout rate was 27.9% (95% CI: 18.8%–39.3%), with marital status, recruitment source, medication frequency, and intervention modality as significant predictors. Control group dropout rates were 25.9% and 28.3%, both higher than those in the intervention group. Conclusions: This meta-analysis revealed substantial dropout among adults with illicit drug use receiving digital psychosocial interventions. Targeted modifications to intervention design may improve engagement and long-term retention. Clinical Trial: The study was registered on PROSPERO (CRD42024534389).
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DNA methylation and machine learning: challenges and perspective toward enhanced clinical diagnostics

DNA methylation is an epigenetic modification that regulates gene expression by adding methyl groups to DNA, affecting cellular function and disease development. Machine learning, a subset of artificial intell...
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STAT+: Digital health M&A picks up, driven by AI and private equity

Earlier this year, Tom Stanis was puzzling through what was next for his startup Story Health, which helps providers care for people with heart failure. The company had some big-name customers and plans to expand, but it last raised money in 2022. Stanis saw two options: shake more cash out of a stingy venture capital market, or sell.

Armed with $275 million in fresh funding and a built-in customer base, artificial intelligence company Innovaccer made the answer easy. It gobbled up Story Health for an undisclosed mix of equity and cash in September. 

Story Health is the fourth Innovaccer acquisition in about a year as it aims to become the default AI platform for health systems. CEO Abhinav Shashank plans to rapidly expand and to “accelerate that development through M&A,” he told STAT.

Innovaccer’s shopping spree is just one example of a trend playing out in digital health: big, well-funded companies with momentum are snapping up smaller players.

Continue to STAT+ to read the full story…

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Opinion: STAT+: 5 things to consider to bring ambient digital scribes to clinical research

About a year ago, I logged into MyChart the day before my annual wellness visit and saw a new consent form. My doctor wanted to record our visit so artificial intelligence could create notes and update my medical record. I agreed. Just hours after my visit ended, a comprehensive, accurate visit summary appeared in MyChart.

As a career clinical trialist, I immediately wondered: What if this tool were used for trial visits? Could it enable a breakthrough in research or patient engagement? How will clinical research adapt to what could be a “new normal” in medical documentation?

Driven by a crisis of clinician burnout, ambient digital scribes (ADS) like the one my doctor used are being rapidly adopted. Studies suggest these digital scribes can reduce documentation burden, improve clinician efficiency, and potentially enhance the patient experience. By digitizing conversations in real time, these scribes open possibilities beyond routine care, particularly in clinical research and trials.

Continue to STAT+ to read the full story…

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Digital twin models for predicting venetoclax and azacitidine-induced neutropenia in patients with acute myeloid leukemia

npj Digital Medicine, Published online: 06 October 2025; doi:10.1038/s41746-025-01978-4

Digital twin models for predicting venetoclax and azacitidine-induced neutropenia in patients with acute myeloid leukemia
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Efficient and accurate search in petabase-scale sequence repositories

Nature, Published online: 08 October 2025; doi:10.1038/s41586-025-09603-w

MetaGraph enables scalable indexing of large sets of DNA, RNA or protein sequences using annotated de Bruijn graphs.
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Stop treating code like an afterthought: record, share and value it

Nature, Published online: 07 October 2025; doi:10.1038/d41586-025-03196-0

Scientists, research institutions, funders, libraries and publishers must all improve software practices.
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HALO: hierarchical causal modeling for single cell multi-omics data

Nat Commun. 2025 Oct 7;16(1):8892. doi: 10.1038/s41467-025-63921-1.

ABSTRACT

Though open chromatin may promote active transcription, gene expression responses may not be directly coordinated with changes in chromatin accessibility. Most existing methods for single-cell multi-omics data focus only on learning stationary, shared information among these modalities, overlooking modality-specific information delineating cellular states and dynamics resulting from causal relations among modalities. To address this, the epigenome-transcriptome relationship can be characterized in relation to time as coupled (changing dependently) or decoupled (changing independently). We propose the framework HALO, adopting a causal approach to model these temporal causal relations on two levels. On the representation level, HALO factorizes these two modalities into both coupled and decoupled latent representations, revealing their dynamic interplay. On the individual gene level, HALO matches gene-peak pairs and characterizes their changes over time. HALO discovers analogous biological functions between modalities, distinguishes epigenetic factors for lineage specification, and identifies temporal cis-regulation interactions relevant to cellular differentiation and human diseases.

PMID:41057364 | PMC:PMC12504611 | DOI:10.1038/s41467-025-63921-1

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Pathobiology and Genetics

Pneumologie. 2025 Oct;79(10):701-711. doi: 10.1055/a-2625-4648. Epub 2025 Oct 6.

ABSTRACT

Genetics and pathobiology were addressed at the 7th World Symposium on Pulmonary Hypertension in Task Forces 2 and 3. The Genetics Task Force also focused on precision medicine approaches, and the Pathobiology working group concentrated heavily on new omics technologies. Therefore, the following not only summarises the current state of knowledge on genetics, genetic testing methods, and molecular pathophysiological changes, but also places it in context and critically discusses it. In addition, the importance of national and international biobanks and cohorts, as well as the active involvement of patients and families, is emphasized.

PMID:41052524 | DOI:10.1055/a-2625-4648

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The Potential of AI in Nursing Care: Multicenter Evaluation in Fall Risk Assessment

Background: With 28%-35% of individuals aged 65 years and older experiencing incidents of falling, falls are the second leading cause of unintentional injury–related deaths globally. Limited availability of clinical staff often impedes the timely detection and prevention of potential falls. Advances in artificial intelligence (AI) could complement existing fall risk assessment and help better allocate nursing care resources. Yet, many studies are based on small datasets from a single institution, which can restrict the generalizability of the model, and do not investigate important aspects in AI model development, such as fairness across demographic groups. Objective: This study aimed to provide a comprehensive empirical evaluation of the potential of AI in nursing care, focusing on the case of fall risk prediction. To account for demographic and contextual differences in fall incidences, we analyze data from a university and a geriatric hospital in Germany. To the best of our knowledge, these are the largest fall risk prediction datasets to date with heterogeneous data distributions. We focus on 3 key objectives. First, does AI help in improving fall risk prediction? Second, how can AI models be trained safely across different hospitals? Finally, are these models fair? Methods: This study used 2 datasets for fall risk prediction: one from a university hospital with 931,726 participants, 10,442 of whom experienced falls, and another from a geriatric hospital with 12,773 participants, 1728 of whom have fallen. State-of-the-art AI models were trained with 3 approaches, including 2 decentralized learning paradigms. First, separate models were trained on data from each hospital; second, models were retrained on the respective other dataset; and federated learning (FL) was applied to both datasets. The performance of these models was compared with the rule-based systems as implemented in clinical practice for fall risk prediction. Additional analyses were conducted to test for model fairness. Results: Our findings demonstrate that AI models consistently outperform rule-based systems across all experimental setups, with the area under the receiver operating characteristic curve of 0.735 (90% CI 0.727-0.744) for the geriatric hospital, and 0.926 (90% CI 0.924-0.928) for the university hospital. FL did not improve the fall risk prediction in this setting. Our fairness analysis ruled out disparities in model performance between different sex groups, but we found fairness infringements across age groups. Conclusions: This study demonstrates that AI models consistently outperform traditional rule-based systems across heterogeneous datasets in predicting fall risk. However, it also reveals the challenges related to demographic shifts and label distribution imbalances, which limited the FL models’ ability to generalize. While the fairness analysis indicated fair results across sex subgroups, age-related disparities emerged. Addressing data imbalances and ensuring broader representation across demographic groups will be crucial for developing more fair and generalizable models.
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