Sex-related molecular phenotypes in anxiety-depressive disorders: a machine learning analysis of routine blood biomarkers

BackgroundAnxiety disorders and depressive disorders are the most prevalent mental disorders worldwide. Their diagnosis has long relied on clinical symptom assessment, and objective blood−based biomarkers remain lacking. Sex is a critical risk factor for these disorders; however, sex−specific divergence in blood biochemical profiles has yet to be systematically characterized.MethodsThis retrospective study enrolled 778 patients diagnosed with anxiety−depressive state at China−Japan Friendship Hospital. Demographic data, complete blood count parameters, and blood biochemical parameters were collected. Following missing value processing and multiple imputation, Mann–Whitney U tests were applied to identify sex−differentially expressed biomarkers. A random forest classifier was constructed to evaluate the discriminative capacity of combined multi−marker panels, with model performance comprehensively assessed through receiver operating characteristic curve analysis, SHAP−based explainability analysis, and multi−classifier probability projection. Age−stratified analyses were performed with a threshold of 50 years to explore the potential modifying effect of age on sex differences.ResultsSeveral biomarkers exhibiting significant differences between males and females were identified (FDR < 0.05), among which creatinine, hemoglobin, hematocrit, red blood cell count, and uric acid demonstrated the largest effect sizes. The random forest model achieved an area under the receiver operating characteristic curve of 0.902 on the independent test set. Multi−classifier probability projection following hyperparameter tuning yielded a Silhouette coefficient of 0.464 in the two−dimensional space, with permutational multivariate analysis of variance confirming highly significant centroid differences between groups (p < 0.001). Age−stratified analysis using hemoglobin as an example revealed that levels in males were significantly higher than those in females across both age strata, with the magnitude of the sex difference attenuated in the ≥50−year group compared with the <50−year group.ConclusionsRobust sex−related signals are embedded in routine blood biochemical markers. Although complete separation is difficult to achieve under unsupervised dimensionality reduction, these signals can be efficiently integrated through ensemble learning algorithms. This study provides a molecular phenotypic basis related to sex in patients with anxiety−depressive state and underscores the importance of fully considering sex as a variable in clinical laboratory testing.

A comparison between seven scales of neuropsychological assessments for cognitive impairment screening in Chinese older population: a cross-sectional study in Chongqing, China

BackgroundThe Clinical Dementia Rating Scale (CDR), the Ascertain Dementia 8 (AD8), the Mini-Cog, the Verbal Fluency Test (VFT), the Community Screener for Dementia (CSI-D), the Rey Auditory Verbal Learning Test (RAVLT), and the Activities of Daily Living Scale (ADL) represent seven commonly employed methods for community cognitive impairment screening in China that have garnered limited attention. This study aimed to assess the discriminatory power of these seven tests when administered concurrently in a single screening to detect cognitive impairment in the absence of a gold standard.MethodsWe conducted a cross-sectional survey among 1,506 elderly people aged 60 and above in the community. The cognitive and social functions of the elderly population were evaluated by using the Seven scales. The characteristics related to demographics and health were collected through questionnaire surveys, and the correlations and consistencies of the Seven scales with cognitive impairment were analyzed respectively. Multifactor logistic regression model was used to analyze the risk factors of cognitive impairment in each scale.ResultsThe positive screening proportions for the seven scales—CDR, ADL, AD8, CSI-D, Mini-Cog, VFT, and RAVLT—were 61.1%, 33.7%, 38.0%, 37.1%, 53.7%, 39.3%, and 52.9%, respectively. Agreement on cognitive impairment risk between each pair of scales was fair-to-moderate (Kappa: 0.32–0.645, all p < 0.001). Screening results differed significantly across the seven scales by age, educational, marital status, epilepsy, cerebral infarction, brain atrophy, and depression (all P < 0.001). Notably, Screen-positive proportions for cognitive impairment rose significantly with increasing age (p < 0.001); the ≥ 80-year-old group showed the highest proportions across scales. Conversely, higher educational attainment was associated with lower risk of screening positive for cognitive impairment (p < 0.001).ConclusionsOur study identified a relatively high screening positivity proportion for cognitive impairment in Chongqing, Age, Sex, Education, Marital status, Brain atrophy, Anxiety, and Depression are risk factors for screening positivity. The identified screening positivity for cognitive impairment varied across different neuropsychological assessment methods, indicating that assessment choice should be tailored to population characteristics rather than applying a one-size-fits-all approach. Selecting the appropriate tool can improve sensitivity and reduce missed diagnoses.

Changes in depression, anxiety, and post-traumatic stress symptoms among children and adolescents exposed to adverse childhood experiences following participation in the PROACT intervention in Nairobi, Kenya

IntroductionGlobally, children and adolescents exposed to Adverse Childhood Experiences (ACEs) face an increased risk of developing mental health disorders. The prevalence of these mental disorders is further amplified by the lack of access to specialised mental health treatment especially in low resource settings. There is an urgent need for scalable mental health interventions that can effectively address the needs of these vulnerable populations. Non-specialist-delivered interventions, such as PROACT (Psychoeducation, Relaxation, Problem-solving, Activation, and Cognitive Coping Therapy), represent a promising scalable approach that could help bridge the existing mental health treatment gap in low-resource settings.ObjectivesThis study aimed to assess changes in depression, anxiety, and post-traumatic stress symptoms among children and adolescents exposed to adverse childhood experiences following participation in the PROACT intervention delivered by trained social workers in Nairobi, Kenya.MethodologyMixed-methods pre-post study design was employed. Twenty purposively selected sites across Nairobi County each contributed one social worker (N = 20), who received training to deliver the intervention. A total of 40 children participated and received 4–6 PROACT sessions. Quantitative data were analysed using STATA version 17. Paired t-tests were used to compare baseline and endline scores, while mixed-effects linear regression models with participant ID as a random effect were fitted to estimate changes in outcomes over time and account for repeated measures. Statistically significant improvements were observed across all mental health outcomes. Mean anxiety scores decreased from 6.2 at baseline to 2.7 at endline (mean difference: −3.5; 95% CI: −4.7 to −2.2; p < 0.001), while mean depression scores decreased from 6.4 to 2.9 (mean difference: −3.6; 95% CI: −4.9 to −2.3; p < 0.001). Mean PTSD scores decreased from 16.7 (95% CI: 12.8–20.5) at baseline to 7.3 (95% CI: 4.4–10.1) at endline (mean difference: −9.4; 95% CI: −14.6 to −9.3; p < 0.001). Mixed-effects linear regression analyses corroborated these findings, demonstrating significant reductions in PTSD (β = −9.44), anxiety (β = −3.48), and depression (β = −3.59) symptoms (all p < 0.001).ConclusionThe PROACT intervention was feasible and acceptable when delivered by social workers in Nairobi primary healthcare facilities and was associated with improvements in mental health outcomes among children and adolescents. These findings highlight the potential of task-sharing approaches to expand access to mental healthcare in low- and middle-income countries (LMICs) and warrant further evaluation in controlled studies.

How AI helps scientists design the next generation of medicines

Designing and developing a new medicine is an expensive, failure-prone scientific challenge. A new drug can take many years to develop, at the cost of a significant investment. And even then, most possible candidates never reach the patient. For biologic medicines, therapies made from engineered proteins rather than synthetic chemistry (which are often used to treat conditions across most major acute and chronic diseases), the complexity is even greater.

Scientists explore vast quantities of possible molecules, looking for the rare few that will bind to the right target, remain stable in the human body, and be manufacturable at scale. Today, AI is speeding up these processes and has quickly become a core part of the infrastructure in pharmaceutical R&D.

AI-assisted design is a growing part of how biologic drug candidates are developed, and companies like AstraZeneca are actively building its engineering teams to push this further. “Everything we do, whether it’s design, make, test, or analyze, is now computationally enhanced,” says Puja Sapra, senior vice president and head of R&D biologics engineering and oncology targeted discovery at AstraZeneca. “The cycle times are getting shorter while productivity and innovation increase.”

Sapra explains that AstraZeneca’s approach follows a build-measure-learn loop. AI generates or prioritizes candidate molecules computationally, predicting which designs are most likely to succeed. Scientists then focus lab resources only on the top-ranked candidates. This leads to a tighter feedback cycle with fewer dead ends, faster iteration, and the ability to go after disease targets that were previously considered untreatable by medicine. Because the number of possible molecular combinations far exceeds what any human team can systematically explore, using AI to narrow and refine the options for testing has become a major focus in biologics drug design.

Navigating complex drug design problems

Beyond accelerating timelines, AI is also being applied to the discovery of entirely new classes of medicines. Traditional biologics typically target one disease pathway. The next generation of drugs can hit multiple targets simultaneously or precisely deliver therapeutic payloads to specific cells. Achieving this requires optimization across many variables at once. Looking ahead AI-driven models could help design these increasingly complex, multi-specific biologics, explains Puja Sapra. “For example,” she continues, “such models could help identify which two or three targets to prioritize based on the underlying biology, then optimize across multiple parameters to balance a molecule’s potency, stability, manufacturability, and safety.” “Drugging the undruggable is becoming a reality,” Sapra says. “These technologies will eventually enable us to develop medicines against targets once thought impossible to reach. The potential for benefit to patients is remarkable.”

The data moat

McKinsey estimates that generative AI, combined with other computational tools, could cut drug discovery timelines by as much as 50%. But every AI model is only as good as its training data. In drug discovery, that means ample quantities of high-quality biological data. Experiments can provide a rich source of such data. Whether they succeed or fail, each experiment generates a signal about what does and does not work.

“Data is our differentiator,” says Sapra, explaining how the company’s datasets are proprietary and multimodal and include molecular structures, binding measurements, safety profiles, and manufacturing outcomes. “We’ve built an intentionally diverse portfolio across multiple disease areas and drug types. All of that data empowers us to fine-tune frontier AI models with richer, more representative training sets.” She continues, “Further, we have invested in deep screening technologies to generate additional datasets required in volume to constantly refine and validate our models.”

Building an autonomous discovery engine

To bring all of that data together in one place, AstraZeneca is building what it calls a “lab of the future” facility in Kendall Square, Cambridge, Massachusetts where AI and robotic automation will be able to form a continuous, closed-loop discovery system. “Where a self-driving car uses sensors and models to navigate its environment, this system uses AI to make predictions, robotic systems to execute experiments, and instruments to generate data,” explains Sapra. That data feeds directly back into the models, accelerating each subsequent cycle.

“Throughout, scientists will remain central to the process, providing the oversight, judgement, and strategic direction that ensure outputs are explainable, tolerable, and directed toward potential patient benefit,” she adds.

Eventually, automated high-throughput systems will be able to make and evaluate thousands of molecular interactions on a weekly basis. “This will generate AI-ready data at a scale that traditional workflows cannot match,” Sapra says. “Robotic sample handling, automated quality checks, and integrated data pipelines also have the potential to help accelerate early drug development timelines significantly.”

The next frontier: Generating medicines from scratch

Ultimately, Sapra says, the end-state vision for AI in biologic drug discovery is what the field calls “de novo” design. For this, the goal is for AI to generate entirely new protein sequences that precisely fit the desired drug properties. This includes designing the structure, predicting safety, how it will behave in the body and how to make it manufacturable.

“The field is making great progress toward a completely AI-generated biologic, designed from scratch all the way to a clinical candidate,” Sapra says. “As we continue to leverage frontier models and fine-tune them with the right datasets, we bring ourselves closer to this reality. I believe it will come. It’s a matter of time.”

Several key elements are needed to reach this point, however. First is richer and more standardized training data across the industry. Second, robust evaluation benchmarks for AI-generated candidates. And third, teams that know how to work at the intersection of machine learning and biology. Of all the prerequisites, however, safety prediction may be the most consequential, and perhaps the least discussed, Sapra says.

“One of the hardest problems in de novo design is predicting whether a computationally generated molecule will be safe in the human body,” Sapra explains. AstraZeneca is tackling this with what amounts to virtual clinical trials. These are advanced cell systems and micro-scale organ models that function as physical testbeds, paired with AI that learns from their outputs.

 “These systems have the potential to generate enhanced biological signals without traditional testing bottlenecks, and they’re a critical missing piece in closing the loop between AI-generated designs and clinical-ready candidates,” Sapra adds.

A shift currently underway is the move toward agentic AI systems that can simultaneously generate molecule candidates and predict how efficacious and safe they are likely to be. These autonomous workflows can connect disease-level insights directly to molecule design, bridging what were previously separate data silos. “The complexity of the biology goes hand-in-hand with the design of the molecule,” summarizes Sapra.

Human talent unlocks AI potential

The transformation underway in biologics is not just about technology. “With more autonomous systems, human oversight remains at the heart of this approach—ensuring explainable and ethical AI for the benefit of patients,” says Sapra.

For scientists, working with AI is a collaborative process. “Scientists will work hand-in-hand with these model systems,” she says. “There will be a world where models will design molecules, then scientists will work with the systems to test those molecules and put all that data together.” Through this process of human checks, balances, and judgement calls, the models will evolve and constantly improve, ultimately with potential to benefit patients.

For engineers, designing and building effective systems ready for human-AI collaboration will mean ensuring high levels of model transparency and explainability. According to Sapra, AstraZeneca’s engineering teams include data scientists, automation specialists, and AI engineers, who are developing systems that act as “thinking partners” rather than black boxes. “Engineers are designing systems that generate, validate, and learn at speed. And the problems are genuinely hard: Multimodal data fusion, closed-loop optimization, uncertainty quantification, and interpretability at the point of clinical decision-making,” she adds.

In taking on such technically demanding challenges, engineers and scientists have the opportunity to contribute to the research and development of potentially life-changing treatments for many diseases, says Sapra. “The biologic medicines we can develop today, and those we’ll design tomorrow, depend on combining world-class AI and engineering talent with deep scientific expertise.”

This article has been initiated and funded by AstraZeneca.  Z4-85058, July 2026.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

STAT+: New data on Eli Lilly’s ‘triple-G’ drug leave open questions on heart benefit

Eli Lilly reported more results Thursday showing that its next-generation obesity drug is highly efficacious at weight loss, but the data from the study, focused on people with heart disease, aren’t enough to answer a critical question about the therapy — whether it reduces cardiovascular risk.

The Phase 3 study enrolled nearly 2,000 people with severe obesity and heart disease, with or without diabetes. Those on the highest dose of the drug, called retatrutide, lost 22.6% of their weight after 80 weeks, while those on placebo lost 3.2%, when analyzing only the participants who stayed on treatment.

However, on additional analyses that looked at the occurrence of major cardiovascular events such as death, heart attack, or stroke, those taking retatrutide did not have a statistically significant lower risk of major events than those on placebo. Lilly said the trial was not powered to study cardiovascular outcomes and there were fewer heart events than anticipated.

Continue to STAT+ to read the full story…

Filing of bipartisan Senate bill boosts momentum for office of men’s health

The Men’s Health Act, a bipartisan bill to establish an office of men’s health within the Department of Health and Human Services, will be introduced in the U.S. Senate on Thursday by Ruben Gallego (D-Ariz.), with co-sponsorship from Roger Marshall (R-Kan.).

Mirroring the bipartisan bill that was introduced in the House this year, the measure would require a study from the Government Accountability Office on the state of men’s health in the U.S. to be presented within a year of the law’s enactment. Following the report, and incorporating its findings, the office would coordinate existing and new research and raise awareness about men’s health, both physical and mental. 

Read the rest…

The power line that could reshape New York’s grid is hitting snags

On July 3, as a heat wave swept the region, New York State’s grid imported 52 gigawatt-hours of electricity from Canada—enough to meet about 9% of its total electricity demand that day.

Some of that power shuttled in on a 339-mile power line stretching from Quebec to Queens called the Champlain Hudson Power Express (CHPE). It opened in May and is officially the longest underground transmission line in North America.

An underground power line might not sound all that exciting, but this could be a big deal for the state’s grid planning, and for emissions. It could provide up to 20% of New York City’s electricity demand, largely with abundant hydropower from Quebec.

One wrinkle: The line has been down for most of this month, and some experts are concerned about how drought will affect the power supply feeding it. Let’s look at how the CHPE transmission line could help shape the future of our grid, and what barriers it needs to overcome to make a difference.

Planning for the CHPE (which is charmingly pronounced “chippy”) started 15 years ago, with the permitting process formally beginning in March 2010. The vision was to build infrastructure to better connect Quebec and southern New York.

Over 99% of Quebec’s electricity comes from renewable sources; most demand is met with hydropower, though the province’s wind capacity is growing quickly. New York has some hydropower of its own, as well as nuclear and wind, but the state still relies on fossil fuels for most of its energy generation.

Transmission Developers, a company owned by the alternative asset management firm Blackstone, and Hydro-Québec, the province’s manager of generation and transmission, partnered to build CHPE. Construction began in late 2022 and wrapped up earlier this year. The total cost for the privately funded project turned out to be  $6 billion.

The construction of this line was a feat. It’s made up of a bundle of two high-voltage direct-current power cables, each measuring roughly five inches across. Developers buried the bundle underground or underwater across the length of New York State. Much of the line was laid at the bottom of the Hudson River, requiring special boats that shot water jets deep into the sediment to create trenches for the cable.

Connecting grids together can help accelerate the transition away from fossil fuels. The ability to move electricity to where it’s needed could also help limit the amount of new capacity we need to build. Research has shown that interconnection can help cut emissions and lower system costs.

But CHPE is off to a slow start and has seen two outages so far. The first, on July 1, was reportedly caused by a trip at a converter on the Canadian side of the border. The second outage began on July 4, and the power line is still down as of the morning of July 22.

Some experts say this isn’t unusual for a new infrastructure project. Other power lines have seen similar startup challenges, and the equipment hasn’t really been fully tested until it’s in operation, Normand Mousseau, a physics professor at Université de Montréal, told the Gazette.

Officials traced the issue to a damaged section of cable on the US side of the border, and the company that manufactured the line sent experts to investigate the cause, according to reporting from RTO Insider, a trade publication. 

The damaged portion of the cable has been removed and replaced, says Lynn St-Laurent, a spokesperson for Hydro-Québec. “It is currently estimated that the remaining work, including necessary post-repair testing, will be completed by the weekend.”

Similar woes have afflicted the New England Clean Energy Connect line, which opened in January, stretching 145 miles from Quebec to Maine. That project has also seen outages, and very little additional energy has flowed into the Northeast.

The good news for New York is that the grid wasn’t relying on CHPE yet. “Our planning studies did not assume CHPE would be available this summer, and that was one reason the grid performed reliably during the heat wave earlier this month,” Kevin Lanahan, a spokesperson for the New York Independent System Operator, the state’s grid management company, said in a statement. “A core principle of reliability planning is not relying on any single project.” 

The idea is that eventually, states and regions will be able to rely—at least in part—on these projects, so there is pressure to get them working smoothly: Building massive transmission lines is a major long-term investment. In future years, as the equipment gets stress-tested and utilities begin to feel more confident in the projects’ reliability, they could play a bigger role on the grid.

One thing to keep an eye on moving forward is the condition of Quebec’s hydropower fleet: The region has seen intense drought for the past three years, eating into the water reserves used to generate electricity. That could mean there won’t always be abundant hydropower to ship across the border—even if the transmission lines are able to carry it. 

This article is from The Spark, MIT Technology Review’s weekly climate newsletter. To receive it in your inbox every Wednesday, sign up here. 

Multilingual Voice AI for Postoperative Cataract Follow-Up in Turkish Speaking Patients in the United Kingdom: Patient and Public Involvement Focus Group Study

Background: Conversational voice AI assistants can automate postoperative follow-up calls in high-volume, low-complexity pathways such as cataract surgery but may widen health inequalities if language access and inclusive design are not built in. This patient and public involvement focus group was conducted to inform the Turkish-language adaptation of Dora ahead of a forthcoming multilingual clinical trial at Moorfields Eye Hospital. Objective: This study aims to inform the Turkish-language adaptation of Dora by gathering input from Turkish speaking community contributors about their experiences with UK ophthalmic care, language-related barriers, and design requirements for an equitable voice AI. Methods: We conducted a 1-time, 2-hour patient and public involvement focus group with 7 Turkish speaking adults recruited via the Derman community charity. The session ran in 2 phases: contributors first discussed their experiences with UK ophthalmic care, then evaluated a prerecorded Turkish-language telephone call from a voice AI to a Turkish speaking volunteer. The session was delivered bilingually, recorded with consent, and synthesized using an approach informed by the principles of reflexive thematic analysis. The voice AI uses automatic speech recognition and neural text-to-speech, with a large language model–based dialog manager for open-ended conversation within a postoperative review protocol. Results: Contributors described how pathway delays and limited language support shape their care, including reliance on family members for translation and concerns about privacy and autonomy. A language-concordant voice AI was conditionally acceptable for standardized postoperative follow-up, provided specific safeguards were met. Priorities included advance notice of calls, caller verification, privacy assurances, a clear standard Turkish accent at a slower pace, tolerance for regional dialects, interpersonal warmth, interactivity, accessibility for low vision and low literacy, and clinician escalation for complex issues. These priorities were synthesized into a 10-point checklist: preparation, verification, confidentiality, clarity and pace, voice, empathy, interactivity, dialect handling, accessibility, and efficiency. Conclusions: For patients facing language barriers, conversational voice AI may complement existing services when implemented with clear verification, privacy protections, and a defined scope under clinician oversight. The 10-item checklist will guide the Turkish-language adaptation of Dora and will be tested alongside similar consultations with other language communities in the forthcoming multilingual cataract follow-up trial.
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