Preliminary Usability Assessment of a Rule-Based Digital Self-Monitoring Platform for Patients With Brain Tumors Toward Digital Early Warning Systems: Pilot Feasibility Study
Tunneling Neurons in Adult Bird Brains Provide New Insights into Neurogenesis
Despite its small size—it could sit in the palm of your hand—the zebra finch is a remarkable learner. A songbird native to Australia, it’s renowned for its ability to pick up new songs. That talent has made it a favorite of scientists studying how animal brains imprint new skills, particularly vocal learning, or the capacity to perfect new sounds.
Researchers at Boston University, working with scientists at the Max Planck Institute for Biological Intelligence and the MRC Laboratory of Molecular Biology, have now discovered another quirk to the zebra finch brain—one that could also have implications for understanding our own. In a study that looked at the bird’s brain in unprecedented detail, the scientists uncovered new insights into neurogenesis—the birth, migration, and maturation of neurons—that may help the brain learn, add new skills, and restore and repair itself.
Observing the finch brain using a high-powered microscope, the researchers watched as new neurons made their way through the brain en route to bolstering existing circuits and connections. The expectation was that these neurons would step around established brain structures, including more mature brain cells, to better preserve them. Instead, the investigators saw the neurons tunnel right through. According to the BU-led team, the findings could help explain human vulnerability to a range of brain disorders. The researchers also noted that cell tunneling is used by some metastatic cancer cells.
“We found that in songbirds, new neurons in the adult brain behave like explorers forging a path through a dense jungle,” said Benjamin Scott, PhD, a BU College of Arts & Sciences assistant professor of psychological and brain sciences and the study’s corresponding author. That may help them learn new things or repair damage, but it could come with a cost to existing cells and memories—and that might be why neurogenesis is, in humans, something that doesn’t seem to extend beyond the womb. “This potentially disruptive behavior may help explain why humans and other mammals have limited capacity to regenerate brain tissue in adulthood,” commented Scott, “leaving us more vulnerable to neurodegenerative disorders such as Alzheimer’s disease.”
Scott is senior and corresponding author of the team’s published paper in Current Biology, titled “Songbird connectome reveals tunneling of migratory neurons in the adult striatum,” in which the researchers commented that their collective findings “… suggest that migrating neurons may physically reshape the mature circuit to reach their targets, revealing an unexpected degree of structural and functional plasticity in the adult brain.”
At birth our brains have pretty much all the neurons they are ever going to have. Other organs—from your skin to your heart—might get frequent cell updates, but the brain is working on version 1.0. That’s true for most mammals, but not for fish, reptiles, and birds—their brains get a regular refresh.
“This raises two questions,” said Scott, who’s also affiliated with BU’s centers for neurophotonics, photonics, and systems neuroscience. “Why do other species have high rates of neurogenesis throughout life and why is it so restricted in humans? And is there something we can learn from their biology that we might be able to harness in future?”
Scott typically studies the neural circuits that control behavior in humans and other mammals, but chose the zebra finch to investigate neurogenesis because it has a reputation as a champion species—it’s really good at generating new neurons. “Songbirds are valuable model organisms for the study of neuron migration in the adult brain,” the authors wrote. “In these species, new neurons integrate into brain regions that control complex learned behaviors, where they establish synapses with mature neurons and respond to sensory stimuli.”
However, the team pointed out, a key question is how these new neurons interact with mature circuit structures in the brain. “It is not known whether neurons pursue migratory routes that flexibly avoid these structural obstacles or deform surrounding tissue to reach their targets,” they wrote. “While prior studies have examined the molecular mechanisms and functional consequences of adult neurogenesis, few have investigated the physical interactions between migrating neurons and their surrounding microenvironment.”
For their newly reported study the team used electron microscopy (EM)-based connectomics to examine how migrating neurons interact with mature circuit elements. “We applied a new tool to study this process [neurogenesis] called electron microscopy-based connectomics—basically a really high-powered microscope—to image these cells at a very high resolution,” Scott explained. “Our first hope was just to say, what does this look like at a detail we couldn’t see before?”
Their resulting data revealed intricate interactions between migratory neurons in the adult striatum and their environment, but also showed up the tunneling neurons. “Our findings support a model in which migrating neurons disperse throughout dense neural tissue in multiple directions, making various contacts with surrounding structures,” the team wrote in summary. “In addition, our data reveal a previously undescribed form of neuron migration in which new neurons cause deformities in nearby neurons and synapses.”
The authors say that, to their knowledge, tunneling migration by neurons hasn’t previously been reported in the vertebrate nervous system. It’s possible that this is due to the constraints of study methods used, but it’s also possible that tunneling is a specialization of neurogenesis in birds.
If these new neurons are deforming brain tissue, commented Scott, are they also disrupting memories along the way? And, if neurogenesis comes with a cost, how does that balance against the brain’s capacity for learning new things and repairing after injury? And as the authors pointed out, “Interestingly, tunneling-like behavior has been described in metastatic cancer cells, which navigate confined spaces by actively deforming their microenvironments. Tunneling may therefore reflect a conserved strategy adopted by specialized migratory cell types in dense tissues.”
Scott has two—as yet untested—hypotheses for what the findings might mean for the human brain. The first is that our brains evolved to limit neurogenesis after birth as a form of protection—a way of making sure determined neurons couldn’t barge through mature connections and damage memory storage. “There is an alternative framing that is more optimistic,” he also noted. “Our discovery of tunneling shows how cells can move without glia scaffolds.”
These are the structures that operate as highways for migrating neurons. “Most glia scaffolds are lost in humans after birth, and this loss was thought to be an obstacle for neurogenesis in the adult brain,” says Scott. “However, our work shows that new neurons in the bird do not need this glia scaffold. This is exciting because it means that brain repair may not require specialized glia scaffolds.” That opens the door for scientists to explore potential stem-cell therapies that would spark neurogenesis in humans.
In summary, the authors wrote, “These results reveal the value of applying EM connectomics to adult neurogenesis and suggest that migratory neurons may dramatically perturb the existing functional circuits as they migrate and integrate. Furthermore, they reveal the remarkable structural flexibility of mature neural circuits.”
In current studies, Scott and the team in his BU Laboratory of Comparative Cognition are digging into the biology driving neurogenesis to uncover which genes are regulating the process. Much of the work merges ideas and tools from biomedical engineering and neuroethology, the study of the mechanisms underpinning animal behavior.
“Right now, we’re using a technique called single-cell RNA sequencing to identify genes that are expressed by these new neurons as they migrate,” said Scott. “We want to know what other cells they’re talking to as they move and how they are speaking to these different cells.” That’ll help them figure out whether neurons warn other cells they’re traveling through and how they know where to stop and integrate with a current circuit.
“We share a lot with our animal relatives on this planet,” noted Scott. And, while the term “bird brain” might be an insult, by learning more about the biology of songbird brains, he says, we could learn some remarkable things about our own.
The post Tunneling Neurons in Adult Bird Brains Provide New Insights into Neurogenesis appeared first on GEN – Genetic Engineering and Biotechnology News.
Use of Wearable Devices to Augment Traditional Measurements of Postoperative Outcomes Following Total Joint Arthroplasty: Systematic Review
Background: Wearable devices enabling remote monitoring by surgeons of their patients have gained prominence around total joint arthroplasty (TJA), offering continuous patient data to identify those not meeting postoperative goals, thereby facilitating timely interventions. While multiple studies highlight the utility of these devices in tracking postoperative progress, a standardized approach to their application is lacking. This review aims to synthesize existing literature on the use of wearable device-tracked activity for monitoring TJA outcomes. Objective: We examined the current literature to evaluate how wearable devices are used in monitoring and improving patient rehabilitation and outcomes following TJA. Methods: A systematic review was conducted following Cochrane methodology. A literature search of all available literature was performed in April 2024 and identified 102 studies to undergo full-text review. Systematic reviews, duplicate papers, and theoretical papers were excluded. Ultimately, 35 studies met the selection criteria. Results: The review revealed that 32 of 35 (91.4%) studies used wearable devices to monitor step counts. A total of 21 (60%) studies incorporated joint-specific patient-reported outcome measures, though the specific measures varied. Further, 9 studies used standardized performance-based outcome measures, which also differed across studies. Finally, 7 (20%) studies collected sleep data; however, the methods and outcomes for sleep measurement were inconsistent among these studies. Conclusions: Remote monitoring via wearable devices offers a novel approach to tracking outcomes in TJA patients. Although the use of these devices in perioperative care is expanding, significant variability exists in the data reported across studies. Wearable monitoring is often integrated with patient-reported outcome measures and standardized functional assessments, yet the optimal data parameters that best correlate with established outcome metrics remain undefined. Additionally, data collected by wearables has not yet been shown to predict patient recovery or satisfaction. Further research is essential to refine these data parameters and the development of postoperative protocols that leverage wearable devices to enhance patient compliance and improve clinical outcomes. Trial Registration: PROSPERO CRD420261346230; https://www.crd.york.ac.uk/PROSPERO/view/CRD420261346230
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Impact of Prescribed and Self-Selected Music Interventions on Stress, Sleep, Heart Rate Variability, and Brain Connectivity in Surgeons Using 7-Tesla Functional Magnetic Resonance Imaging and Wearable Actigraphy: Multimodal Feasibility Randomized Controlled Trial
Involving Health Care Professionals in the Human-Centered Design of a Digital Platform for Work-Focused Health Care: Lessons From a Mixed Methods Study
Exploring Influencing Factors of Medication Adherence Among Chinese Patients With Alzheimer Disease: Delphi Study Informing Future Artificial Intelligence–Supported Interventions
Background: Alzheimer disease (AD) affects cognition, treatment adherence, family connections, and health care resource allocation. Most patients with AD have low adherence to medication therapy due to the limitations associated with cognitive impairment. Therefore, increasing the involvement of patients and their family members in medication management is important to improve treatment outcomes and reduce the burden of care. Objective: This study explores the potential application of artificial intelligence (AI) in medication management for Chinese patients with early- to mid-stage AD focusing on enhancing medication adherence. The study first predicts and evaluates key factors through an online Delphi study, which provides a basis for their subsequent incorporation into the AI model as input variables to enable prediction of medication-taking behaviors. Since AI research in medication management for this population is still undeveloped, this paper further explores the multiple potentials of AI from a theoretical view, including drug dosage optimization, multidrug interaction detection, and family education support. It will provide a preliminary direction and theoretical basis for the development of an intelligent medication management system in the future. Methods: The exploratory online Delphi study with no modification predicted the key factors influencing medication adherence. Based on the results, the study confirmed the potential of AI to improve adherence. Participation by 12 experts in 3 rounds systematically assessed the core elements influencing patients’ adherence to their medication. Results: Family care, social support, environmental factors, emotional support, and patient behaviors were identified as the primary factors influencing medication adherence among Chinese patients with AD. These factors were validated and ranked through iterative Delphi rounds, with family care and social support receiving the highest importance scores. The Wilcoxon signed-rank test indicated no significant difference between rounds (=.06), supporting the stability of the consensus. These findings establish a foundational set of variables for AI systems that predict and enhance medication adherence. Conclusions: This study highlights the critical factors affecting medication adherence by Chinese patients with AD. It was designed as an exploratory online Delphi study to identify and prioritize key influencing factors, rather than to validate a specific AI-based system, and the findings provide a theoretical foundation for future AI-informed interventions. The results also indicate theoretical potential roles for AI in supporting medication management, such as optimizing drug dosage, detecting multidrug interactions, and enhancing family education.
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Community Health Worker Feedback on an mHealth Intervention for Hypertension in Rural Guatemala: Mixed Methods Formative Study
Targeted Gene Delivery Calms Lung Inflammation in Respiratory Infection Mouse Models
A group of scientists have developed a targeted delivery platform that can induce anti-inflammatory cytokine expression in mouse lungs, which helps restrict tissue damage from respiratory infections without triggering systemic side effects. Full details are published in Science Immunology in a paper titled “Gene delivery of immunomodulatory cytokines to the lung preserves respiratory function during inflammatory challenge.”
The study was led by scientists in the pathology department at the University of Cambridge working alongside collaborators elsewhere. Together, they “developed a gene delivery system to express anti-inflammatory cytokines in the lung, which reestablishes local immune homeostasis without triggering systemic effects,” according to details provided in the paper. Specifically, they used an adeno-associated virus cargo system (AAV6.2-CC10) to induce “production of interleukin-2 (IL-2), IL-1 receptor antagonist (IL-1RA), and IL-10 in situ in the lung microenvironment.” They accomplished this “with no detectable expression or immunological deviation in the peripheral immune system.”
According to the developers, their work could lead to new therapeutics that control inflammation following several viral infections, which has been linked to higher mortality rates in cases of SARS-CoV-2 and influenza. Prolonged inflammation during a viral infection also increases the chances that patients could contract bacterial and fungal infections. Importantly, the approach provides a way to harness the “therapeutic potential of immunomodulatory cytokines” which to date have had limited success as biologic drugs due in part to the short half-lives of cytokines as well as the risks of multiorgan effects. “This tool has been proven to deliver sustained and localized expression as evidenced by the results from three tested cytokines,” the effects of which were “restricted to the lungs” and resulted in “prolonged production over the course of weeks.”
The paper goes into the details of how the scientists characterized their method and demonstrated that it induced expression only in specific lung epithelial cells without off-target accumulation. Also provided are details of how they used the system to assess how lung-specific expression of IL-2, IL-1RA, and IL-10 affected disease severity in mouse models of influenza. They found that IL-2 expression was not especially beneficial during infection, possibly due to the amplification of protective regulatory T cells and proinflammatory CD8 T cells in the lungs. However, IL-1RA and IL-10 reduced tissue damage and improved recovery after infection and inflammation.
In addition, data from their experiments showed that delivering either individual cytokines or a cocktail of all three protected mice from influenza-associated aspergillosis. In fact, treated mice showed “reduced neutrophil infiltrates and improved health outcomes,” including reduced weight loss compared to untreated mice, the scientists wrote.
Future experiments with human cell culture systems could lay the groundwork for preclinical testing. However, there are still some limitations. For example, “we did not evaluate the kinetics of repeated administration of the same AAV vectors,” the scientists wrote. “Repeated administration can lead to the development of neutralizing antibodies, which can hinder the uptake of AAVs in subsequent treatments.” Another challenge is with the cargo itself. Though it performs well in mouse models, its “utility in a patient-based setting needs to be tested,” the scientists said.
The post Targeted Gene Delivery Calms Lung Inflammation in Respiratory Infection Mouse Models appeared first on GEN – Genetic Engineering and Biotechnology News.
First-Line Zongertinib Shows Strong Activity in HER2-Mutant Lung Cancer
For years, patients with HER2-mutant non–small cell lung cancer (NSCLC) have occupied a frustrating gap in precision oncology. While targeted therapies have transformed outcomes for EGFR– and ALK-driven lung cancers, HER2-mutant disease has lagged behind, with chemotherapy remaining the standard first-line option.
New data from the Phase Ia/Ib Beamion LUNG-1 trial, published in The New England Journal of Medicine, suggest that this may be changing. The oral HER2 inhibitor zongertinib demonstrated high response rates and durable clinical benefit in treatment-naïve patients, positioning it as a potential new first-line standard.
A long-standing unmet need
HER2 mutations occur in approximately 2–4% of NSCLC cases and are associated with aggressive disease and poor prognosis. Despite advances in targeted therapy across lung cancer, patients with HER2-driven tumors have historically had limited options, particularly in the first-line setting.
Until recently, treatment largely relied on chemotherapy, with or without immunotherapy, yielding modest outcomes, including progression-free survival typically under seven months.
“Just a few years ago, patients with this disease had no effective targeted therapies,” said John Heymach, MD, PhD, principal investigator of the study. “Now, healthcare providers have a HER2-targeted treatment option that can make a meaningful difference.”
High response rates and durability
In the trial, 74 previously untreated patients with advanced or metastatic HER2-mutant NSCLC received zongertinib at the selected dose of 120 mg daily. The results were striking.
A confirmed objective response was observed in 76% of patients, including both complete and partial responses. Tumor shrinkage was both rapid and durable, with a median duration of response of 15.2 months and median progression-free survival of 14.4 months.
These outcomes represent a substantial improvement over historical benchmarks and suggest that HER2-mutant NSCLC may finally benefit from the kind of targeted therapy success seen in other molecular subtypes.
“We observed unprecedented response rates for this cancer subtype,” Heymach said.
A more selective approach to HER2 targeting
One of the key differentiators of zongertinib is its selectivity. Unlike earlier HER2-targeted approaches, the drug inhibits HER2 while sparing wild-type EGFR, a closely related receptor whose inhibition is often associated with toxicity.
Zongertinib is described as an oral, irreversible tyrosine kinase inhibitor that selectively targets HER2 while minimizing EGFR-related side effects.
Clinically, this translated into a manageable safety profile. Most adverse events were low-grade, with relatively low rates of severe diarrhea and rash, common toxicities associated with EGFR inhibition. Serious complications such as interstitial lung disease were rare.
Activity in brain metastases
HER2-mutant NSCLC is also characterized by a high incidence of brain metastases, a major clinical challenge. Notably, the study demonstrated meaningful activity in this setting as well.
Among patients with active brain metastases, 47% achieved a confirmed intracranial response. Responses were also observed regardless of HER2 mutation subtype or baseline brain involvement, suggesting broad applicability across patient subgroups.
This intracranial activity is particularly significant, given the limited effectiveness of many systemic therapies in the central nervous system.
Implications for first-line treatment
The emergence of zongertinib as a first-line option marks a potential inflection point in the treatment of HER2-mutant NSCLC. For the first time, patients may be able to receive a targeted therapy at diagnosis, rather than progressing through less effective chemotherapy regimens.
The data have already translated into regulatory momentum. Zongertinib recently received accelerated FDA approval for this indication, reflecting both the strength of the clinical data and the unmet need in this population.
However, important questions remain. The current study is single-arm and lacks a direct comparison with standard-of-care therapies. A Phase III trial is ongoing to evaluate zongertinib against chemotherapy-based regimens in the first-line setting.
Positioning within a changing landscape
The broader treatment landscape for HER2-mutant lung cancer is also evolving. Antibody–drug conjugates such as trastuzumab deruxtecan have shown activity in previously treated patients, but are associated with notable toxicities and are typically used after progression.
Zongertinib’s oral administration, favorable safety profile, and first-line efficacy could shift treatment sequencing, potentially moving targeted therapy earlier in the disease course.
At the same time, resistance mechanisms are likely to emerge. Early data suggest that distinct resistance pathways may develop for tyrosine kinase inhibitors compared to antibody-based therapies, raising the possibility of sequential or combination strategies.
Looking ahead
As HER2-targeted therapies move into earlier lines of treatment, the focus will increasingly shift toward optimizing sequencing, managing resistance, and identifying combination approaches.
For now, the results from Beamion LUNG-1 provide strong evidence that HER2-mutant NSCLC, long considered a difficult-to-treat subtype, may finally be entering the era of precision oncology.
With high response rates, durable benefit, and activity in brain metastases, zongertinib offers a compelling new option, and a clear signal that the treatment paradigm for these patients is changing.
The post First-Line Zongertinib Shows Strong Activity in <i>HER2</i>-Mutant Lung Cancer appeared first on Inside Precision Medicine.

