Tag: Academic research

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Path and Bayesian network analyses in the complex design of a well-being survey via New Zealand’s Integrated Data Infrastructure

IntroductionIn mental health research involved with sensitive features and privacy issues, using integrated data offers an efficient alternative to traditional approaches such as interviews or in−person data collection. These conventional methods frequently face logistical barriers, including low response rates among study populations. Using integrated data from multiple existing administrative and survey sources provides protection for participants and economic savings for researchers, despite being constrained by the limitations of the original data sources. Our research questions were: 1) Can we conduct path and network analyses of school absenteeism, psychosocial factors, and mental health outcomes using the integrated survey data from New Zealand’s Integrated Data Infrastructure (IDI)? and 2) How can we account for the complex design of the General Social Survey (GSS) to ensure representative inference?Materials and methodsThe study population was New Zealand youth enrolled in school, aged 15 years and older in 2018, who participated in the 2018 GSS. The study analyzed the Ministry of Education data integrated with the 2018 GSS survey data from New Zealand’s IDI. To explore the relationship between outcomes of including the WHO-5, “perceived life worthwhileness”, “perceived general health”, and predictors including school absenteeism, psychosocial factors, and family factors, quantile mixed−effects regression, path analysis, and Bayesian network (BN) analysis were used. The complex survey design was calibrated using replicated weights from the GSS, a design-based method for complex sampling, in path and regression analyses, and bootstrap resampling, in BN analysis.ResultsIn descending order from the weighted path model, overall life satisfaction (standardized path coefficient: 0.36), perceived health condition (0.34), ease in accepting cultural identity (0.12), and trust in the education system (0.07) were all significantly (positively) related to students’ mental health well-being (WHO-5). Perceived life worthwhileness correlated with the WHO-5 but was only connected to overall life satisfaction. Similar factors were identified for perceived health, with additional attributing factors, such as fear of crime in the area and the family’s overall well-being.ConclusionThe integration of Bayesian networks and path analysis offers rigorous methods for detecting complex interrelationships among integrated mental health outcomes from population data and variables from a complex survey design.
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Comprehensive Human Vagus Nerve Map Unveiled

Scientists at Northwell Health’s Feinstein Institutes for Medical Research said they have released the world’s first comprehensive human vagus nerve anatomical map. The achievement could change our understanding of the autonomic nervous system and accelerate the development of bioelectronic medicine and neuromodulation therapies, according to the researchers.

The first dataset release, collected over three years from 30 human donors encompassing 60 vagus nerves, is now available to the global scientific community via SPARC Science.

The vagus nerve is the longest cranial nerve and a critical “information superhighway,” consisting of two main bundles (one on the left side of the neck and the other on the right side of the neck) containing more than 200,000 individual nerve fibers stretching from the brainstem to all major organs.

Stavros Zanos, MD, PhD [Feinstein Institutes]
Stavros Zanos, MD, PhD [Feinstein Institutes]

The nerve manages automatic functions such as heart rate, breathing and digestion, and serves as the body’s “on/off switch” for immune response and inflammation. To better understand the function of each vagal fiber, this new dataset resource offers a 3D view into the intricate anatomy of the human vagus nerve, utilizing techniques such as microCT imaging, immunohistochemistry, and ultrasound.

By mapping the organization of fascicles and fibers, investigators expect to gain critical insights into how the vagus nerve communicates with various organs and influences human health and disease.

“This dataset represents a major step forward in bioelectronic medicine, offering the most detailed anatomical reconstruction of the human vagus nerve to date,” said Stavros Zanos, MD, PhD, associate professor in the Institute of Bioelectronic Medicine at the Feinstein Institutes and co-leader of the project. “For the first time, we can visualize the vagus nerve’s complex architecture that will allow us to design more precise, effective and safe neuromodulation therapies and devices.”

The accomplishment marks a milestone that began with a $6.7 million National Institutes of Health (NIH) grant awarded to the Feinstein Institutes in October 2022 for its Reconstructing Vagal Anatomy (REVA) project, part of the NIH Common Fund’s SPARC program. The successful delivery of the map was supported by Peter J. Pappas, Jr., whose donation provided philanthropic support towards the goals of this project.

Kevin J. Tracey, MD [[Feinstein Institutes]
Kevin J. Tracey, MD [Feinstein Institutes]

“Decoding the vagus nerve’s intricate language is an important advance for science and medicine,” said Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes, Karches Family Distinguished Chair in Medical Research and author of the book The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes. “This knowledge will further empower researchers to re-engineer human biology and unlock novel therapies for future patients.”

The Feinstein Institutes for Medical Research is a global scientific leader in bioelectronic medicine and vagus nerve stimulation, where medical researchers use modern technology to develop new device-based therapies to treat disease and injury, according to a Feinstein spokesperson, who points out that the field of bioelectronic medicine integrates insights from neuroscience, molecular medicine and biomedical engineering, and researchers at the Feinstein Institutes leverage the connection between the brain and the immune system to develop bioelectronic medicine interventions.

The vagus nerve helps regulate blood pressure, heart rate, sleep, mood, breathing, bladder function, digestion, and the immune system. [Feinstein Institutes]
The vagus nerve helps regulate blood pressure, heart rate, sleep, mood, breathing, bladder function, digestion, and the immune system. [Feinstein Institutes]

The discovery that initiated the field of bioelectronic medicine—called the “inflammatory reflex”—was made more than 30 years ago by Tracey, continues the Feinstein official. This discovery emerged from studies on vagus nerve signaling and showed that the brain and body communicate to regulate inflammation and, if uncontrolled, inflammation could lead to disease, said Tracey.

It was the first FDA-approved vagus nerve stimulation device in July 2025 to treat rheumatoid arthritis. Northwell Health was the first in the nation to implant the newly approved treatment in patients in August 2025.

Today, engineers, computer scientists, immunologists, neuroscientists and clinicians develop cutting-edge medicine, including neuroimmune modulation, miniature implants for stimulating and recording the vagus nerve, noninvasive ultrasound neuromodulation to suppress inflammation, and novel brain-computer interfaces to overcome injuries of the nervous system, according to a Feinstein Institutes statement. These collaborative efforts are focused on converging to create personalized, precise treatments that hold promise in treating acute and chronic diseases, often with fewer side effects compared to current therapies.

Scientists believe these treatments have the potential to enhance or replace existing treatments across a range of conditions such as arthritis, heart disease, inflammatory bowel diseases, diabetes, cancer, and autoimmune disorders. By producing bioelectronic medicine knowledge, disease and injury could one day be treated by our own nerves without costly and potentially harmful pharmaceuticals, predict a number of researchers.

 

 

 

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Implementing a Smartphone and Wearable-Based Stress Management Intervention in Women With Coronary Artery Spasms to Reduce Cardiac Symptoms: Multicenter, Single-Arm, 1-Way Crossover Study

Background: Mental stress is a well-known trigger of cardiac symptoms in patients with coronary artery spasms. Hence, stress management is recommended along with medical therapy. However, specific programs for patients with coronary spasms are lacking. We collaborated with patients to develop a smartphone-based app as a tailored solution. The app provides biofeedback based on heart rate variability–driven stress level estimations. Objective: This study aimed to evaluate the effect of a biofeedback-driven smartphone stress management app on cardiac symptoms in women with coronary vasospasms. Methods: We enrolled 117 women aged 18 to 70 years diagnosed with coronary vasospasms, as confirmed by a gold standard coronary function test. A multicenter, single-sequence, 2-period crossover study was conducted, comprising a 4-week control period followed by a 4-week period using the Wavy intervention app. The intervention comprised breathing-based exercises that were prompted when measured stress levels were too high. The primary outcome was the Seattle Angina Questionnaire Summary Score, and the secondary outcomes included the 36-Item Short Form Health Survey and the Perceived Stress Scale-10 items. Additionally, the user experience and the impact of the breathing exercise on heart rate variability were evaluated. Results: A total of 102 patients completed the study, yet no significant improvements were observed in the Seattle Angina Questionnaire following the intervention period, with the control group scores at 50.4 (SD 15.4) and the intervention group scores at 50.9 (SD 15.0; <i>P</i>=.92). Similarly, no differences were found in the 36-Item Short Form Health Survey and the Perceived Stress Score. However, the 1236 breathing relaxation exercises performed during the study led to a significant improvement in heart rate variability, as indicated by a median root mean square of successive differences increase from 18.59 (IQR 8.38-36.58) milliseconds before the exercises to 34.93 (IQR 24.19-50.64) milliseconds after the exercises (<i>z</i>=−13.72; <i>P</i><.001). Furthermore, two-thirds of participants (68/102, 66.7%) indicated that they would use a more refined version of the app in the future. Conclusions: A 4-week intervention using the Wavy app did not significantly alleviate anginal symptoms in female patients with coronary vasospasms. However, the breathing exercises demonstrated a notable improvement in heart rate variability, suggesting a reduction in stress levels. Patient feedback indicated broad support for the app and its wearable-based functionality, emphasizing the need for substantial refinements. Future development should incorporate patient perspectives to optimize the app as a comprehensive lifestyle management tool. Clinical Trial: ClinicalTrials.gov NCT06171893; https://classic.clinicaltrials.gov/ct2/show/NCT06171893
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Samsung’s chip workers are jumping ship to rival SK Hynix 

Lee, an engineer at Samsung’s semiconductor division, clocks out when his shift ends. He used to work longer hours, going the extra mile to excel at his projects. But lately, he’s been coming straight home to work on his job application for the chipmaker’s South Korean rival SK Hynix, sharing tips with his coworkers on how to draft a stellar personal statement. Even his boss encourages him to make the move.

“My team lead tells us all to jump ship to SK Hynix,” says Lee. He and his coworkers are feeling demoralized by the $476,000 bonus that SK Hynix is set to pay its employees, flush with record profits from making the high-bandwidth memory (HBM) chips that power Nvidia’s AI accelerators. The figure dwarfs what chip workers at Samsung are set to receive and is sparking an exodus.

As the AI boom heats up, the semiconductor titans are waging a fierce talent war with flashy bonuses, aggressive recruiting, and even a courtroom injunction. Who wins could tilt the race to dominate the next generation of the HBM chips at the heart of the AI boom.

“Except for our two team leads, my entire team [of 30 people] just applied to SK Hynix,” Lee says, referring to a job posting the company published in July. Lee, who has worked at Samsung for three years, even applied for an entry-level position at its rival. A coworker, who has worked at Samsung for eight years, applied for the same one. They both got rejected. But they’re hopeful that they’ll get a callback for a posting seeking a more experienced engineer.

All employees at Samsung and SK Hynix that MIT Technology Review spoke with asked to be identified by just their last name or a pseudonym because they feared retaliation from their employer. Samsung declined to comment, and SK Hynix did not respond to requests for comment.

After prolonged negotiations with its labor union, Samsung struck a deal in May to pay out 10.5% of the semiconductor division’s operating profits to employees as bonuses annually for 10 years, mostly in company stock that vests over three years. The move came after SK Hynix agreed last year to pay out 10% of operating profits to employees, which translates to $476,000 per employee this year—mostly in cash.  

But at Samsung, each division’s bonus is tied to its own bottom line. Chip workers in its memory division, which is also reaping a windfall from making HBM chips, are getting paid a bonus of roughly $400,000 per employee this year. But those who, like Lee, work in Samsung’s foundry division, which manufactures logic chips that companies like Tesla and Google design and has been operating at a loss, are getting a bonus of roughly $135,000. 

Employees told MIT Technology Review that Samsung said it can’t give as many bonuses to divisions that aren’t performing well. Lee, after watching the labor union wrestle with the company for months, says he has felt disappointed by what he ended up with: “Even if Samsung does well in the future, I don’t think any of it will trickle down to me.” 

The workers’ lagging bonuses are making SK Hynix suddenly look appealing. According to a survey by the Samsung labor union in June, 81.5% of employees in the company’s foundry division, and nearly half of employees in the semiconductor division as a whole, said they wanted to go to another company in the next two years. In April, Samsung labor union chief Choi Seung-ho said more than 200 members of the union had left for SK Hynix over the past four months. On Blind, an anonymous workplace forum, a chorus of disgruntled engineers at Samsung confess that they want to defect to SK Hynix for the bigger bonuses. 

For decades, SK Hynix lived in Samsung’s shadow. It was the smaller, scrappier memory maker that elite engineering students at universities looked past when applying for jobs. But in 2019, Samsung downsized its HBM team, betting the market would stay niche, while SK Hynix doubled down on the technology. Then the AI boom supercharged the demand for HBMs, which feed AI chips the enormous amounts of data they need at ultra-high speed, driving prices to unprecedented levels. SK Hynix now leads the global market for HBMs, while Samsung is playing catch-up. Both companies topped $1 trillion in market value in May, and SK Hynix briefly dethroned Samsung as South Korea’s most valuable company in June.

Predicting that demand for memory chips will continue to surge, the semiconductor titans are making aggressive investments to expand their business. Last month, the companies unveiled plans to invest more than $2 trillion by 2040, including a semiconductor “mega-cluster” in Yongin, a city south of Seoul. To staff the expansion, SK Hynix added 2,152 employees in the first half of 2026 alone and aims to double its manufacturing capacity in five years. Samsung plans to hire 60,000 employees over the next five years, especially for its semiconductor division. Even so, the pipeline will fall short: South Korea’s semiconductor industry will need about 304,000 workers by 2031 and faces a shortage of roughly 54,000, according to the Korea Semiconductor Industry Association.

Now the longtime rivals are showering workers with big bonuses to keep—and poach—talent. “[SK Hynix] seems to target Samsung engineers when hiring because it’s a rival,” says Baek, a manager at SK Hynix. “From what I heard internally, the big performance bonuses we got were aimed at luring away talent from our competitor.”

Courts are starting to weigh in. In July, Samsung won an injunction barring two former chip workers from working at SK Hynix for 18 months, on the grounds that chips are a national core technology deserving protection. “With competition in the semiconductor industry fierce, it’s necessary to establish a fair market order,” the court ruled.

The talent exodus threatens a crucial advantage that Samsung still holds in the HBM race. “Samsung is the only memory maker in the world that owns a foundry business,” says Park Jun-young, a semiconductor expert at the Industrial Anthropology Laboratory, a research institute, who worked at Samsung for a decade. 

With the latest generation of the technology, known as HBM4, the logic chip at the base of each memory stack must be manufactured with the kind of advanced process that only foundries run. Samsung can do this in-house, while SK Hynix outsources it to the Taiwanese foundry giant TSMC. “If Samsung keeps losing engineers in the foundry … the collaboration between memory division and foundry division could become difficult,” says Park. “SK Hynix, which used to have only a memory team and is now hiring foundry engineers, could do better research on HBMs.”

Choi, an engineer who has worked at Samsung for seven years, says he was once a star on his team, getting glowing performance reviews from his managers. But lately, he and his coworkers have been busy applying for every SK Hynix job posting they see. “We tell each other when the next SK Hynix job posting is up,” he says. “There’s always more work to do beyond our basic duties. But there’s no point in doing it.”

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Lessons From Building a Large, Public HIV-Related Database in Support of the Ending the HIV Epidemic in the US Initiative

The HIV epidemic remains a national priority in the United States, and the Ending the HIV Epidemic initiative has renewed the call for expanded prevention and treatment strategies capable of reducing new HIV infections by 90% by 2030. Achieving this goal requires robust, integrated data for understanding HIV-related needs, barriers to care, and the effectiveness of interventions. However, despite the existence of numerous publicly available datasets, few integrate multiple domains such as HIV outcomes, social determinants of health, and community-level factors. The lack of unified data and difficulty linking datasets hampers efforts for meaningful cross-domain analyses to tailor HIV management and treatment strategies. The resulting fragmentation constitutes a methodological gap: implementation teams lack replicable guidance for constructing unified HIV and contextual databases from public sources. In this viewpoint, we describe our experience building a unified compilation of publicly available HIV and community data to identify factors influencing HIV outcomes and interventions. The completed database comprises 242 variables drawn from 8 public sources mapped across clinic, zip code, county, and state levels of geography. Rather than simply reporting what we built, we position four core decisions as transferable methodological advances: (1) treating source identification as a bounded phase before construction begins, (2) adopting automated data engineering tools from the outset rather than manual entry, (3) establishing a shared data dictionary before the first variable is entered, and (4) integrating quality control throughout the workflow rather than as a final phase. The build required approximately 350 total project hours and revealed an initial spot-check error rate of approximately 33%, which we attribute primarily to manual data entry. By sharing the approach used to develop this database and making the final resource publicly accessible through the Yale Center for Methods in Implementation and Prevention Science, we aim to reduce barriers to data access and encourage similar data integration efforts. The methodological framework described in this paper is intentionally designed to be replicable with modest resources, and we present it as a practical model for research teams operating without specialized infrastructure. Consolidating HIV, social determinants of health, and contextual variables into a unified data source is a critical step toward enabling deeper, more comprehensive analysis and supporting ongoing efforts to end the HIV epidemic in the US.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/5ea9fe72c2273a99e2615ef582c2512a" />

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Structuring Digital Mental Health Care Navigation: Co-Design Nominal Group Technique Study to Develop the MChart Definition and Typology of the Characteristics of Digital Mental Health Care Navigation Tools

<strong>Background:</strong> Australia’s mental health care system has been characterized by complexity and fragmentation, as highlighted by numerous reports, commissions, and inquiries. In response, digital mental health care navigation tools have emerged as a promising solution to help individuals locate appropriate mental health services. The rapid proliferation of these tools—without a clear understanding of their definitions and characteristics—risks creating confusion rather than clarity for users. Terms such as “navigation” and “navigators” are often used interchangeably, further complicating the landscape. <strong>Objective:</strong> This study addressed the need for a standardized definition and typology of the characteristics of digital mental health care navigation tools. <strong>Methods:</strong> This study was part of the development of a digital mental health care navigation tool for navigators and planners (MChart). It used a co-design approach using expert-based cooperative analysis, which is a nominal group technique to develop a definition and typology of the characteristics of digital mental health care navigation tools. This process was guided by the Technology Readiness Level for Implementation Sciences framework. The co-design process involved two 2-hour sessions with an expert panel comprising 28 participants, including representatives from mental health planning, primary health care, health care financing and delivery, community-managed organizations, clinical settings (psychiatrists, psychologists, and general practitioners), and consumers. <strong>Results:</strong> The expert panel collaboratively developed a consensus definition of digital mental health care navigation tools, outlining their scope and intended targets. Through the co-design process, the panel identified 157 characteristics of digital mental health care navigation tools. These characteristics were organized into 5 primary domains: type, management, content, design, and quality. The definition and typology characteristics provide a structured framework for understanding and evaluating the diverse range of digital mental health care navigation tools currently available. <strong>Conclusions:</strong> The co-designed definition and typology offer a foundational step toward reducing confusion in the digital mental health care navigation space. This study supports the development of quality standards that can be used to assess and compare existing and future tools. This framework has the potential to guide developers, end users, and policymakers in creating more effective, user-centered navigation solutions within Australia’s mental health care system and internationally.
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Solving the Mystery of Why Blocking and Stimulating a Brain Receptor Helps Weight Loss

Researchers headed by a team at the Institute of Metabolic Science, University of Cambridge, have solved the mystery of why both stimulating and blocking a particular receptor, or switch, in the brain can help people lose weight. Their study in mice indicated that the answer lies in where the receptor, called GIPR, is located. The results showed that stimulating this switch in the brainstem suppresses appetite, while the same effect can be achieved by blocking it in the hypothalamus. The researchers say their findings could help in the development of more effectiveness therapeutic strategies.

Jo Lewis, PhD, at the Institute of Metabolic Science at the University of Cambridge, said, “Understanding which brain circuits respond to these medications—and how they do so—could help us design better drugs that produce more weight loss with fewer side effects, and which might work in combination with other obesity medicines to even greater effect.” Lewis is first author of the team’s published paper in Nature Metabolism, titled “Distinct brain regions mediate regulation of food intake in response to GIPR agonism or antagonism.”

More than a billion people worldwide are living with obesity, which increases the risk of diseases such as type 2 diabetes (T2D), cardiovascular disease (CVD) and cancer. Weight loss can help mitigate these complications, but losing weight through diet and exercise alone can prove challenging.

In the past few years, a new generation of weight loss drugs has emerged that target particular receptors in the brain, reducing appetite and leading to weight loss, as well as helping to control blood sugar levels. Several of these drugs, such as Wegovy and Ozempic, work by stimulating the glucagon-like peptide 1 receptor (GLP-1R).

Other weight loss drugs act on both this receptor and on GIPR. “The development of dual agonists for the glucagon-like peptide-1 receptor (GLP-1R) and glucose-dependent insulinotropic polypeptide receptor (GIPR) has been a landmark moment in the treatment of type 2 diabetes and obesity,” the authors wrote.

However, some drugs, such as Mounjaro and Zepbound, stimulate GIPR, while others, such as the Phase III-stage MariTide, block it. Why these opposite actions have the same result has puzzled scientists. “… for reasons that are incompletely understood, in preclinical and clinical studies, adding either a GIPR agonist or GIPR antagonist to GLP-1R agonism causes additional weight loss,” the team continued. “There is emerging evidence that GIPR agonism and antagonism exert their paradoxically similar effects on weight loss via distinct neuronal populations.”

The investigators’ newly reported preclinical research has now shown that the two different types of GIPR drugs act on distinct regions of the brain, but also that they can boost weight loss when combined with certain GLP-1-based weight-loss drugs. For their reported study the team turned to genetically engineered mice and selectively removed GIPR from different parts of the brain to see which regions were responsible for the effects of the obesity drugs.

One group of mice lacked GIPR in the brainstem—the area at the base of the brain, just above the spinal cord, involved in appetite and nausea. A second group lacked GIPR in the hypothalamus, a major center controlling hunger and body weight. A third, control group included normal, unmodified mice. The researchers treated the mice with various combinations of a GIPR agonist (which activates the receptor), a GIPR antagonist (which blocks the receptor) and a GLP-1 drug, and measured food intake, body weight, fat mass, glucose control and brain activity.

“We knock out Gipr in either the area postrema (AP) or hypothalamus of mice (GiprAP-KO  and Giprhypo-KO, respectively) and compare body weight and food intake responses to GIPR agonists and antagonists, alone and in combination with the GLP-1R agonist liraglutide,” they wrote in summary.

By comparing the responses of normal mice with mice lacking GIPR in different brain areas the investigators showed that GIPR agonists act on the brainstem to suppress appetite and reduce weight. They then showed that GIPR antagonists help weight loss by acting on this receptor in the hypothalamus, where they release a “brake” that otherwise limits the brainstem’s ability to respond to signals telling us we are full. Blocking GIPR also appeared to boost the effect of emerging new drugs targeting the amylin receptor—such as cagrilintide (Cagri)—suggesting that GIPR antagonists could potentially be used to strengthen several types of anti-obesity medicines.

“Overall, our results suggest that the AP is responsible for the appetite-suppressing effects of GIPR agonism but that GIP receptors in the hypothalamus underlie the ability of GIPR antagonism to enhance the weight loss effects of GLP-1R and amylin receptor agonists,” they stated. “GIPR antagonism and Giprhypo-KO also sensitize to cagrilintide-induced weight loss.

The findings explain why drugs such as MariTide, which combines GIPR antagonism with GLP-1 receptor agonism, are effective, and suggests how to design even better combination therapies. And as the authors noted, “Future work is still, however, required to identify the neuronal networks underlying GIPR interactions in the AP and hypothalamus and their crosstalk with other appetite-regulating circuitry.”

Lewis said the work strengthens the idea that the brain is central to obesity treatment, commenting, “Obesity drugs are not acting simply on the gut or pancreas. Instead, they have important effects on specific, identifiable brain circuits that regulate appetite and food intake.”

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