Self-referential processing (SRP), the mental activity of linking experiences and stimuli to the self, is fundamental to shaping identity, regulating affect, and navigating complex social environments. Disruptions in SRP are increasingly recognized as a transdiagnostic hallmark across psychiatric disorders, including schizophrenia spectrum disorders, major depressive disorder, and anxiety disorders. Such disruptions often manifest as distorted self-perception, negative cognitive-affective biases, and dysfunctional connectivity within key neural networks, particularly the default mode network (DMN) and the medial prefrontal cortex (mPFC). Emerging evidence reveals a dynamic bidirectional relationship between SRP and empathy. Impairments in self-processing may hinder the capacity to accurately infer others’ emotional and cognitive states, while deficits in empathic attunement may reinforce maladaptive self-focus. This interplay contributes to social withdrawal, interpersonal dysfunction, and emotional dysregulation across diagnostic boundaries. Recent therapeutic advances suggest that interventions targeting the interface between SRP and empathy may effectively modulate shared neurocognitive mechanisms. Such interventions include metacognitive therapy, mindfulness-based interventions, and psychedelic-assisted psychotherapy. These therapeutic approaches show preliminary but promising evidence for reducing maladaptive self-focused attention, enhancing emotion regulation, and improving social functioning. This review synthesizes empirical evidence regarding the neural underpinnings of SRP, delineates disorder-specific alterations in self-referential processing, and examines the bidirectional interplay between SRP and empathic functioning. We further outline a conceptual framework for empathy-based interventions targeting SRP dysfunction and propose future directions for precision psychiatry research. Emphasis is placed on developing personalized, mechanism-driven therapeutic strategies informed by computational modeling, transdiagnostic biomarker identification, and digital therapeutic platforms.
Commentary: Associations between attention-deficit/hyperactivity disorder and allergic diseases: a two-sample Mendelian randomization study
Construct Validation of a Remote Brain Health Assessment Battery to Evaluate Vocational Aptitude and Factors Associated With Cognitive Resilience in the Military: Observational Trial
<strong>Background:</strong> Vocational aptitude and cognitive resilience predict military success, yet current assessments rely on resource-intensive, in-person testing that limits scalability. A brief, self-administered, remotely deployable computerized battery offers a practical solution for large-scale screening and monitoring. <strong>Objective:</strong> This study aims to deploy a set of computerized assessments among National Guard recruits and assess their preliminary construct validity against a standardized aptitude measure and a research-based proxy for cognitive resilience. <strong>Methods:</strong> In this observational study, 267 enlisted service members from the Minnesota Army National Guard participated in 2 complementary ethics-approved observational trials: Office of Naval Research Neuropsychometrics and Advancing Research on Mechanisms of Resilience (ARMOR). National Guard soldiers in ARMOR completed the Armed Forces Qualification Test (AFQT), Penn Computerized Neurocognitive Battery (Penn CNB), and a 20-minute computerized brain health assessment battery (BrainHQ) at separate time points over the course of their military careers. BrainHQ assessments consisted of adaptive psychophysical tasks measuring the speed and accuracy of visual and auditory information processing. The battery assessed decision-making speed, emotion-processing speed, selective attention under speeded conditions, working memory capacity for speeded visual elements, verbal memory and learning of speeded speech, and problem-solving speed. The Penn CNB included nonspeeded neuropsychological assessments of executive function, verbal memory, social cognition, and reasoning. Linear regression evaluated the association between BrainHQ performance and AFQT percentiles, and partial correlations assessed associations between conceptually related BrainHQ and Penn CNB subtests. <strong>Results:</strong> Participants were predominantly young (mean age 19.1 years) and male (178/267, 66.7%). BrainHQ performance was significantly associated with enlistment eligibility and vocational aptitude, as measured by the AFQT (<i>P</i><.001), after controlling for age and education. The overall model explained 24.4% of the variance in AFQT percentiles (adjusted R2=0.227). The BrainHQ assessment composite was the strongest predictor, uniquely accounting for 19.2% of the variance and supporting the construct validity of aptitude. These associations persisted despite the temporal separation between assessment time points. Quartile analyses showed graded relationships between BrainHQ performance and AFQT eligibility thresholds, with higher BrainHQ performance associated with progressively greater probabilities of meeting higher AFQT benchmarks. Preplanned partial correlations between BrainHQ subtests and standardized neurocognitive measures from the Penn CNB showed significant positive associations (r=0.17-0.25; all <i>P</i><.001 to .02) with cognitive domains typically associated with cognitive resilience. <strong>Conclusions:</strong> A brief, self-administered, and scalable brain health battery demonstrates associations with military vocational aptitude and with neurocognitive domains associated with cognitive resilience. Future studies should evaluate whether integrating these assessments into current practices predicts success in Basic Combat Training, guides military progression, and supports long-term cognitive screening and monitoring across the Armed Forces.
Impact of Short and Mistimed Sleep on Adolescents With ADHD: The Adolescent Attention and Circadian Timing Study
Conditions: ADHD
Interventions: Behavioral: Aligned sleep extension; Behavioral: Misaligned sleep extension
Sponsors: Children’s Hospital Medical Center, Cincinnati; National Institute of Mental Health (NIMH)
Not yet recruiting
Interventions: Behavioral: Aligned sleep extension; Behavioral: Misaligned sleep extension
Sponsors: Children’s Hospital Medical Center, Cincinnati; National Institute of Mental Health (NIMH)
Not yet recruiting
Longitudinal Study on the Sustainability of Transcranial Magnetic Stimulation Protocols – Biomarkers
Conditions: Depression – Major Depressive Disorder; Depression Bipolar; Depression Unipolar
Interventions: Other: Repetitive transcranial magnetic stimulation
Sponsors: Hospital Center Guillaume Régnier
Recruiting
Interventions: Other: Repetitive transcranial magnetic stimulation
Sponsors: Hospital Center Guillaume Régnier
Recruiting
StockWatch: New UC Data Sparks Smoother Sailing for Abivax
Less than a month after its stock roller-coastered on safety signals associated with its late-stage ulcerative colitis (UC) drug candidate obefazimod, shares of Abivax (Euronext Paris and Nasdaq: ABVX) enjoyed smoother sailing this past week—namely a 63% surge in Europe and a 50% leap in the United States over four trading days, following more positive data that appeared to reassure investors.
Abivax declared that obefazimod “delivered meaningful clinical benefit” to adults with moderately to severely active UC in the ABTECT Maintenance Part 2 supplemental portion of its Phase III UC maintenance program, with 37.2% of induction nonresponders achieving clinical remission and 34.5% achieving endoscopic remission at Week 44 following continued 50 mg treatment. Of those patients, 61.5% also showed clinical response, 48.0% endoscopic improvement, and 44.6% Histologic-Endoscopic Mucosal Improvement (HEMI).
In patients whose doses were escalated to 50 mg, clinical remission was recaptured in 45.5% of patients who relapsed during ABTECT Maintenance Part 1—a result Abivax said supported a practical dose-escalation strategy for regaining and sustaining disease control over time.
Of special interest to investors, no new safety signals were seen since earlier this month, when Abivax disclosed various malignancies in nine patients among the 580 enrolled in the study. The earlier disclosure triggered price plunges of 44% for both Abivax’s ordinary shares traded on Euronext Paris and the company’s American depositary shares (ADSs) traded on the Nasdaq Global Market.
Established risk factors
The latest data from ABTECT Maintenance Part 2 showed four total cases of non-melanoma skin cancer (NMSC)—two in the study’s 25 mg arm, two in the 50 mg arm: “All occurred in patients with established NMSC risk factors including advanced age, thiopurine use, prior skin cancer history, and failure of multiple prior advanced therapies,” Abivax stated.
Significantly, incidence rates of malignancies (including NMSCs) when adjusted for patient-year exposure were well within the pre-defined background reference ranges based on previous UC studies.
Exposure-adjusted incidence rates (EAIRs) for malignancies excluding NMSC were 0.48 and 0.69 events per 100 person-years (PYs) in the all-active combined (50 mg + 25 mg) and 50 mg cohorts, respectively, and for NMSC were 0.95 and 0.69 events per 100 PYs, in the all-active combined (50 mg + 25 mg) and 50 mg cohorts respectively, all consistent with expected UC background rates
EAIRs for malignancies excluding non-melanoma skin cancer (NMSC) were 0.48 per 100 PYs in the all-active combined (50 mg + 25 mg) cohort, and 0.69 events per 100 PYs in the 50 mg cohort. For NMSC, EAIRs were 0.95 in the all-active combined cohort and 0.69 in the 50 mg cohort. All those results were consistent, Abivax said, with expected UC background rates ranging from 0.30–0.70 for malignancies excluding NMSC, and 0.70–1.40 for NMSC.
“Paradigm-defining treatment”
“The expanded cumulative safety data further strengthens our confidence in the long-term safety profile of obefazimod and reinforces the favorable benefit-risk profile for our program as we prepare for our planned NDA [New Drug Application] submission later this year,” Abivax CEO Marc de Garidel stated. “We believe this growing body of evidence positions obefazimod, if approved, to become a paradigm-defining treatment option for patients living with ulcerative colitis.”
Investors appeared to share de Garidel’s optimism. The data sparked a buying surge among investors, who sent Abivax shares traded on Euronext Paris soaring 39% the day after the announcement, from €83.30 ($94.71) to €115.50 ($131.31) on Tuesday. The shares rose another 1.7% Wednesday, closing at €117.50 ($133.59), then climbed another 9% Thursday to €127.80 ($145.28) before finishing the week with a 6% increase, to €135.80 ($154.38) and a 63% one-week gain.
On Nasdaq, Abivax ADSs surged 50% for the week, consisting of a roughly 39% leap Tuesday from $96.15 to $133.26. From there, shares dipped 0.5% the following day to $132.56, before rebounding 9% Thursday, finishing the Independence Day holiday-shortened week at $144.65.
Wednesday was a shorter trading day than usual since the company requested a temporary, single-day halt. Abivax requested the halt to price an upsized offering of its U.S. American depositary shares (ADSs), which increased from the originally announced $600 million to $800 million—6.4 million ADSs at $125 per ADS, which the company expected would extend its cash runway into the second quarter of 2029.
The offering closed Thursday at $920 million, of which approximately $874.1 million consisted of net proceeds, after underwriters exercised in full their option to purchase 960,000 additional ADSs representing 15% of the total number initially sold in the offering.
The size of the offering appeared, based on investor chatter cited by Stocktwits, an effort to dampen speculation about Abivax being a prime candidate for a buyout; the company appears in GEN’s most recent A-List of Top 10 Takeover Targets of 2026. But the upsizing of the offering rekindled buyout speculation by individual or “retail” investors, the same outlet reported Thursday.
Abivax said it intends to use the net proceeds toward expenses relating to potential commercialization of obefazimod in the United States; clinical R&D expenses, primarily related to UC and Crohn’s disease; and the remainder, if any, for general corporate purposes.
Leerink Partners, Morgan Stanley, Piper Sandler, and Guggenheim Securities were joint bookrunning managers for the offering, while LifeSci Capital acted as a passive bookrunning manager and Van Lanschot Kempen as the lead manager.
“Response rates (clinical & endoscopic remission) in this portion also appear compelling, especially given the refractory nature of patients in this subset, reaffirming obe’s best-in-disease efficacy,” Thomas J. Smith, senior managing director, immunology and metabolism, and a senior research analyst with Leerink Partners, commented in a research note.
“Should allay investor concerns”
“We believe this update further de-risks obe’s profile in UC and Crohn’s and should allay investor concerns following Part 1 maintenance data released earlier this month,” Smith added.
Smith raised his firm’s 12-month price target on Abivax shares 6%, from $140 to $148.
Two other firms also raised their price targets on Abivax stock:
- BTIG (Julian Harrison)—Up 17%, from $150 to $175, maintaining “Buy” rating.
- Wedbush Securities (David Nierengarten)—Up 22% from $90 to $110, maintaining “Neutral” rating.
Even more positive feedback on the latest data came from Faisal Khurshid, a managing director and equity research analyst with Jefferies. Khurshid upgraded his firm’s rating on Abivax’s stock from “Hold” to “Buy,” and boosted Jefferies’ price target 46%, from $108 to $158.
On June 1, Khurshid downgraded Jefferies’ rating on Abivax from “Buy” to “Hold,” citing the safety concerns he said have since been addressed.
“Mgmt. did a nice job addressing investor concerns w/ how they presented the safety data [June 29] vs. the Part 1 update. On top of that, the efficacy profile strengthens w/ each add’l piece of data,” Khurshid observed.
He also cautioned: “There is still risk on cash runway, catalyst path, and commercial needs for a pot’l standalone launch. But ultimately, good data should generate value.”
The biggest outstanding risk for Abivax, Khurshid wrote, is the need for significant resources associated with a commercial launch for an indication in inflammatory bowel disease (IBD): “We still think pot’l of asset better realized w/ a strategic partner.”
Obefazimod is a small molecule upregulator of miR-124, an anti-inflammatory microRNA. It enhances the selective splicing of a single long noncoding RNA to generate miR-124, which downregulates cytokines and chemokines shown to promote inflammation, including tumor necrosis factor (TNF) alpha, IL-6, monocyte chemoattractant protein-1 (MCP-1), and IL-17, as well as Th17+ cells.
Under its former name ABX464, obefazimod was initially developed against HIV but was repurposed to fight inflammatory conditions based on its anti-inflammatory effect.
Leaders and laggards
- Elicio Therapeutics (Nasdaq: ELTX) shares tumbled 37% from $5.14 to $3.22 Thursday after the developer of immunotherapies for high-prevalence cancers said it entered into a definitive securities purchase agreement led by two new “fundamental institutional investors” with participation from a large existing shareholder—all undisclosed—to purchase 4,380,313 shares of Elicio common stock through a registered direct offering. The offering is expected to result in gross proceeds of approximately $15 million before deducting placement agents’ fees and other expenses, Elicio said. Titan Partners, a division of American Capital Partners, is acting as lead placement agent while B. Riley Securities is acting as co-placement agent.
- Takeda Pharmaceutical (Tokyo Stock Exchange: 4502) shares increased 2.4% from ¥5,150 ($31.91) to ¥5,274 ($32.68) Thursday and rose another 1.6% to ¥5,359 ($33.20) after the pharma announced an up to $600 million artificial intelligence (AI)-based drug discovery collaboration with Insilico Medicine (Hong Kong Exchange: 3696.HK). Insilico agreed to use its end-to-end platform in leading AI-driven discovery to identify molecules meeting predefined scientific and early development criteria, while Takeda agreed to apply its global development capabilities to advance selected candidates through clinical validation across its therapeutic areas. Takeda gained exclusive worldwide rights to develop, manufacture, and commercialize novel therapeutics selected through the collaboration. Takeda’s American depositary shares (NYSE: TAK) rose 5% from $15.95 to $16.77 Thursday (U.S. markets were closed Friday for the Independence Day holiday). Insilico shares fell 4.1% from HKD 39.62 ($4.97) to an even HKD 38 ($4.77) Thursday and slid 1.6% to HKD 37.38 ($4.66) Friday.
The post StockWatch: New UC Data Sparks Smoother Sailing for Abivax appeared first on GEN – Genetic Engineering and Biotechnology News.
Strong Public Support for Embryonic Genome Editing to Eliminate Severe Conditions, European Survey Shows
A European survey launched at the 42nd Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) suggests broad public support for fertility treatment and research, including genome editing in human embryos for specific reasons.
The report, “Fertility, Embryo Research and Genome Editing: Public Attitudes in Europe,” was commissioned by the charity Progress Educational Trust (PET), which aims to improve choices for people affected by infertility and/or genetic conditions, and was supported by ESHRE. It explored public attitudes towards fertility treatment, embryo research, genome editing, surrogacy, and related topics.
The authors say the findings will “inform ESHRE’s ongoing work in Europe, linked to implementation of the European Union’s SoHO (Substances of Human Origin) Regulation and to the ethical considerations that arise in our field.”
The survey included 8688 participants aged 16–75 years across the U.K., Netherlands, Spain and Italy, with more than 2000 respondents in each country.
Across all four countries, a large proportion of respondents supported state-funded fertility treatment for people experiencing infertility and wishing to conceive, ranging from 54% in the Netherlands to 57% in the U.K., 62% in Spain, and 64% in Italy. Support was highest for heterosexual couples (47–59%) and lowest for transgender people (12–18%).
Conversely, most respondents said they did not support people being able to choose the biological sex of their child, based on personal preference. Opposition was strongest in the Netherlands (72%) followed by the U.K. (59%), Italy (55%) and Spain (47%). Nonetheless, there was still a significant minority that expressed support for sex selection. This support was strongest in Spain (32%) followed by the U.K. (26%), Italy (22%) and the Netherlands (18%), and was more common among younger participants than their older counterparts.
The age differential across responses could mean that with time, there will be a shift in views and potential changes in policy, the authors note.
The survey also found public backing for the use of human embryos in research to better understand and develop treatments for congenital diseases. Support ranged from 41% in Italy to 48% in the Netherlands and Spain, substantially exceeding opposition in all four countries (15–24%), including Italy, where research uses of human embryos are currently prohibited.
Respondents were then asked whether they supported or opposed the use of genome editing in human embryos, in three different scenarios:
- For scientific and medical research to help understand or develop treatments for congenital disease, without human implantation.
- In human embryos that will be transferred to a human to establish pregnancy to help eliminate a severe or life-threatening condition, like cystic fibrosis, in the resulting child.
- In human embryos that will be transferred to a human to establish pregnancy to help eliminate a common or medically manageable condition, like asthma, in the resulting child.
In all four of the countries, more respondents supported than opposed all three of the uses of genome editing, with the highest level of support given if the technique helps eliminate a severe or life-threatening condition.
It is important to note that this use of genome editing—which was supported by 55% in the Netherlands, by 53% in Spain, by 52% in the U.K. and by 46% in Italy—is not permitted by law in any of these four countries at present.
PET commented: “It is heartening to see such substantial support for uses of genome editing in human embryos, across all four of the countries surveyed. That said, these findings present an interesting conundrum. Respondents seem to be more ready to countenance the use of genome-edited embryos in treatment—at least, if helps to eliminate a severe or life-threatening condition—than they are to countenance the use of genome-edited embryos in research. Realistically, research must occur first. There is therefore a need for wide-ranging public conversations, where the vital role played by research—in enabling treatment, and ensuring that treatment is safe and effective—can be conveyed.”
Professor Karen Sermon, immediate past chair of ESHRE, said, “Reproductive medicine and embryo research are advancing rapidly, and these findings show the importance of understanding how the public views those developments. It is particularly striking that support for some applications extends beyond what is currently permitted in certain countries. As science advances, it is essential that public awareness keeps pace, so that decisions about future treatments are informed by both evidence and societal values.”
The post Strong Public Support for Embryonic Genome Editing to Eliminate Severe Conditions, European Survey Shows appeared first on Inside Precision Medicine.
Identifying Behavior Change Techniques for Digital Interventions Addressing Alcohol and Tobacco Co-Use: Findings From a Delphi Consensus Study
Background: Alcohol and tobacco use frequently co-occur and contribute significantly to the global burden of disease. Despite the well-established benefits of addressing both behaviors simultaneously, health care professionals often face substantial challenges in delivering integrated interventions, including limited time, training, and resources. Digital health interventions offer a promising avenue to directly support patients in reducing alcohol and tobacco use, while bypassing some of the barriers encountered in clinical settings. However, there is a lack of consensus on the key behavior change techniques (BCTs) that must be incorporated to ensure that interventions are evidence based and contextually appropriate, making them effective. Objective: The study aims to identify expert opinions on the most suitable and effective BCTs (reflecting both behavioral relevance and delivery feasibility) to be included in a 1-time, self-guided digital intervention intended to initiate behavior change and support alcohol reduction among people trying to quit smoking. Methods: We conducted a 2-round modified Delphi study with 14 panelists with expertise in behavioral science, alcohol and tobacco treatment, and digital interventions. Panelists rated 20 BCTs identified in a previous rapid review using the acceptability, practicability, effectiveness, affordability, safety, and equity (APEASE) criteria. BCTs were deemed “appropriate” if at least 70% (n=10) of panelists agreed on all criteria. Results: Six BCTs were identified as appropriate for implementation: goal setting, action planning (individualized change plan), action planning (reduction strategies), feedback on behavior, reattribution, and pros and cons. These BCTs were considered effective for promoting behavior change through structured planning and personalized strategies. The panel reached partial consensus on several BCTs, while 8 BCTs were deemed inappropriate for a 1-time, unsupervised digital intervention. Conclusions: The results of this study offer a consensus-based view, reflecting expert opinion on the perceived appropriateness and feasibility of the BCTs that should be included in a 1-time digital intervention to address co-occurring alcohol and tobacco use.
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Using Ecological Momentary Assessment to Document and Investigate Caregiver Practices Between Pediatric Therapy Sessions: Prospective Pilot Cohort Study
Background: Determining the appropriate dosage of pediatric occupational therapy, physical therapy, and speech-language pathology services is important when supporting families of children with disabilities. However, therapy dosage is inconsistently reported, and caregiver-delivered practice between sessions is rarely documented. Ecological momentary assessment (EMA) offers a method to capture caregiver practice in real time and to examine factors that influence it. Objective: This study aims to pilot the use of EMA to measure caregiver practices between therapy sessions and to compare EMA-reported practices with caregiver recall. Methods: This pilot prospective cohort study used convenience sampling to recruit caregivers of children receiving therapy services. During September 2024, participants completed a confidential baseline Qualtrics survey in their homes, which included recall of home practice from the previous week. Participants were then invited to complete 30 days of EMA logging of daily practice. Five participants enrolled in the EMA phase, which began 24 to 72 hours after baseline survey completion and took place during October and November 2024. Semistructured follow-up interviews were conducted immediately after the 30-day EMA period. Results: Of the 34 survey participants, 5 continued to the EMA phase, contributing 150 days of data, with 82 completed entries (82/150, 55%). Caregivers primarily completed EMA logs on days when practice occurred; missing entries were coded as zero practice based on caregiver reports. Recalled practice averaged 4.5 (SD 5.65) bouts/day and 11.6 (SD 6.35) minutes/bout, totaling 71.2 (SD 121.02) minutes/day. EMA-reported practice across all days (n=150) averaged 2.7 (SD 4.39) bouts/day and 6.5 (SD 6.45) minutes/bout, totaling 23.2 (SD 14.12) minutes/day, which was substantially lower than recalled estimates. On days when practice was reported (n=82), EMA-documented practice averaged 5.2 (SD 3.28) bouts/day and 6.5 (SD 6.45) minutes/bout, totaling 23.9 (SD 14.72) minutes/day. Variability in recalled practice was high (mean 71.19, SD 121.02 min/d). Caregivers described practice as occurring in short, frequent bouts embedded within daily routines, with routine integration, child engagement, and recall of therapist strategies identified as key facilitators. Conclusions: Caregiver-delivered practice occurred in short, frequent bouts integrated into daily routines. EMA-reported practice was substantially lower than caregiver recall, suggesting that retrospective recall and prospectively reported EMA data may differ substantially. These findings highlight the importance of teaching strategies that are brief, engaging, and easily incorporated into daily routines. Despite the small sample, EMA was acceptable to a subset of caregivers who completed participation; however, substantial attrition between survey enrollment and EMA initiation suggests significant feasibility and participation barriers that warrant further investigation.
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Use of Electronic Patient Record Systems for Rapid Response to an MHRA Public Assessment Report: Retrospective Observational Study
Background: Digital health data and infrastructure facilitate rapid analysis to provide actionable data, thereby fulfilling the principles of a learning health system. In response to a report from the UK Medicines and Healthcare Products Regulatory Agency (MHRA), a rapid service evaluation was carried out to identify patterns of modified-release (MR) opioid use after elective surgery. Objective: We aimed to describe the prescribing patterns of MR opioids, methods to repurpose existing infrastructure, and the experience of collaboration between clinical and research teams using shared data pipelines. Methods: A retrospective case-control study was conducted at a tertiary care organization across multiple hospital sites in London, United Kingdom. Prescription and administration data for adult patients undergoing elective surgery between March 31, 2019, and June 20, 2025, were extracted from a standardized research data pipeline within 4 weeks of the publication of the MHRA report. Patients were screened for MR opioid prescriptions in the postoperative period and at hospital discharge. Counts and proportions of encounters in which MR opioids were administered or prescribed were evaluated across the study period. Reflections on the application of the infrastructure for this purpose were also documented. Results: Of 126,882 elective surgeries screened, 102,879 (81.1%) met the eligibility criteria. Over the study period, patients received a new MR opioid prescription after 7525 (7.3%) of the 102,879 eligible encounters, with 2438 (2.4%) encounters receiving a new MR opioid prescription at hospital discharge. Postoperative administration of MR opioids and prescribing at discharge have declined since 2020. As a result of this study, a new context-aware alert system was developed to monitor and reduce MR opioid prescribing in this surgical cohort. Reflections on the implementation experience demonstrated how collaboration between clinical and research teams in conjunction with integrated and seamless research pipelines allowed rapid knowledge generation. Key issues raised were the difficulty of validation between parallel data extraction systems and how the two different teams compared nonequitable data points and results. Conclusions: Mature digital and analytical infrastructure within health care institutions can enable swift evaluation of local practices in the context of national medication safety alerts. This can shorten action response times and improve patient care but requires close collaboration between clinicians and research teams. Shared infrastructure between teams across the learning health system improves data quality and provides easy access to the key users. Further work is needed to understand the benefits and challenges of infrastructure built for other use cases and the effectiveness of the intervention.
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