Background: Emergency department (ED) revisits are critical quality indicators, particularly in medically underserved areas, where traditional prediction tools show limited performance. Machine learning (ML) approaches may offer improved predictive performance for identifying high-risk patients. Objective: This formative study aimed to develop and validate an ML-based model for predicting 30-day ED revisits using electronic health records from a tertiary hospital serving a medically underserved area in South Korea and to evaluate its clinical utility through interpretability analysis and risk stratification. Methods: This retrospective cohort study analyzed 36,230 adult patients visiting the Gangneung Asan Hospital ED in 2023. We developed and compared 3 ML models (extreme gradient boosting [XGBoost], random forest, and ElasticNet) using electronic health records. Model interpretability was ensured through Shapley additive explanations (SHAP) analysis, and clinical utility was evaluated through 5-tier risk stratification. Results: Among 36,230 patients, 798 (2.2%) revisited within 30 days. XGBoost achieved superior performance with an area under the receiver operating characteristic curve of 0.90 (95% CI 0.88‐0.92), a sensitivity of 0.94, and a specificity of 0.69. The SHAP analysis identified ED length of stay, oxygen saturation, systolic blood pressure, computed tomography performance, antibiotic use, and liver disease as key predictors. Risk stratification demonstrated a 25-fold difference in the actual revisit rates between the lowest (152/8450, 1.8%) and the highest (686/1500, 45.7%) risk groups. Conclusions: The XGBoost model demonstrated excellent predictive performance with high interpretability for 30-day ED revisit predictions. The implementation of this model could enable risk-stratified interventions and more efficient resource allocation in medically underserved settings, potentially reducing unnecessary revisits and improving patient outcomes. This formative study establishes feasibility and provides a foundation for future multicenter validation studies in similar medically underserved settings.
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Neuronal Protein Tracing Reveals How the Brain Routes Its Waste
The brain is one of the busiest organs in the body, constantly processing and reshaping itself. That activity produces an equally constant stream of molecular byproducts—proteins that need to be moved out before they accumulate. When those clearance routes slow or break down, waste lingers, and the consequences can be profound. In Alzheimer’s disease, for example, toxic proteins build up in vulnerable regions. Yet despite decades of research, scientists have lacked a clear view of how waste normally leaves the brain.
A new study from the Gladstone Institutes offers the clearest picture yet of how the brain normally takes out its trash—and what happens when those routes fail. Published in Cell as “Physiological brain clearance architecture revealed by neuronal protein tracing,” the work introduces a method that traces waste proteins from the moment they are produced inside neurons to the moment they leave the brain.
For decades, researchers have relied on injecting tracers into the cerebrospinal fluid (CSF) to visualize drainage. But this approach, while illuminating, shows all possible routes, instead of pinpointing the most-used exit. “These injected tracers disturb the very system we’re attempting to measure,” said lead author Andrew Yang, PhD, a Gladstone investigator. “We wanted to find a better way.”
Yang’s team engineered neurons in mice to produce a fluorescent protein, ZsGreen, that could be followed as it exited the brain through its natural routes. This allowed the researchers to track waste as it moved into the dura, skull, nasal cavity, and lymph nodes—regions populated by specialized immune cells that interact with brain‑derived proteins.
The resulting map diverged sharply from the field’s long‑held assumptions. Traditional CSF tracers had pointed to the cervical lymph nodes as a major drainage site. But the new method revealed that very little neuronal waste actually reaches those nodes. “We were surprised to find that very little ZsGreen drained to the cervical lymph nodes,” Yang said. “Instead, waste drained through the dura, skull, and nasal cavity. Our findings underscore why tracking waste proteins themselves, rather than movement of the cerebrospinal fluid, provides a more accurate understanding of waste clearance dynamics.”
The team also uncovered a striking organizational principle: where a protein is made determines where it drains. Proteins produced in upper forebrain regions exited through upper routes, while those from deeper structures, such as the striatum, used lower pathways. The researchers call this the brain’s “nearest‑exit” model. “It’s like each brain region has a biological ZIP code system to ensure waste will be sent to the correct drainage site,” said Nalini Rao, PhD, a postdoctoral fellow. She noted that in aging or disease, these ZIP codes may become scrambled, potentially explaining why certain regions are more vulnerable to disorders like Alzheimer’s.
Disease models reinforced the system’s fragility. In mice with acute inflammation, ZsGreen leaked directly into the bloodstream, bypassing normal routes. In an Alzheimer’s model, waste became trapped inside the brain, unable to drain effectively. “Understanding how diseases disrupt brain clearance could help us design therapeutics to target the brain border compartments and enhance waste removal,” Rao said.
With their new tracing method, Yang’s group plans to probe how clearance changes across aging, sleep, and disease—and whether brain tumors exploit these pathways to evade immune detection. The architecture of brain waste disposal, once opaque, is now open for exploration.
The post Neuronal Protein Tracing Reveals How the Brain Routes Its Waste appeared first on GEN – Genetic Engineering and Biotechnology News.
<![CDATA[DSM’s future adds biomarkers and context, yet validity remains unresolved—are diagnoses real? Critics urge an evidence-based overhaul.]]>
Kenya court suspends U.S. plan for Ebola quarantine facility for Americans
NAIROBI, Kenya — A court in Kenya on Friday suspended a U.S. plan to establish a quarantine facility for Americans exposed to a rare type of Ebola virus spreading in northeastern Congo, following a backlash by medical workers and activists.
A U.S. administration official said on Wednesday that the U.S. was planning to send Americans who are exposed to Ebola while abroad to a new facility in Kenya instead of flying them home. The official spoke on condition of anonymity to share the administration’s plans. It was unclear where in Kenya the new facility will be built or whether the Kenyan government has signed off on the plan.
<![CDATA[Patient selection, monitoring, and counseling on dissociation are critical to safe ketamine treatment.]]>
<![CDATA[Experts explain how careful pediatric psychopharmacology and early intervention protect development, curb relapse, and address substance-use risk.]]>
Mental Health Fitness Through a Youth Perspective
Insights on building and advancing mental health care solutions through collaboration — from the Global Youth Advisory Council at the SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute
Mai El Shoush, Partnerships Campaign Manager, Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute
Tatiana P. Claridad, MBA, Director of Board Affairs and Institutional Strategy, Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute
Mental health fitness is shaped by lived experience, context, and the systems of care that surround us. During Mental Health Awareness Month, we invited young leaders from the Global Youth Advisory Council (GYAC) at the Stavros Niarchos Foundation (SNF) Global Center at the Child Mind Institute — from Brazil, South Africa, and Greece — to share their unique perspectives.
Their reflections offer insight into how young people define, build, and experience mental fitness globally, highlighting the influence of their environments, communities and everyday realities. Their views are essential to shaping more relevant and effective support for young people everywhere.
From daily habits to systemic change, here’s how young people are reimagining mental health care as mental health fitness:
These reflections raise a broader question — how can global collaboration strengthen mental health support for children and adolescents?
While these insights from the GYAC members highlight the importance of collaboration, they also reflect a new paradigm of youth leadership.
What continues to inspire you as a young leader about the ideas and perspectives shared through the Global Youth Advisory Council, and what does it say about the future of mental health care?
“What continues to inspire me most is the diversity of perspectives across different countries, yet the shared commitment to improving youth mental health. There is something powerful about young people coming together across contexts, bridging gaps through a global lens while staying rooted in their lived experiences. It reminds me that the future of mental health care will be more inclusive, shaped by real voices, and focused on breaking stigma in ways that feel authentic and meaningful.”
Delice Lumbu, 20, Director of Youth Engagement, SNF Global Center
Contributors: Delice Lumbu, Director of Youth Engagement, Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute
The post Mental Health Fitness Through a Youth Perspective appeared first on Child Mind Institute.
STAT+: Pharmalittle: We’re reading about Replimune drug getting third try at FDA approval, a Pfizer deal in China, and more
And so, another working week will soon draw to a close. Not a moment too soon, yes? This is, you may recall, our treasured signal to daydream about weekend plans. Our agenda, so far, is very low-key. We hope to catch up on our reading, promenade with the official mascots, and take a few naps. We may also manicure the Pharmalot grounds. And of course, we hope to hold still another listening party, where the rotation will likely include this, this, this, this and this. And what about you? The choices are endless this time of year. In particular, the great outdoors are beckoning — trails can be hiked, streets can be walked, country roads can be driven. If this fails, there is always the great indoors. You could cook a fabulous meal, shop for something that looks spiffy, or binge watch on the telly. Or you could be totally zen and do absolutely nothing. Well, whatever you prefer, have a grand time. But be safe. Enjoy, and see you soon…
A U.S. Food and Drug Administration advisory panel recommended updating this fall’s Covid shots to target the XFG variant, a fast-growing strain nicknamed “stratus,” NBC News tells us. The recommendation — from the FDA’s Vaccines and Related Biological Products Advisory Committee — is meant to help vaccine makers prepare shots for the fall and winter, when Covid infections typically rise. The meeting was the agency’s first since FDA Commissioner Marty Makary resigned. His resignation did not play a role; the meeting was already on the calendar before he resigned. Makary drew criticism last year after the agency imposed stricter requirements on who could get Covid shots.
Pfizer and China’s Innovent Biologics agreed to a global licensing and collaboration deal worth up to $10.5 billion to develop 12 early-stage cancer medicines, as global drugmakers race to tap China’s booming biotech pipeline, Reuters says. The deal also includes a $650 million upfront payment to Innovent and up to $9.85 billion in potential development, regulatory and commercial milestone payments. The value of such deals in the greater China region rose nearly tenfold from 2021 to an unprecedented $137.7 billion last year. The partnership spans a portfolio of antibody-drug conjugates with novel differentiated payloads and multi-specific antibodies, comprising eight Innovent-originated early-stage assets and four Pfizer-proposed discovery programs.
The World Health Organization identified drugs from Regeneron Pharmaceutical, Mapp Bio, and Gilead Sciences that should be fast-tracked through clinical testing to respond to the current Ebola outbreak, Pharmaphorum notes. The WHO’s independent experts have said Regeneron’s maftivimab, Mapp’s MBP134, and Gilead’s remdesivir should be studied in patients infected with the Bundibugyo form of Ebola currently infecting more than 1,000 people in the Democratic Republic of the Congo, with cases also reported in neighbouring Uganda. At last count, the Bundibugyo outbreak had led to 10 confirmed deaths, with another 223 suspected, although the WHO has said it could be much larger as the virus is thought to have circulated undetected for some time.
STAT+: Allogene CEO David Chang stepping down
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Hiya. In this week’s episode of “The Readout LOUD,” biotech vet Jeremy Levin talks about how scientific progress is outpacing the institutions that support it. Also, WHO experts are recommending the use of an antiviral and two monoclonal antibodies in the response to the Bundibugyo Ebola outbreak, and Allogene CEO David Chang is stepping down.
The need-to-know this morning
- Replimune Group said it had reached an agreement with the FDA to resubmit its experimental melanoma drug for approval, after the therapy was twice rejected by the agency.
Albert Bourla loves China
We are referring, of course, to the Pfizer CEO, who is once again putting billions of dollars of Pfizer cash on the table to buy drugs invented in China.
Derbyshire Healthcare to roll out Psyomics mental health platform
Derbyshire Healthcare NHS Foundation Trust will roll out Psyomics’digital platform to improve access to community mental health care.