Background: In recent years, digital patient portals have become an increasingly common feature of care in various medical fields. Despite growing scientific evidence of their effectiveness and the benefits they offer to patients and caregivers, their implementation, especially in hospital mental health settings, lags behind expectations. Objective: The study aimed to identify the barriers and facilitators to implementing a patient portal in a public mental health hospital setting in Germany. Moreover, it aimed to develop recommendations for implementing a patient portal. Methods: Three psychiatric clinics in the early stages of implementing an online portal for patients participated in this implementation study. We assessed objective usage data (log data from the patient portal) and performed qualitative interviews with professionals and questionnaire surveys with both patients and professionals. We combined the results to develop generic recommendations for the implementation of patient portals in a mental hospital setting using a 2-stage Delphi method with a group of professionals and patients. Results: Portal log data from 71 patients indicated variation in the use of the portal functions. On average, users logged in 9.5 (SD 14.9) times (median 4, IQR 2-7 times). The variability in the number of logins per patient, ranging from 1 to 72, indicated a high variance in the frequency of use. On average, the portal was used for 47 (SD 59) days (median 27, IQR 2-62 days). Questionnaire data from 27 patients showed satisfaction with the portal and elucidated perceived barriers to usage. Qualitative interview data from 15 professionals revealed patient-related, professional-related, organizational, structural, and technical facilitators and barriers to the implementation process. We developed 10 actionable recommendations for the implementation of digital patient portals in psychiatric hospitals, which were rated by an expert group on different dimensions. Conclusions: To our knowledge, this is the first implementation study in a German mental health hospital setting that provides experience-based recommendations for advancing the implementation of digital patient portals in hospital mental health care. The next steps will include the analysis of a larger number of users and functions, which will help to specify recommendations for different target groups and settings. Trial Registration: German Clinical Trials Register DRKS00036894; https://drks.de/search/en/trial/DRKS00036894
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ADHD Brain Marker Value in Doubt
Longstanding links between attention-related problems and changes in the brain’s cortex during childhood and adolescence could simply be due to developmental differences between the sexes, a study suggests.
The findings, in PNAS, showed that links between attention problems and slowed rates of cortical thinning were no longer evident after taking sex into account.
The results call into question proposals to use brain maturation patterns as biomarkers for attention deficit/hyperactivity disorder (ADHD) and related conditions.
More generally, they reveal the importance of accounting for sex differences during scientific investigations.
“For nearly two decades, delayed age-related cortical thinning has been widely viewed as a neurodevelopmental marker of attention-related psychopathology and ADHD,” reported Shannon O’Connor, PhD, from the University of Vermont, and co-workers.
“However, our findings suggest that this association may be largely confounded by sex differences in cortical development.”
Delayed thinning of the brain’s cortex—its outermost layer of grey matter—has long been proposed as a biomarker for ADHD-related conditions.
To investigate its value further, O’Connor and team studied 26,496 MRI scans from 11,025 adolescents.
The team initially found there was a link between attention problems and reduced rates of age-related cortical thinning across predominantly frontoparietal regions. Reduced rates of age-related thinning were associated with higher scores relating to attention problems.
However, this link dramatically reduced after accounting for sex differences in cortical thickness trajectories.
There were no significant age and attention problem interactions on cortical thickness when the sexes were studied separately. Furthermore, the genetic risk of ADHD was also not associated with slowed thinning in this region of the brain.
“Taken together, these findings suggest that previously reported associations between attention problems and delayed cortical thinning are largely attributable to unaccounted-for sex differences in neurodevelopment,” the authors concluded.
“Our results call into question an influential framework in developmental neuroscience and psychiatry that has shaped clinical understanding of ADHD for nearly 20 years, underscoring that cortical maturation patterns should not be interpreted as biomarkers for attention-related psychopathology without rigorous accounting for sex-related variation in brain development.”
The post ADHD Brain Marker Value in Doubt appeared first on Inside Precision Medicine.
Understanding the modern cybercrime landscape
Throughout 2025, HPE observed significant changes in how cybercriminals operate. Analyzing real-world threats, our HPE Threat Labs highlighted an industrialization of the cyber criminals’ methods in its new In the Wild Report, enabling greater scale, speed and structure in their campaigns. They typically use automation and AI to exploit longstanding vulnerabilities, and many have adopted a professional, corporate hierarchy to optimize their efficiency.
Cybersecurity threats today are as menacing as ever for enterprises, as any CISO or CIO can probably confirm. But, digging behind that straightforward statement, there is a much more nuanced, complex cybersecurity landscape at play. This can make it significantly harder to plan, execute, and sustain effective strategies and solutions to protect the network—plus the often valuable—sometimes priceless—data, apps, and assets it transports and stores.
But it can be done, with the right philosophy and strategy, and the right tools and insights.
We must first understand the contemporary cybersecurity landscape. This understanding can unlock the right strategy and then onward to identify the tools and insights necessary to protect an enterprise’s network effectively.
There are five primary factors influencing the landscape, some old, some new, all dynamic. These factors are distinct but often interdependent, both within themselves and with one or more of the others. Another meaningful way of looking at them is “internal” and “external”; as ever, understanding and dealing with what is in your control can also help to navigate and mitigate what is beyond your control.
Five key factors influencing today’s dynamic cybersecurity landscape
1. Expectations
The first factor is predicated on the fundamental reality of an enterprise’s reliance on its network. Most enterprises have already undergone some form of digital transformation and are reaping the day-to-day benefits. This means that the number of people, devices, and things using the network continues to grow; it also means that people’s expectations of the network are higher than ever before – they demand that it does exactly what they need it to do, typically across a proliferation of devices and from multiple locations. Conversely, many employees might not be fully aware of cyber threats and infiltration methods, so their skillsets can easily be the weak point that admits bad actors into the network.
Equally, senior management and board members have high expectations at a meta level. Embracing digital transformation and network reliance means the enterprise’s function and reputation are inextricably tied to that. Loss of reputation due to a security breach is a chilling prospect, as is the threat of financial penalty and revenue loss. So, in the minds of leadership, the network has to be safe from cyber threats and be compliant.
2. Financial pressures
The first factor arguably contradicts its neighbor in the landscape: general financial constraints and the pressure on CISOs and CIOs to achieve more with less. Despite the strategic reliance on the network and the expectation that it will be protected from cyber threats regardless, the appropriate latticework of defenses (e.g., skilled and right-sized IT teams using progressive tools and meaningful data insights, plus constant workforce education) is not always properly funded and sustained, particularly in the current tough economic climate.
3. Complex infrastructure operations
The ongoing pursuit of digital transformation and consequent network reliance also drives the third factor. Ironically, there is another facet of enterprise protection and financial control wrapped up in this. The widespread move from one-stop shops (avoiding IT vendor lock-in in favor of more competitive pricing and autonomy) has created a more complex, multivendor environment. This is coupled with multiple IT domains required to handle many diverse functions and layers of IT infrastructure (e.g., cloud, on-prem), all connected to the network. Complex, mission-critical IT operations now need to be monitored and protected from increasingly sophisticated cyber breaches.
4. Unpredictable geopolitics and economics
Shifting from the first three factors—all internal to an enterprise—the fourth is unquestionably external and without doubt the most intractable risk for any enterprise, individual, or industry group. Global uncertainty and tension are unavoidably putting even greater pressure on already-tight IT budgets, component supply chains and power costs. This can easily exacerbate existing constraints on cybersecurity budgets when vigilance and protection are more needed than ever. Unfortunately, in cyberspace one cannot always point a finger in one direction to identify an adversary. Geopolitical alliances in cyberspace are much more difficult to track, and defending against an escalating tension becomes an all-out fight to secure the network.
5. Evolving cyber threats
The fifth factor is obviously the epicenter of today’s cyber security landscape. According to the HPE Threat Labs’ report, governments were the most frequently targeted sector globally in 2025, followed by finance, technology, defense, and manufacturing. The prevailing global geopolitical and economic situation may further accelerate the twin motivations of nation state-linked espionage and organized crime for extortion and theft.
Use the network to protect the network… and beyond
The current cybersecurity landscape calls for a re-think of the network’s pivotal role and how it can manage an enterprise’s digital defenses effectively, dynamically, and comprehensively. Overall, the network can be an excellent security sensor and enforcement point, using built-in security capabilities rather than being a collection of devices with an inflexible, bolted-on security layer.
Much as cybercriminals use agentic and generative AI to intensify their campaigns, CISOs can stay ahead more easily by leveraging AI-driven network platforms for 24×7 automated management of security policy enforcement (e.g., zero trust), threat monitoring, and mitigation, encompassing devices, things, and users. Meaningful data insights can be harvested, analyzed, and recycled back into secure networking management tools for dynamic protection.
This approach helps the progressive enterprise to overcome increasingly sophisticated, multi-step, and prolific attacks, while better managing IT costs and simplifying oversight of IT operations. It can also significantly improve the user experience, going a long way to meet and even exceed those rising expectations consistently.
As a strategy in today’s uncertain world, embracing this self-driving network paradigm enables flexibility, visibility, and consistency in an enterprise’s frontline digital defenses.
For more, read the “In the Wild” report.
This content was produced by HPE. It was not written by MIT Technology Review’s editorial staff.
The Download: Musk v. Altman, smart glasses for warfare, and Google I/O
This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.
Here’s why Elon Musk lost his suit against OpenAI
Elon Musk has lost his lawsuit against OpenAI, which centered on whether the company breached its founding contract as a nonprofit. A jury found that he sued too late, meaning his claims are barred by statutes of limitations. But the verdict didn’t judge if OpenAI violated its nonprofit mission—only whether Musk brought the case in time.
The dispute centers on when OpenAI began shifting toward a for-profit structure. The company argued that signs of a shift were visible as early as 2017, while Musk said he only discovered the change in 2022.
—Michelle Kim
Join us later today for a subscriber-only Roundtables discussion about what happened in the courtroom and what the verdict means for OpenAI and the larger AI race. Register here.
Inside Anduril and Meta’s quest to make smart glasses for warfare
The defense-tech company Anduril has shared new details about the augmented-reality headset for the military it’s prototyping with Meta, including a vision for ordering drone strikes via eye-tracking and voice commands.
Quay Barnett, who leads the effort at Anduril following a career in the Army’s Special Operations Command, says he aims to optimize “the human as a weapons system.” Find out how he plans to do it—and what smart glasses could mean for warfare.
—James O’Donnell
What to expect at Google I/O this week
When Google opens its doors today for its annual developer conference, I/O, it will do so as a clear third place in the foundation model race.
A foundation model’s reputation these days rests largely on its coding capabilities, and for months Google’s coding tools have been outgunned by Anthropic’s Claude Code and OpenAI’s Codex. But the company still shapes the cutting edge in areas such as AI for science. At I/O this week, it will try to prove it can compete on both fronts.
I’m going to be at Mountain View this week to see what goes down. Here are three things to keep a close eye on.
—Grace Huckins
This story is from The Algorithm, our weekly newsletter giving you the inside track on all things AI. Sign up to receive it in your inbox every Monday.
Can AI learn to understand the world?
As the limits of LLMs become clearer, researchers are developing a new kind of AI designed to understand the physical environment: world models.
Recent developments from Google DeepMind, Fei-Fei Li’s World Labs, and Yann LeCun’s new startup have pushed these systems to the forefront of AI. At an upcoming virtual event, MIT Technology Review will examine the progress—and what comes next.
On Thursday, May 21, editor in chief Mat Honan, senior AI editor Will Douglas Heaven, and AI reporter Grace Huckins will take part in an exclusive Roundtables discussion on world models. Register here to join the session at 19:30 GMT / 2:30 PM ET / 11:30 AM PT.
World models are one of our 10 Things That Matter in AI Right Now, a new guide to the technologies and ideas shaping the future of AI.
The must-reads
I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.
1 OpenAI’s legal win over Elon Musk clears its path to a blockbuster IPO
The jury’s verdict was a critical moment for the company’s future. (Reuters $)
+ The trial spilled plenty of dirt about Silicon Valley. (MIT Technology Review)
+ And added to concerns about AI’s leadership. (The Verge)
2 Google and Blackstone are launching a new AI cloud company
The venture will use Google’s specialized chips. (Bloomberg $)
+ It aims to mount a challenge to Nvidia. (FT $)
+ Blackstone is investing $5 billion in the company. (WSJ $)
3 Meta is reshaping its workforce around AI while preparing deep layoffs
It’s reassigning 7,000 employees to four new AI-focused groups. (NYT $)
+ And plans to lay off 10% of its staff on Wednesday. (Reuters $)
+ More cuts are expected later this year. (CNBC)
4 The Iran conflict is straining the AI supply chain
TSMC, Foxconn, and Infineon have felt major disruption. (CNBC)
+ The war also threatens a vital water technology. (MIT Technology Review)
5 China’s AI-powered brain implants are moving to real-world use
Some devices will soon be sold to the public. (Nature)
+ BCIs now must be proven as products. (MIT Technology Review)
6 A US cybersecurity agency exposed its own digital keys on GitHub
A researcher said it’s the worst leak he’s ever seen. (Krebs on Security)
+ The culprit was the CISA, a relatively new branch of the DHS. (Gizmodo)
7 Supercharging immune cells may help control HIV long-term
CAR-T cell therapy is showing promise for managing HIV. (Wired $)
8 Filipino virtual assistants are powering “thought leadership” on LinkedIn
Low-paid workers use AI to write posts for Western executives. (Rest of World)
9 Big Four accounting firms have more job ads for AI staff than auditors
Accounting giants are rushing to adapt to technological disruption. (FT $)
10 Tech founders are being sent to etiquette school
In the AI era, soft skills may matter more than ever. (WSJ $)
Quote of the day
“Shit, I should have asked for more.”
—President Trump tells Fortune that he should have requested a greater share of Intel than the 10% stake that the US government received.
One More Thing
MICHAEL BYERS
Think that your plastic is being recycled? Think again.
On a kayak trip through a Connecticut salt marsh, plastic waste appears almost immediately. There are bags in reeds, bottles in the water, and tiny pieces scattered everywhere. What looks like a pristine ecosystem is already saturated.
Plastic is produced at enormous scale but rarely recycled. Instead, it breaks apart into microplastics, which are now detected across the environment and in human bodies.
Read the full story on why plastic pollution is so hard to contain.
—Douglas Main
We can still have nice things
A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)
+ Discover the beauty hidden within numbers at this charming site.
+ Find out how many millions of miles you’ve traveled through space since birth.
+ An extraordinary image has captured the split-second the ISS silhouetted itself against the Moon.
+ The most insane megaproject you’ve never heard of tried to turn atomic bombs into peaceful construction tools.
Automated PACS-integrated pipeline for TractSeg-based segmentation of the arcuate fasciculus in patients with hearing loss
ObjectiveWhile tractography is used to determine the anatomical course of white matter tracts, it can often be imprecise and time-consuming, which can be a problem when comparing large groups of patients. The aim of this study is to compare the automated process of arcuate fasciculus determination using the TractSeg algorithm with manual AF determination in DSI studio software.MethodsThe process of importing the structured MPRAGE sequence and raw diffusion-weighted images from the PACS system, performing the TractSeg algorithm, superimposing the bilateral AFs obtained on the MPRAGE image and exporting this composite image to the PACS system was automated. This procedure was used to segment the arcuate fasciculus in 25 patients with hearing loss.ResultsThe automated algorithm was able to delineate the arcuate fasciculus bilaterally in all 25 patients, while the manual reference method and automated tractography based on DSI Studio software failed in three and one patient, respectively. TractSeg showed a mean distance of 2.0 ± 0.7 mm from manual segmentation, compared with 2.8 ± 1.0 mm for DSI Studio Auto-Tracking. In addition, TractSeg appeared to involve larger portions of the medial AF fibres than the other methods.ConclusionThe TractSeg algorithm has shown high efficacy in segmenting the arcuate fasciculus in patients with hearing loss. The algorithm is fast to run and has great potential to optimise and improve neural pathway delineation.
Altered perivascular-aligned diffusivity in postherpetic neuralgia assessed by the DTI-ALPS index
BackgroundThe glymphatic system has been proposed as a key pathway for interstitial fluid clearance in the brain, but its role in chronic neuropathic pain conditions such as postherpetic neuralgia (PHN) remains unclear. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index has been suggested as a noninvasive proxy of perivascular-aligned diffusivity related to glymphatic-associated processes.MethodsA total of 83 participants were recruited, comprising 42 patients with PHN and 41 age- and sex-matched healthy controls. All participants underwent DTI, and the DTI-ALPS index was calculated using DSI Studio. The primary group comparison was performed using analysis of covariance adjusted for age and white matter hypointensity volume. In the PHN group, neuropathic symptom severity was assessed using the Douleur Neuropathique en 4 questionnaire (DN4).ResultsIn the primary adjusted analysis, the DTI-ALPS index remained lower in patients with PHN than in healthy controls (estimated marginal means: 1.247 vs. 1.348; mean difference = −0.100, 95% CI: −0.172 to −0.029, p = 0.006). In an exploratory subgroup analysis, participants with higher DN4 scores (≥ 4) had a higher DTI-ALPS index than those with lower DN4 scores (<4) (1.270 vs. 1.108, p = 0.023). In patients with PHN, the DTI-ALPS index was negatively correlated with age (r = −0.397, p = 0.009) and positively correlated with DN4 score (r = 0.441, p = 0.003).ConclusionPatients with PHN demonstrate altered perivascular-aligned water diffusivity as reflected by the DTI-ALPS index. These findings may reflect alterations in perivascular-aligned diffusivity, an indirect proxy related to glymphatic-associated processes. Further studies are warranted to clarify the relationship between neuropathic pain and glymphatic-related processes.
Stronger associations of affectivity than social leisure activities with cognitive impairment: a 10-year trajectory study of Chinese older adults
BackgroundBoth positive and negative affectivity (PNA) and social leisure activities (SLA) are significantly associated with cognitive function, yet their relative strength of association with long-term cognitive decline remains unclear. Exploring this issue has significant implications for designing precise and effective cognitive health promotion programs in the future.MethodsThe data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Our analysis included 1,847 older adults (≥65 years) without diagnosed dementia at baseline, who were followed from 2008 to 2018. Using Group-Based Trajectory Models (GBTM), participants were classified based on their PNA and SLA trajectories to identify distinct subgroups. Binomial logistic regression analyzed associations between these groups and cognitive function, with Likelihood Ratio and Wald Tests comparing their relative strengths of association.ResultsThe “High-rapid-increasing PNA” group exhibited a 264% higher risk of cognitive impairment compared to the “Low-stable-increasing PNA” group (OR = 3.64, 95% CI: 2.92, 4.52). The “Low-stable SLA” group was associated with increased cognitive impairment risk (OR = 1.66, 95% CI: 1.32, 2.08). PNA demonstrated a stronger association with cognitive function than SLA [Likelihood Ratio Test: Δχ²(1) = 137.37, p < 0.001]. However, a formal test for multiplicative interaction was not statistically significant (OR = 0.88, 95% CI: 0.57, 1.35).ConclusionPNA demonstrated a stronger association with cognitive function in older adults than SLA. Affective factors may be a critical, and potentially underutilized, target for cognitive health interventions in aging populations.
Correlation of non-suicidal self-injury with SLC6A4 promoter DNA methylation in children and adolescents with bipolar depression
PurposeTo investigate the association between non-suicidal self-injury (NSSI) and DNA methylation of the SLC6A4 promoter region in individuals diagnosed with bipolar depression.Patients and methodsA total of 48 children and adolescent patients meeting ICD-10 criteria for bipolar disorder with current depressive episodes (Hamilton Depression Rating Scale-24 score >20) were recruited, and stratified into two groups according to the presence or absence of non-suicidal self-injurious (NSSI) behavior(NSSI group and non-NSSI group). Negative life events were evaluated using the Adolescent Self-Rating Life Events Checklist (ASLEC). The methylation levels of five CpG sites within the SLC6A4 promoter region were determined by pyrosequencing, and mRNA expression was assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR).ResultsIn 48 adolescents with bipolar depression, the two groups were comparable in age, gender, education, only-child status, family history of mental illness, and disease course (all p > 0.05). Compared with the non-NSSI group, the NSSI group showed significantly lower CpG2 methylation at the SLC6A4 promoter, higher SLC6A4 mRNA expression, and higher ASLEC scores. The other four CpG sites showed no significant differences. Spearman’s correlation revealed a strong negative association between CpG2 methylation and mRNA expression (ρ = -0.547, p < 0.001). Two logistic regression models both fit the data well. Higher CpG2 methylation was a protective factor against NSSI (OR = 0.131, p = 0.021), while higher mRNA expression was a risk factor (OR = 10.957, p = 0.015). ASLEC scores and interaction terms were not significant.ConclusionThese preliminary findings suggest that lower CpG2 methylation and higher SLC6A4 mRNA expression are each independently associated with NSSI in adolescents with bipolar depression. Stressful life events were higher in the NSSI group, but did not significantly moderate these associations in the current sample. Given the small sample size and cross-sectional design, the results should be viewed as exploratory and require replication in larger studies.
Determinants of antipsychotic prescription in women detainees admitted to an acute forensic psychiatric unit
BackgroundWomen represent a small proportion of the global prison population but carry a disproportionate burden of mental illness. Evidence indicates high rates of psychotropic medication use among women in prison, often independently of the clinical diagnosis. Antipsychotics, particularly second-generation (SGAs) are widely prescribed in forensic settings. Data focusing on the prescription of these agents to women detainees are still scarce.ObjectivesThis study aimed to investigate whether socio-demographic, clinical and forensic characteristics determine SGA prescription to women admitted in an acute forensic psychiatric ward located in prison.MethodsWe conducted a retrospective study of 166 women admitted between 2014 and 2023 to the sole acute forensic psychiatric unit for detainees in French-speaking Switzerland. Among them, 128 cases received second generation antipsychotic medication during their hospital stay. Sociodemographic data included age, nationality, educational attainment and primary spoken language. Criminological variables included types of offense and detention. Clinical variables included psychiatric outpatient and inpatient history prior to conviction, total number of stays during the study period, main diagnosis, presence of substance use disorder and personality disorders. Psychotropic prescriptions were analyzed with conversion of antipsychotic doses into chlorpromazine equivalents. Regression analyses, including LASSO models were used to identify variables associated with antipsychotic dosage.ResultsPsychotropic use was very high with more than two-thirds receiving two or more psychotropic agents. SGAs were prescribed in 77.1% of cases (128 out of 166 cases), while psychotic disorders were diagnosed in only 28.3% indicating frequent off-label use. Regression analyses showed that higher antipsychotic doses were associated with previous psychiatric history, more inpatient stays and court-ordered treatments. Cluster A personality disorders were associated with lower antipsychotic doses.ConclusionsOur findings reveal an extremely high rate of psychotropic use with very frequent off-label prescription for antipsychotics in acute forensic psychiatry wards. Moreover, they show that clinical variables and not demographic and criminological factors determine the use of antipsychotics in this setting.