In the past, even with an icebreaker and during peak melt season, getting to the North Pole wasn’t a sure bet. It took favorable winds to crack the frozen ocean surface, and ships had to fight through ice that had grown many meters thick over several winters. In the summer of 2025, though, Jochen Knies from the Arctic University of Norway, Tromsø, and his team met little resistance on their way to 90 degrees North with the research vessel Kronprins Haakon. The geologist “didn’t hear the usual grinding of ice” against the hull that he remembered from 1996, when he first reached the pole by ship. Instead, thin floes and large stretches of open water made for an easy, quiet passage. To him, it was “a reminder of how quickly the Arctic is changing.”
Since the late 1970s, when satellite observations of the polar seas began, summer ice cover of the Arctic Ocean has declined by more than 40%. In less than half a century, a frozen area the size of the Mediterranean Sea has turned into blue open water with the rapid warming of the high northern latitudes. If this trend continues, there could soon be summers at the North Pole with no sea ice whatsoever. The last time this happened may have been some 120,000 years ago. But no one knows for certain.
That’s why Knies and his colleagues, a team of researchers from Norway and Germany, set out from Svalbard to the central Arctic last August. The aim of their five-week mission was to determine whether this region had been ice-free in recent Earth history—and if so, when. As part of a €12.5 million project financed by the European Union, they also came to answer some questions about the future of the Arctic and beyond: How does the loss of sea ice affect the marine ecosystem? What are the consequences for ocean circulation and global climate?
In search of clues, the expedition collected sediment cores up to 22 meters in length at different locations across the Arctic seafloor. Marine sediments are valuable climate archives that give scientists a window into bygone eras. Like diligent record keepers, they can log past water temperatures, sea-ice coverage, and the strength of ocean currents. These data are encrypted in the chemical and physical properties of the plankton remains and weathered rock deposited on the seabed.
The ship’s crew and researchers recover the sediment corer, a 25-meter-long steel pipe that is driven into the seafloor using a top weight of more than three metric tons.
TIM KALVELAGE
Together, the scientists pull out long plastic pipes filled with precious deep-sea mud.
TIM KALVELAGE
The pipes are cut into shorter pieces and split in half before being processed in the ship’s laboratories. Each of these one-meter sections covers several tens of thousands of years of Earth’s history.
TIM KALVELAGE
While sediment cores several meters long had been recovered on earlier expeditions in the central Arctic, there is no scientific consensus on how old the deposits actually are or whether sea ice ever completely disappeared in summer.
To decode the Arctic’s climate archive, Knies brought a team of experts from various disciplines onboard the Kronprins Haakon to dig deeper and obtain fresh samples they could subject to the latest analytical techniques.
Samples await paleomagnetic dating. Like tiny compass needles, iron-rich particles align with Earth’s shifting magnetic field as they settle on the seabed. By measuring their orientation, researchers can estimate the age of the different sediment layers.
TIM KALVELAGE
Under the microscope, PhD student Paulina Romel picks shells of unicellular foraminifera from a sample. The chemical composition of these microfossils can give clues about the age of the sediment and the surface water temperature when the organisms were still alive. “These are really cool creatures!” says Romel.
TIM KALVELAGE
Agathe Ollive, a geochemist from the Alfred Wegener Institute in Germany, takes water samples from a CTD rosette, an instrument package that measures conductivity (salinity) and temperature at various depths. She uses certain elements to trace the inflow of fresh water and seawater from rivers and adjacent ocean basins into the Arctic. “I didn’t expect there to be so little ice up here,” Ollive says. She is worried about how the Arctic will look 20 years from now.
TIM KALVELAGE
Some of this work was done while the researchers were still at sea. Now, at their home laboratories, they are finalizing their analysis of the seafloor samples. One important task is dating the sediments, which may be up to 2 million years old. The team uses a combination of methods to do this, including measuring magnetization, the decay of radioactive elements, and the exposure of mineral grains to sunlight before sinking to the depths. Once they can place them on a timeline, the materials in the cores will help researchers paint a picture of what the Arctic Ocean looked like in times that were warmer than today. For example, the presence or absence of the molecule IP25, which is produced exclusively by ice algae, could tell them how far the sea ice receded at a given time.
Toward the end of the expedition, the Kronprins Haakon passes this iceberg near the northeast coast of Greenland.
TIM KALVELAGE
At the end of the study, the team hopes to have data that could improve climate projections for a future ice-free “blue Arctic,” helping us understand how it could affect marine life and carbon storage, Atlantic Ocean circulation, or extreme weather events in Europe and North America.
Tim Kalvelage is a freelance science reporter based in Bremen, Germany, who focuses on climate, ocean, and polar research. He has been to the North Pole twice.
The concept of multimorbidity, the co-occurrence of two or more long-term conditions, has become an important focus for research in the burden of ill-health associated with ageing. A burgeoning literature shows that the prevalence of multimorbidity is substantial, even though estimates vary according to definition and method of ascertainment.1 Not many studies have taken a longitudinal approach and evaluated the incidence of multimorbidity. In The Lancet Public Health, Eirion Slade and colleagues2 report on the incidence of multiple long-term conditions, also known as multimorbidity, in an electronic health records dataset for nearly the whole of England, UK.
How does HIV, armed with only nine genes, manage to hijack the immune system so effectively? For decades, researchers have known that the virus depends on human proteins to enter, replicate, and persist—yet the full roster of those host factors has remained elusive. One major reason: most HIV studies have relied on immortalized cell lines rather than the primary CD4+ T cells the virus actually infects in the body. As a result, scientists have lacked a comprehensive picture of how real human T cells respond when HIV attacks.
A new study from Gladstone Institutes and the University of California, San Francisco (UCSF), changes that. In the study, titled “Systematic Discovery of Pro- and Anti-HIV Host Factors in Primary Human CD4+ T Cells” and published in Cell, researchers report the first genome‑wide map of human genes that either promote or restrict HIV infection in primary human CD4+ T cells, offering a long‑sought blueprint of the host–virus interface.
“HIV has been a global crisis for over 40 years,” said Alex Marson, MD, PhD, director of the Gladstone‑UCSF Institute of Genomic Immunology and senior author of the study. “By studying human T cells, which are the primary target of the virus, we’ve finally mapped the genes—many of which were previously unknown—that influence whether or not they can be infected by HIV.”
Scientists in the Marson Lab at Gladstone Institutes have opened a new door to understanding HIV by creating the first genetic roadmap of how the virus interacts with real human cells. [Gladstone Institutes]
Achieving this required overcoming a fundamental technical barrier. “One challenge of using real human T cells for research is they’re very difficult to infect with HIV; out of a whole dish of cells, typically only one or two percent would get infected,” said first author Ujjwal Rathore, PhD. After years of optimization, the team pushed infection rates to roughly 70%, enabling genome‑scale CRISPR perturbations in primary cells for the first time.
With that platform in hand, the researchers performed orthogonal genome‑wide CRISPR activation (CRISPRa) and CRISPR knockout (CRISPRn) screens in CD4+ T cells, systematically testing nearly every human gene. Disrupting genes revealed those HIV depends on, while overactivating genes exposed natural antiviral defenses that HIV normally suppresses. “Over‑activating the genes gave us a wealth of information,” said co–first author Eli Dugan, a PhD candidate in Marson’s lab. “We discovered natural antiviral proteins that were previously invisible because the virus could effectively silence them.”
Across both screens, the team identified hundreds of host factors that shape HIV infection. Among the most striking were two previously unrecognized antiviral proteins: PI16 and PPID (Cyp40). “PI16 interacts with host factors involved in HIV fusion and inhibits viral entry, whereas PPID, a paralog of the proviral cyclophilin CypA, binds capsid and reduces nuclear import of the HIV core,” wrote the authors. Targeted mutagenesis, along with structural modeling and evolutionary analyses, pinpointed residues essential for PPID’s restriction activity, and engineered variants were up to tenfold more potent, according to Dugan.
To test whether these defenses could counter real‑world viral strains, the team collaborated with HIV pioneer Jay Levy, MD, who provided isolates from the early AIDS epidemic. Elevated levels of PI16 or PPID restricted even these aggressive HIV strains.
“This was the first genome‑wide effort to show how human genes affect HIV infection in cells taken directly from human blood samples,” said Nevan Krogan, PhD, director of the HIV Accessory and Regulatory Complexes (HARC) Center. “Our findings could eventually lead to new treatments that help the body’s immune system resist the virus.”
Beyond identifying antiviral factors, the study offers the potential for a powerful new platform for probing HIV latency—the persistent reservoir that evades antiretroviral therapy. “Now, we have the platform to ask the biggest questions in the field,” Rathore said, “and hopefully learn how to eliminate hidden HIV that current drugs can’t reach.”
Damage to the liver in patients developing end-stage liver disease has become too severe for the organ’s normally extraordinary regenerative capacity to repair or compensate for that damage. Once this point of no return has been reached the only option is an organ transplant. However, donor livers are in high demand and very limited supply.
Ambitious efforts are on the way that eventually could enable the engineering of entire implantable liver organs. However, the maximum size of laboratory-engineered liver constructs remains limited and cannot yet provide therapeutic benefits for patients. A research team at the Wyss Institute at Harvard University, Boston University, and MIT has now approached this important problem from a different angle.
“We asked if it would be possible to first implant a small-scale liver construct and then drive it to expand in the body following its engraftment,” said Christopher Chen, MD, PhD, a Wyss Institute core faculty member and the William Fairfield Warren Distinguished professor of biomedical engineering and director of the Biological Design Center at Boston University. “A sufficiently grown, functional ‘satellite liver’ could immediately relieve the metabolic burden in a damaged liver and help bridge the time until a transplant becomes available.”
Chen co-led the research together with associate faculty member Sangeeta Bhatia, MD, PhD, who is the John J. and Dorothy Wilson Professor of Health Sciences and Technology and of Electrical Engineering and Computer Science at the Koch Institute for Integrative Cancer Research at MIT, and a Howard Hughes Medical Institute investigator. Chen is also a leader of the Wyss Institute’s 3D Organ Engineering Initiative, and team lead of the recently awarded ARPA-H PRINT-supported ImPLANT project, which focuses on whole organ liver engineering at the Wyss and collaborating institutions.
The project, spearheaded by Amy Stoddard, PhD, (MIT ’25), who developed the approach in her doctoral research and then as a postdoctoral fellow, integrates tissue engineering and synthetic biology tools in a genetic strategy the team has named “bioengineered on-demand outgrowth via synthetic biology triggering,” or BOOST. By specifically rewiring the gene expression of primary liver hepatocytes and supportive fibroblast cells, the scientists were able to effectively switch on a tissue growth program in small, engineered liver constructs after their implantation into mice.
“Using engineered liver tissue as a proof-of-concept application, we integrated synthetic biology and tissue engineering tools to build liver tissues that can be expanded on-demand after implantation in vivo,” the team reported in their published paper in Science Advances, which is titled “Synthetic control of implanted engineered liver tissue growth.” In the paper they concluded “In this study, we define the first steps toward an unconventional approach to cell therapy scale-up: engineering a small construct and then inducing it to grow in situ … “This strategy, which we have named BOOST, could provide several key advantages, including circumventing the need for large quantities of cellular raw materials and bypassing the formidable challenge of generating a rapidly perfusable construct that can survive the engraftment period.”
The authors wrote, “Organ transplant is currently the only curative treatment for patients with end-stage organ failure, yet this therapy is inaccessible to many due to the paucity of organs available for transplant.” And while significant progress has been made in the field of engineering tissue-based cell therapies that could represent alternatives, or bridges to transplant, they acknowledge, “… scaling of these constructs to sizes of therapeutic relevance remains a barrier to clinical translation.”
In order to address current challenges associated with fabrication, Chen and colleagues looked at the problem from different angle, asking whether it would be possible to first implant a small-scale construct and then trigger it to expand in situ, after its engraftment into the host.
To be able to induce growth of an implanted small liver constructs in situ within a recipient’s body the researchers first needed to identify the relevant cues that would allow them to do so. “A key first step toward this method of in situ scale-up would be the successful control of cellular growth within the engineered construct after engraftment,” they wrote. Since liver growth is known to be regulated by soluble growth factors (GFs), Stoddard screened a collection of candidate factors to identify those that, when added to cultured human primary hepatocyte cells (HEPs), had the strongest growth-inducing effects.
The genetic “BOOST” strategy integrates tissue engineering and synthetic biology tools to enable on-demand liver growth inside the body. By specifically rewiring the gene expression of primary liver hepatocytes and supportive fibroblast cells, a tissue growth program is switched on in a small, engineered liver construct after its implantation into recipients and upon addition of an inducing agent (shown as a pill). As a result, the hepatocytes in the construct start and continue to proliferate until a desired construct size has been reached and the inducing signal is not provided anymore. In mice, BOOST resulted in robust and healthy liver growth. [Wyss Institute at Harvard University]
“We ended up with a set of four growth factors, HGF, TGFa, WNT2 and RSPO3, that potently induced sparsely scattered HEPs to grow in the culture dish,” said Stoddard. “But when we tested whether they could do the same in 3D liver tissues consisting of densely packed HEPs and fibroblasts, they turned out to be ineffective. This led us to hypothesize that there must be an additional mechanism at work in human HEPs that inhibits cell proliferation in high-density conditions.”
The team homed in on a protein, YAP, that senses mechanical signals, and which was known to move from cells’ cytosol to their nucleus in low-density conditions to help express genes involved in cell proliferation. However, in high-density conditions when cells are compressed, YAP is degraded in the cytosol, which prevents the activation of those target genes and restricts proliferation.
“Importantly, when we overexpressed a non-degradable version of YAP in HEPs, which also reaches the nucleus in high-density conditions to partake in gene regulation, we successfully overrode this density checkpoint in HEPs,” Stoddard said. “Interestingly, we found that HEPs needed to be stimulated with both YAP and GFs in order to grow in densely packed 3D liver tissues.”
Toward the goal of safely inducing and controlling HEP proliferation in a living organism, and eventually human patients, the researchers deployed synthetic biology tools to locally install control of these signaling pathways in HEPs and fibroblast cells within the engineered 3D liver tissues themselves. “We set out to engineer a synthetic biology toolkit capable of locally modulating growth factor and YAP signaling within engineered liver tissue, enabling on-demand control of proliferation even after implantation,” they noted.
The team engineered fibroblast cell lines that each secreted one of the four GFs, and HEPs that expressed the non-degradable YAP protein. And they made the expression of all proteins doxycycline (DOX)-inducible. They determined in time course experiments that a continuous seven-day treatment with DOX led 3D liver tissue composed of engineered cells to robustly expand in size and cell numbers in the culture dish. On DOX removal the HEPs reverted back to a non-proliferating state.
However, Stoddard noted, “… when we compared the gene expression of single cells in BOOST-engineered, DOX-induced 3D liver tissue to that of cells in non-engineered or BOOST-engineered, non-induced 3D liver tissue, we noticed that the expansion came with a trade-off: high proliferation rates went hand in hand with a less functional HEP state. While we believe this is a natural trade-off seen in a wide variety of biological settings, we hope to be able to address this in the future, recognizing that the liver also has native re-functionalization signals to harness.”
The litmus test for BOOST-engineered growth in 3D liver tissues was to see whether they would similarly expand following their implantation into living mice that were systemically treated with DOX for the same seven-day duration. Experiments showed that the implanted tissue exhibited a striking 500% increase in proliferation with a doubling of the engineered HEPs alone, and was vascularized to accommodate the metabolic demands of the expanded tissue. The tissue implants were also well tolerated by the mice, with no signs of fibrosis due to invading immune cells and fibroblast inflammation, or of tumor growth.
“These results were particularly exciting to us,” said Stoddard. “Prior to our work, injury to the host liver has always been required to trigger hepatocyte engraftment and proliferation. Here we were able to relieve this dependence, and trigger on-demand growth of implanted liver tissue in a completely healthy host.”
In the future, the team will explore the capacity of BOOSTed liver tissue to rescue the host in the setting of liver injury. “Our BOOST strategy lays the foundation for a future when solid organ cell therapies can be controlled non-surgically according to the needs of patients and their physicians,” Bhatia noted. “Beyond treating liver disease, the premise of BOOST could be applied to other engineered tissue therapeutics that are similarly constrained by challenges associated with tissue scale-up, such as engineered heart or pancreatic tissue to address serious diseases.”
In their paper the authors concluded, “… this work serves as an exciting proof-of-concept demonstration that scale-up of tissues via growth could be possible … Together, this work helps lay the foundations for a future of ‘smart’ tissue therapeutics that can be scaled to a patient’s needs and thereby offer treatment for numerous, previously incurable, diseases.”
Background: Visuospatial neglect (VSN) is a cognitive disorder following a stroke, where individuals fail to perceive or respond to stimuli on the contralesional side of space. Visual scanning training (VST) is the recommended treatment in clinical guidelines. Objective: This qualitative study explored how patients (N=10) and informal caregivers (N=8) perceived the usability and potential implementation of 3 extended reality (XR)–based serious games to enhance VST—1 in virtual reality and 2 in augmented reality—as tools for VST. These technologies not only enhance patient engagement but also enable detailed data collection to monitor therapeutic progress. Methods: The themes and feedback were compared with themes and feedback from VSN therapists from a previous study: (1) suitability for VSN rehabilitation, (2) applicability, (3) motivation, (4) guidance, (5) versatility, and (6) detailed insights in game performance. Results: Highlights were that patients reported high engagement and enjoyment, with many expressing willingness to use the games in both clinical and home settings. Informal caregivers supported these findings and emphasized the motivational value of the games. Additionally, both groups noted the importance of accessible instructions and technical support. Conclusions: Although XR technology offers potential in neurorehabilitation, a uniform solution may not suit all users. This study showed the importance of including diverse end-user groups in development for usability, acceptance, and implementation. Successful integration of XR in rehabilitation requires customizable features, structured support, and attention to the differing roles of caregivers. Further research is needed to evaluate the clinical effectiveness and optimize patient-tailored applications of XR in VSN treatment.
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<strong>Background:</strong> Effective communication about the relative risks of cigarettes and e-cigarettes can help increase switching away from cigarettes while minimizing unintended use. <strong>Objective:</strong> This study examined comprehension of a proposed modified exposure claim (MEC) about an e-cigarette (IQOS VEEV, the study product [SP]) and the effects of claim exposure on SP use intentions and risk perceptions among adult tobacco users and nonusers. <strong>Methods:</strong> Adult smokers with no intention to quit smoking (S-NIQ, n=606), adult smokers with an intention to quit smoking (S-IQ, n=600), adult e-cigarette users (ECU, n=630), adult former smokers (FS, n=619), adult tobacco and nicotine products (TNP) never-users aged 18-24 years (n=648), and adult TNP never-users aged 25 years and older (n=749; total N=3852) participated in a randomized between-groups online experimental study. Participants viewed a marketing brochure for the SP with (test condition) or without (control condition) an embedded MEC. Outcome measures included claim comprehension, intention to use the SP regularly, and perceived health risk to self from using the SP or smoking cigarettes. <strong>Results:</strong> Most participants were female (n=2110, 54.8%), had a mean age of 40.2 (SD 14.93) years, and were equally split across the 4 US regions. S-IQ and S-NIQ were long-term, frequent cigarette smokers, while 91.4% (566/619) of FS were long-term quitters. ECU on average used e-cigarettes ≥15.2 times per day, and the majority of them (552/630, 87.6%) had started using e-cigarettes more than 12 months before. Most participants correctly understood the key elements of the claim: the SP produces lower levels of harmful chemicals compared to cigarettes (1818/1926, 94.4%), and switching completely from cigarettes to the SP reduces exposure to harmful chemicals (1832/1926, 95.1%). In both conditions, positive intention to use the SP was high among ECU (control: 238/314, 75.8% vs test: 249/315, 79%; <i>P</i>=.33), moderate among S-IQ (control: 127/299, 42.5%; test: 166/299, 55.5%; <i>P</i><.001) and S-NIQ (control: 140/299, 46.8%; test: 166/307, 54.1%; <i>P</i>=.07), low among FS (control: 28/306, 9.2%; test: 33/312, 10.6%; <i>P</i>=.55), and very low among adult TNP never-users aged 18-24 years (control: 3/330, 0.9%; test: 8/318, 2.5%; <i>P</i>=.11), and adult TNP never-users aged 25 years and older (control: 5/373, 1.3% vs test: 12/375, 3.2%; <i>P</i>=.09). All groups understood that the SP posed a lower health risk compared to cigarettes. In all groups, claim exposure was associated with significantly lower risk perception of the SP relative to cigarettes (all comparisons, <i>P</i><.001). <strong>Conclusions:</strong> The tested MEC has the potential to benefit public health by simultaneously increasing already high levels of SP use intention and reducing SP risk perceptions relative to cigarettes among adult tobacco users while generating low levels of use intention among tobacco nonusers. <strong>Trial Registration:</strong>
Background: Access to mental health care is critical for the effective management of serious mental illness (SMI), but consumers with low socioeconomic status (SES) have lower rates of service usage and worse retention in care. Digital technologies are often lauded as a way to bridge access gaps; however, little is known about how technology-mediated care may influence care access among low-SES consumers and how consumers use technology in care access. Objective: This study aimed to examine the applicability of Levesque et al’s access framework to technology-mediated care for SMI and analyze how low-SES consumers use technology to facilitate care access. Furthermore, the study assesses whether and how technologies are involved in care access at multiple points within the process of accessing care. Methods: This study used 2 qualitative methods: ethnographic observations at a mental health treatment court and interviews with low-SES consumers with SMI using community mental health care (n=14) and key informant interviews with health and service providers working with this population (n=14). Observations occurred from July 2022 through September 2023, and interviews occurred between January 2022 and May 2024. Data analysis involved both inductive and deductive coding approaches. Data from both the interviews and observations were analyzed in NVivo and further triangulated through analytic memos. Results: Levesque et al’s framework required several extensions to accommodate technology-mediated care related to SMI for low-SES consumers: (1) a cyclical rather than linear trajectory; (2) simultaneous care acquisition from multiple health and service providers; (3) staying in care long-term; (4) identification of both one-time and ongoing health needs; and (5) an emergency pathway for entering care. Consumers often faced challenges related to the varied digital requirements of each provider and a dearth of integrative, patient-facing tools like portals. Within this context, some consumers use mobile apps, communication, and telehealth technologies across various care access stages. Consumers used technology by figuring out how to navigate technology-mediated care, especially by leaning on others, such as case managers, for support. These others provided consumers with temporary technologies, showed them how to use technologies, and accompanied them through the process of using technology for accessing care. Conclusions: This study highlights that accessing care is iterative and ongoing, involving multiple forms of co-occurring service provision. A theoretical contribution of this work is its extension of Levesque et al’s care access framework to better reflect technology-mediated care for SMI among low-SES consumers. This work also underscores ongoing challenges for accessing technology-mediated care and the importance of human support in addressing access difficulties. Clinical implications include incorporating digital readiness assessments and providing comprehensive guidance on how consumers can effectively use technologies for care. Future work should investigate how technology-mediated care can make care access easier rather than harder.
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<strong>Background:</strong> Campus shootings, though infrequent, result in significant loss of life, psychological trauma, and disruption to university communities. Traditional preparedness programs developed for K-12 settings do not translate well to university environments. Virtual reality (VR) offers an immersive and engaging method to enhance situational awareness and decision-making during high-stress events. <strong>Objective:</strong> This study aimed to develop the Safe@Campus prototype, a theory-informed, stakeholder-engaged VR-based prototype designed to prepare university students to recognize and respond to campus shooting threats, and to evaluate its initial usability and feasibility among undergraduate students. <strong>Methods:</strong> We followed a 2-phase, user-centered design process. Phase I (stakeholder-informed feasibility assessment and prototype refinement): through interviews with campus safety experts, firearm safety practitioners, school safety specialists, and students, we identified key content, scenario requirements, and implementation considerations. A 360-degree video–based VR prototype depicting an active shooter incident in a university classroom was developed using Unity3D, incorporating branching decision points aligned with the “run, hide, or fight” framework. Expert and user feedback guided iterative refinements. Phase II (student usability and acceptability testing): 2 focus groups with undergraduates at The Ohio State University (N=17) viewed a VR scenario and then participated in guided discussions about prior training experiences, the acceptability of VR, and recommendations for improvement. Transcripts were analyzed using constant comparative methods in ATLAS.ti (version 25). <strong>Results:</strong> The first focus group comprised 8 students (n=5, 63% female; n=3, 38% White, n=4, 50% Asian/Asian American), and the second comprised 9 students (n=6, 67% female; n=6, 67% White). Across both groups, 82% (14/17) reported participating in active shooter drills during K-12 schooling, yet many felt these experiences did not adequately prepare them for the complexity of university environments. The following four major themes emerged: (1) prior experience with active shooter drills: K-12 drills varied widely in realism and left students uncertain about appropriate actions in university settings; (2) need for university-specific training: participants noted substantial gaps in preparedness and expressed strong support for required, standardized training; (3) perceived usefulness of VR: students found VR highly engaging, realistic, and effective for reinforcing situational awareness and decision-making; and (4) recommendations for prototype improvement: students suggested increasing interactivity, adding time-pressured decisions, expanding scenarios to diverse campus spaces, and integrating the program into required university activities such as orientation. <strong>Conclusions:</strong> Safe@Campus is a feasible, acceptable, and engaging VR-based approach to campus shooting preparedness. Students viewed the immersive, decision-driven format as an effective way to build practical skills not addressed by traditional training. Future development should expand scenario diversity, increase interactivity, and evaluate program effectiveness in larger trials. <strong>Trial Registration:</strong>
Background: Youth experiencing early psychosis in West Africa often face delays in accessing evidence-based treatment. Digital mental health interventions may offer an acceptable and scalable approach to improve access to early psychosis care in West Africa; however, few data exist on the experiences and perspectives of patients with early psychosis and their caregivers to inform digital intervention development. Objective: This study aims to explore current experiences of early psychosis care, identify barriers and facilitators to in-person early psychosis care within health facilities, and identify opportunities for digital interventions to support patients with early psychosis and caregivers in Ghana. Methods: We conducted qualitative focus group discussions among patients with early psychosis, their caregivers, and their mental health care providers recruited at Accra Psychiatric Hospital in Accra, Ghana. Trained qualitative researchers facilitated discussions using a structured qualitative interview guide, exploring current care practices for early psychosis in Ghana, barriers and facilitators to facility-based care, and perceptions of digital mental health interventions. Transcripts were translated, transcribed, and analyzed thematically using a hybrid inductive and deductive approach grounded in the theoretical framework of acceptability. Results: Overall, we conducted 4 focus group discussions (N=31) among 7 patients with early psychosis (median age 28, IQR 21‐41 years), 6 caregivers (median age 58, IQR 29‐34 years), and 18 clinicians (median age 30, IQR 29‐34 years). Participants described current early psychosis care practices in Ghana, including seeking spiritual and traditional healing, the dearth of information and resources about psychosis, and the integral role of caregivers in facilitating treatment engagement and continuation (often at the cost of caregiver mental distress and burnout). Common barriers to facility-based mental health care included stigma associated with mental illness, lack of prior knowledge about early psychosis and treatment options, and practical constraints (eg, financial, logistical, and health care system limitations). Motivating factors for facility-based care included success stories from community members and strong rapport and trust in mental health clinicians. Technology (eg, mobile phones, laptops, radio, and television) was commonly used among participants in typical daily tasks, health information seeking, and stress reduction. Participants expressed support for digital tools that could deliver psychoeducation about early psychosis, support treatment adherence, and extend patient-provider communication between clinic visits. Conclusions: Digital mental health interventions have the potential to complement facility-based early psychosis services in Ghana by addressing misinformation, reducing access barriers, and supporting caregiver roles. These qualitative findings inform potential integration points, content, attributes, and strengths of digital modalities that could be leveraged to support patients with early psychosis and their caregivers in Ghana.
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Background: Treatment-as-usual (TAU) conditions are intended to reflect the support typically received in routine treatment settings. For digital mental health interventions (DMHIs) delivered online, TAU conditions should reflect the usual patterns of online help-seeking. The lack of ecologically valid TAU control conditions has been a gap in effectiveness trials of online DMHIs. In this study, mental health–related popular online content (eg, advice TikToks, lived experience vlogs, and self-care infographics) was examined as a valuable TAU control condition. Objective: This study examined the feasibility of popular online content as a TAU control condition in DMHI trials. Methods: This study was a secondary analysis of two randomized controlled trials. Both trials recruited participants online, primarily via an online study recruitment platform. In study 1 (N=916), US adults with elevated depression or anxiety were randomized to either (1) complete a single-session DHMI for depression and anxiety (n=291), (2) search the web for popular online content relevant to their struggles (n=312), or (3) search a curated library of mental health–related popular online content (n=313). In study 2 (N=431), US adults with elevated loneliness were randomized to (1) complete a single-session DHMI for loneliness (n=136), (2) search a curated library of popular online content related to loneliness (n=145), or (3) complete an attention-matched control condition (n=150). All 6 programs took approximately 10 to 20 minutes to complete and were entirely self-guided. Participants rated each program’s credibility and expected benefit, as well as their feelings of distress (study 1) and loneliness (study 2). The studies did not involve interaction between participants and the research team. Results: In study 1, dropout during the treatment was 4.8% (14/291) for the single-session intervention, 25.9% (81/312) for online help-seeking, and 9.6% (30/313) for the curated library. The curated library’s credibility and expected benefit score did not differ from that of the single-session intervention (Cohen =0.08; =.88) and was higher than that of unguided help-seeking (Cohen =0.23; =.01). In study 2, dropout was higher in the curated library condition (7/145, 4.8%) than in the single-session intervention and the attention-matched control condition (0/136, 0.0% and 0/150, 0.0%). The mean credibility and expected benefit score for the curated library was comparable to that of the attention-matched control condition (Cohen =0.00; >.99) but lower than that of the single-session intervention (Cohen =0.32; =.02). Changes in distress and loneliness from baseline to 8-week follow-up did not differ across the conditions in study 1. All effect sizes were small in study 1 (Cohen <0.15 and no comparisons were statistically significant >.06). Similarly, in study 2, all effect sizes were small (Cohen <0.12), and no comparisons were statistically significant (>.25). Conclusions: Curated libraries of popular online content are a feasible, ecologically valid TAU benchmark for effectiveness trials of online DMHIs. Future research on TAU conditions in online help-seeking contexts should better align with observed DMHI attrition rates and account for the increasingly central role of conversational artificial intelligence in online mental health support. Trial Registration: OSF Registries 3DYMA; https://osf.io/3dyma and NVD79; https://osf.io/nvd79; ClinicalTrials.gov NCT05687162; https://clinicaltrials.gov/study/NCT05687162
![The genetic “BOOST” strategy integrates tissue engineering and synthetic biology tools to enable on-demand liver growth inside the body. By specifically rewiring the gene expression of primary liver hepatocytes and supportive fibroblast cells, a tissue growth program is switched on in a small, engineered liver construct after its implantation into recipients and upon addition of an inducing agent (shown as a pill). As a result, the hepatocytes in the construct start and continue to proliferate until a desired construct size has been reached and the inducing signal is not provided anymore. In mice, BOOST resulted in robust and healthy liver growth. [Wyss Institute at Harvard University]](https://www.genengnews.com/wp-content/uploads/2026/04/Low-Res_Press-graphics-01-300x225.jpg)
