Dozens of US states are considering legislation to allow people to install plug-in solar systems, often called balcony solar. These small arrays require little to no setup and could help cut emissions and power bills.
Balcony solar is already popular in Europe, and proponents say that the systems could make solar power more accessible for more people in the US, including renters. As popularity rises, though, some experts caution that there are safety concerns with how balcony solar would work with existing electrical equipment in homes.
Let’s talk about what balcony solar is, why it’s unique, and how new testing requirements could affect our progress toward deploying the technology in the US.
Plug-in solar systems are designed to be simple to install, often requiring no electrician or specialized worker at all. They’re small, and many can be plugged into existing outlets.
People across Germany have installed over a million balcony solar systems. They generally measure up to roughly two square meters or about 20 square feet, and can generate up to 800 watts—enough to power a standard microwave.
Now the plug-in solar wave is coming to the US. Many Americans have already installed DIY balcony solar without the permission of their utilities—it’s something of a regulatory gray area. In late 2025, Utah became the first state to explicitly allow people to install and use balcony solar systems. Over two dozen other states are now considering similar legislation.
Generally, utilities require users to sign an interconnection agreement before they can plug in large arrays of solar panels that generate power for the grid. There can be fees and permits, and it all amounts to an expensive and lengthy process.
Utah’s law ditched the interconnection requirement for panels that have a low power cap and that are certified by a national testing facility. (Legislation under consideration in other states, including New York, includes the same requirements.) The thinking is that since the panels produce very little power, which would be used to meet a home’s own energy demand and probably not get sent back to the grid, the same requirements shouldn’t apply.
As for that certification piece, in January the national testing and certification lab UL Solutions released UL 3700, a testing protocol to certify balcony solar systems and ensure that they’re safe.
There are three main safety considerations to address for these plug-in solar systems, says Joseph Bablo, manager of principal engineering, energy, and industrial automation at UL Solutions. First, there’s the possibility of overloading a circuit. Generally, electrical circuits have circuit breakers, which can trip and interrupt current if necessary. But if there’s a solar panel adding extra power to a circuit, a traditional breaker might not be able to respond to overload. Over time, overloaded circuits can damage equipment or even start a fire.
Second, these small systems are typically installed on the outside of homes, and outdoor power outlets generally have ground fault circuit interruption (GFCI). Basically, if an outlet or its surroundings are wet, it can shut down to prevent electric shock. Many GFCI systems may not work if there’s power going back into an outlet from a solar panel.
Finally, there’s touch safety: If a plug gets disconnected from the wall, the blades of the plug may still have power running through them for a short time. If a panel is getting sunlight, those blades could be energized for longer than is typical.
The new UL Solutions testing framework aims to address these concerns. One of the key recommendations is that plug-in solar panels should use a special outlet that’s designed specifically for them. The safety measures included in that connection, and within a panel, would ensure that the panels are safe.
The need for a special outlet means that currently, people who want to plug in a solar panel array would probably need to have an electrician come and update their wiring in order to comply with the protocol, Bablo says. “I know they want to say ‘No electrician, no permits’—we’re not there.”
Today, anyone can buy products like solar panels and inverters, some of which carry their own component UL certifications, and string them together. (Inverters are covered under UL 1741, for example.)
But the gold standard is to have an entire system that meets the safety requirements, and that means adhering to the new standard, Bablo says. As of early May, there aren’t any plug-in solar systems that have been fully certified by UL Solutions. And Bablo said he couldn’t share information about what, if any, are in the pipeline.
Even with the new certification requirements, Bablo still thinks plug-in solar still has the potential to help more people access the technology. “There’s a way for it to work, but we want it to work safely,” he says.
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Forty-eight years ago this July, Louise Joy Brown became the world’s first person born with the help of in vitro fertilization. Millions more IVF babies have entered the world since then. And that’s partly thanks to advances in technology that have made IVF safer and more effective.
But it’s still not perfect. The process can be slow, painful, and expensive—and that’s for the lucky people who are able to access it in the first place. And by at least one measure, IVF success rates have been declining in recent years.
Reproduction is complex, and there’s a lot that embryologists and gynecologists still don’t know and can’t control. They don’t know why many healthy-looking embryos don’t “stick” in the uterus, for example. They don’t always have an explanation for why their patients can’t get pregnant. And they can’t always account for vast differences in IVF success rates between individuals and between fertility clinics.
Scientists are working on all those questions and more. They’re wrestling with complex ethical questions about how new genetic tools will be used to analyze or even alter embryos. Meanwhile, technologies designed to standardize treatment, eliminate human error, boost success rates, and make IVF more accessible are already beginning to usher in a new era for assisted reproduction—one aided by AI and robots.
1. Helping embryos stick
Some of those technologies are being developed at the Carlos Simon Foundation in Valencia, Spain. When I visited in March, researchers gave me a tour of the labs and showed me a device that had been used to keep a human uterus alive outside the body for the first time.
While some members of the team dream of building artificial uteruses that might one day be able to carry a fetus to term, they first want to use such devices to learn more about implantation—the moment at which a fertilized egg makes contact with the lining of the uterus, burrows inside, and essentially “hatches,” triggering the start of a pregnancy.
Despite decades of advances in IVF, that process is still poorly understood. Even healthy-looking embryos stick no more than 40% to 60% of the time.
In IVF techniques used today, clinics can create early-stage embryos and wait until the uterus is deemed most receptive, but once they insert the embryo into the uterus, it’s on its own. Xavier Santamaria, senior clinical scientist at the Carlos Simon Foundation, and his colleagues are trialing a different approach. They’ve developed a device that, at the press of a button, injects the embryo into the uterine lining.
JESS HAMZELOU / MITTR
In a demonstration I watched with a prototype, Santamaria picked up his speculum and turned to face the vaginal opening of his “patient,” which in this case was just a model of the real thing—a plastic bottom with labia, a vagina, a uterus, and ovaries, two short stumps representing what would normally be a pair of legs held in stirrups.
He hunched over and peered inside. “Embryo,” he called. His colleague Maria Pardo, an embryologist, passed him a thin needle containing a mouse embryo she had recently collected from a petri dish.
Santamaria’s device allows for the embryo-containing needle to be connected to a delivery tube. This tube also has a camera, a light, and a sensor that lets the doctor know when the needle reaches the uterine lining. Once it has been fed into the uterus, the gynecologist can see the inside of the organ and direct the tube to the lining.
JESS HAMZELOU / MITTR
“When everything is ready, you just press the button,” Santamaria said as he activated it using a foot pedal, allowing the embryo to be injected. “There it goes.”
The team has just started a trial of the device; so far, fewer than 10 women have undergone the procedure, and none of those have become pregnant. But foundation director Carlos Simon is hopeful, noting that the inventors of IVF had to perform over 160 cycles before Louise Brown was born (between 1969 and 1978, that team performed 457 cycles in 250 people, resulting in only two live births). “The trial is ongoing,” he says.
2. Picking the “best” eggs, sperm, and embryos
One long-running challenge of IVF has been selection. Say you manage to collect 10 eggs from one partner and a decent-looking semen sample from the other. How do you choose which cells to use? The same question comes up once the resulting embryos have been cultured in a dish for a few days: Which should you transfer to the uterus?
Traditionally, these judgments have been made by eye. Embryologists literally pick the ones that look the best in terms of their shape or, in the case of sperm, how they move. But scientists have been working on alternatives. And over the last decade or so, many have turned to genetic testing to hint at which embryos have the best chances of creating a healthy baby.
The most commonly used test is called PGT-A, which stands for preimplantation genetic testing for aneuploidy. Aneuploidy essentially means having an “incorrect” number of chromosomes, and it is thought that embryos with such characteristics are more likely to be lost through miscarriage or potentially develop into babies with genetic conditions.
Once embryologists have created embryos in the lab, they can pinch off a few cells and test them for aneuploidies. The tests are especially beneficial for women over the age of 38, says Alan Penzias, a reproductive endocrinologist at Boston IVF. “You start to see an improvement: more babies and fewer miscarriages,” he says. The tests can shorten the time to pregnancy.
This type of genetic testing is possible thanks to multiple advances in technology—not just in genomics, but also in the ability to keep embryos alive in a dish for five to six days and the technique of freezing embryos while the cells undergo testing and thawing them once the results are in. And it has become hugely popular—some clinics do PGT-A tests on all their embryos.
But PGT-A won’t give you a perfect readout of a future baby’s genetics, says Sonia Gayete-Lafuente, a reproductive endocrinologist at the Center for Human Reproduction in New York City. And some of the abnormalities might be able to self-correct with time. Gayete-Lafuente and her colleagues have transferred some of those “abnormal” embryos into patients’ uteruses and seen them develop into perfectly healthy children, she says.
Other forms of PGT are even more controversial. PGT-P tests are designed to predict an embryo’s chances of developing complex traits that rely on multiple genes, including medical disorders but also physical characteristics like height or cognitive factors like IQ. These tests are new, and they are illegal in some countries, including the UK. But they are gaining ground in the US. Nucleus Genomics—a company that invites customers to “have [their] best baby”—promises to predict traits running the gamut from eye color and intelligence to left-handedness and risk of Alzheimer’s.
When I asked IVF practitioners how they might respond if a patient asked for this service, most dodged the question and told me there’s not enough evidence that any of these tests actually work. They also cautioned that selecting for one trait might inadvertently introduce new risks. None seemed especially keen on the idea of using genetic testing for anything other than preventing serious disease.
3. Speeding things up with AI
Some seemed more excited about the potential for AI. After all, AI tools are generally good at recognizing patterns. Many researchers have attempted to train tools to spot healthy sperm, eggs, and embryos.
And they’ve had some success. A team at Columbia University Medical Center in New York has developed a device that uses AI to examine semen samples from men who have only tiny numbers of healthy sperm. An embryologist might struggle to find a single healthy sperm in such a sample. But the Sperm Tracking and Recovery (STAR) system can analyze over a million microscope images in an hour. It has already been used to create healthy embryos. The team behind the work announced the first pregnancy resulting from the treatment in November last year.
Other teams are using AI tools to advance IVF in more dramatic ways. Around a decade ago, a reproductive endocrinologist named Alejandro Chavez-Badiola began developing an AI tool trained to rank embryos, another to rank eggs, and another to select sperm. He recalls being struck by a realization that these tools were “the brains that have the potential to drive robots in the future,” he says.
4. Using robots to standardize IVF
In the early 2020s, Chavez-Badiola and his colleagues decided to combine technologies and develop an automated system for IVF. In theory, a robotic system loaded up with AI tools could undertake most of the steps required in the IVF process: selecting the eggs and sperm, fertilizing eggs to create embryos, culturing those embryos in a dish, and selecting the “best” one for transfer. Such a system could “do everything in a standard way” without ever getting tired, he says.
Chavez-Badiola, who is now founder and chief medical officer at Conceivable, started building prototypes by motorizing regular IVF equipment and connecting it to computers. He and his colleagues started testing their system with animal cells before eventually moving on to human ones. “We were able to prove that integrating robots to automate different steps in IVF is doable,” he says.
The device is now being used to prepare sperm and eggs and create embryos. At least 19 children have been born following the automated IVF. It is early days, but Chavez-Badiola is hoping that future iterations of the machine could each process thousands of IVF cycles in a year, potentially making the procedure more affordable and accessible.
Many in the field are excited about the potential for automated devices like Conceivable’s. “This is all time saved for the embryologists,” says Laura Rienzi, a clinical embryologist and scientific director of the IVIRMA network of fertility centers in Italy. She also hopes it will help standardize IVF treatments. “Automation [will allow for] every patient to be treated in the same way in every single lab in the world,” she says.
5. Controversial edits are on the table
There’s a catch, however: All these technologies rely on the availability of at least some healthy sperm, eggs, and embryos at the outset. Embryologists and IVF patients have to work with what they’ve got. And sometimes, what they’ve got won’t result in a healthy baby.
That’s why some scientists are proposing a controversial idea: using gene-editing technologies like CRISPR to tinker with the genome of an IVF embryo before it is implanted. The biophysicist He Jiankui infamously took this approach to create embryos that resulted in the births of three children in the late 2010s. He was widely condemned by the scientific community and ultimately spent three years in a Chinese prison.
His former romantic partner Cathy Tie, who now leads startup Origin Genomics, is pursuing the technology as a potential way to prevent serious disease in children. At a recent event held at the Hastings Center for Bioethics, Tie made the case for using embryo editing to prevent diseases like cystic fibrosis, Huntington’s, and sickle-cell.
It won’t be straightforward from a technical, legal, or ethical perspective. Diseases that are known to be caused by single-gene mutations are good first candidates, but as the Center for Human Reproduction’s Gayete-Lafuente points out, most diseases are much more complicated than that. “I wish we could understand the genetic basis of every disease to be able to prevent it,” she says. So far, we can’t. Besides, most diseases can be influenced by our diets, behaviors, and environments as well as our genes.
As things stand, no one knows if editing a human embryo to eliminate the risk of one disease might increase a future child’s risk of some other disorder. And some scientists worry that such edits might be a slippery slope to genetic enhancement or eugenics.
Rienzi hopes that the technology might be developed in a safe way with regulatory oversight, and only for a specific list of diseases. “It has to be within a legal context,” she says. “But to me, it’s a dream.”
In the meantime, the field looks set to keep transforming with the development of new technologies that are already creating healthy babies. Watch this space.
Bayer has agreed to acquire Perfuse Therapeutics for up to $2.45 billion, the companies said, in a deal designed to broaden the buyer’s ophthalmology pipeline with Perfuse’s sole pipeline drug and two clinical phase programs for eye disorders.
Perfuse’s PER-001 is a small molecule endothelin receptor antagonist being developed for the treatment of ophthalmic diseases. Two of PER-001’s four programs are in Phase II development: One designed to treat open-angle glaucoma by improving the visual field for patients, and the other designed to treat diabetic retinopathy (DR) by improving contrast sensitivity and reducing ischemia in patients with the disorder.
Last year, Perfuse announced positive results from two Phase II clinical trials evaluating PER-001.
One was a Phase IIa trial (NCT05822245) assessing PER-001 in glaucoma, which showed that six months after a single intravitreal administration of PER-00, added to existing standard-of-care intraocular pressure (IOP)-reducing therapies, 22.2% of low-dose and 37.5% of high-dose patients experienced ≥7 decibel (dB) improvement in a pre-defined retina region of minimal five test points compared to 0% in control in six months.
The improvement was 8–14x better than the natural history of disease (2.7%) with currently available treatments, Perfuse said at the time.
In the other Phase IIa trial (NCT06003751), which focused on DR, patients showed a mean of +0.9 dB improvement in low luminance contrast sensitivity in the high-dose group and +0.65 dB in the low-dose group across multiple frequencies measured at week 20. In contrast, a mean of -2.1 dB worsening occurred in the control group over the same period.
The low luminance, low contrast visual acuity was better by a mean difference of 5.5 and 5.1 letters from baseline in low- and high-dose groups compared to control measured at week 20, Perfuse said at the time.
PER-001 is also in preclinical development for dry age-related macular degeneration (AMD)/geographic atrophy, as well as for retinal vein occlusion.
“We are excited by the work of the team at Perfuse Therapeutics and encouraged by the potential of PER-001,” Juergen Eckhardt, MD, head of business development and licensing at Bayer Pharmaceuticals, said in a statement. “With this acquisition, we are complementing our expertise in ophthalmology and our pipeline, reinforcing our commitment to developing urgently needed therapies for patients.”
Looking beyond Eylea®
Bayer’s ophthalmology pipeline has long been dominated by the blockbuster drug Eylea® (aflibercept), co-marketed with Regeneron Pharmaceuticals and initially approved in 2011. However, Eylea is close to losing exclusivity for key U.S. patents: According to Regeneron’s Form 10-K annual report for 2024, patents for Eylea expire between 2027 and 2039, starting with four formulation patents expiring on June 14, 2027. Patents for the higher-dose version, Eylea HD®, expire between 2027 and 2032, starting with two formulation patents expiring on June 14, 2027.
Last year, Eylea and Eylea HD saw their sales slip in the mid-teens, generating a total combined $8.04 billion in revenue, consisting of $4.385 billion in U.S. net sales for Regeneron and €3.11 billion in ex-U.S. sales for Bayer (about $3.655 billion today, up from the $3.506 billion reported in January).
During the first quarter of this year, Regeneron reported $941 million in U.S. sales, down 10% from a year ago; Bayer plans to report Q1 sales on May 12.
PER-001 is an intravitreal bio-erodible implant administered into the vitreous cavity of the eye using a single-use, 25-gauge applicator and designed to provide a sustained release of the drug, allowing for a convenient dosing regimen, according to Perfuse and Bayer.
Bayer has agreed to pay $300 million upfront for Perfuse, which is headquartered in San Francisco with R&D facilities in Durham, NC. The remaining up to $2.15 billion in deal value hinges on Bayer achieving development, regulatory, and commercial milestones.
The acquisition deal is subject to approval by Perfuse shareholders and antitrust clearances.
“I’m incredibly proud of what the Perfuse team has accomplished and deeply thankful to all our investors and collaborators,” stated Sevgi Gurkan, MD, Perfuse’s founder and CEO. “Bayer’s vision aligns closely with ours, and they have the scale and global resources to unlock the full potential of PER-001 to change the trajectory of human blindness. We are very excited to see our mission continue with even greater momentum.”
After a tidal wave of blowback that culminated in a lawsuit, a nonprofit health system has reversed course in its plan to replace its Oregon emergency physicians with a national chain.
PeaceHealth’s announcement Wednesday didn’t disclose what prompted its change of heart, but those familiar with the situation say it’s because the health system’s plan was poised for defeat in a legal challenge. When PeaceHealth said in February it was cutting ties with Eugene Emergency Physicians, the local group that had staffed its Oregon hospitals for 35 years, the news drew tremendous pushback from doctors, nurses, lawmakers, mayors, and emergency medicine groups.
Then, on March 20, the Eugene emergency physicians sued, arguing that PeaceHealth’s plan to use the Atlanta-based staffing chain ApolloMD violated a new Oregon law prohibiting managed service organizations from directly owning medical practices or interfering with clinical decisions. The case has had four hearings, in which the judge was “quite clear” that the scheme violated the law, Senate Bill 951, said Hayden Rooke-Ley, an attorney who represented the doctors and a senior fellow for health care with the American Economic Liberties Project.
Epigenetic markers linking cancers in young adults to pesticide exposure have been uncovered. Scientists from Spain found that specifically, the pesticide picloram was associated with a higher risk of early-onset colon and rectal cancer, providing another lead to the cause of this disturbing new trend.
Their research paper appeared in Nature Medicine and the lead author is Silvana C. E. Maas, PhD, Cancer Computational Biology Group, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona.
“This pesticide seems to have a role in early onset colorectal cancer [patients diagnosed before 50 years of age]. Cases of these have been in the last decades and the biology of the tumors (early onset vs. regular onset) is very similar. So the cause of the rise should be something external, the exposome,” senior author José A. Seoane, PhD, told Inside Precision Medicine. Seoane is head of cancer computational biology group, Vall d’Hebron Institute of Oncology, Centro Saturnino, Spain.
“The exposome is any exposure [environmental, life-style, habits, food, pollution, etc.] that affects us during our lifetime, including development,” he added.
Cancer in young adults is a relatively recent phenomenon, brought to attention by many disturbing personal stories, including that of Princess Kate, and some eye-opening statistics. Until now, age has been a top risk factor for cancer.
The incidence of colorectal cancer (CRC), in particular, is rising rapidly in people younger than 50 years and this increase parallels shifts in lifestyle and environmental factors (the exposome). But whether these are indeed linked to the development of early-onset CRC (EOCRC) remains unknown.
Since there are limited exposome data in most cancer cohorts, this team constructed weighted methylation risk scores as proxies for exposome exposure to pinpoint specific risk factors associated with EOCRC compared to late-onset CRC (LOCRC)—patients diagnosed at age 70+ years.
“We included in the analysis exposures associated with lifestyle, pollution and pesticides, including picloram. The results (different exposure patterns between early onset and late onset) shows that the early onset cancers have more signal of poor diet, smoking, and picloram,” said Seoane.
He added that, “Several pesticides were included in the study. We included different pesticides both in the methylation study and in the population study.”
The team’s analysis confirmed previously identified risk factors, including educational attainment, diet and smoking habits. In addition, they identified exposure to the herbicide picloram as a new risk factor in the discovery cohort. Those findings were replicated in a meta-analysis comprising nine CRC cohorts.
The team then analyzed population-based data from 94 U.S. counties over 21 years and validated the association between picloram use and EOCRC incidence. The association was still statistically significant, after adjusting for socioeconomic factors and other pesticide use.
This research highlights the potential role of the exposome in EOCRC risk, the authors write.
“We are studying how other exposure signals that were not included in this study could be associated with CRC and also other tumors and we are trying to elucidate the mechanisms of action of picloram,” Seoane said.
Other potential causes of EOCRC identified have been linked to diet and pollutants.
A simple finger-prick blood test at home combined with online cognitive tests can reveal signs of Alzheimer’s disease, providing a convenient way to screen for early dementia.
The postal blood test, outlined in Nature Communications, is used to measure levels of two blood biomarkers linked with cognitive function: phosphorylated tau at amino acid 217 (p-tau217) and Glial Fibrillary Acidic Protein (GFAP).
It could provide a way to screen for dementia at home and act as a triage resource to identify those at risk earlier and tailor treatments more effectively, particularly in remote or unsupervised settings.
“This work raises the potential for screening people for their risk without the need for clinic visits or complex clinical assessments,” said lead researcher Anne Corbett, PhD, from the University of Exeter.
“It would ensure the people at highest risk could be prioritized for monitoring and diagnosis, unlocking the best support and treatment for those that need it most.”
While blood biomarkers are increasingly being used to diagnose Alzheimer’s disease, scalable tools are needed to reach the 99% of individuals with early cognitive impairment who are not seen in specialist healthcare services.
In an attempt to develop these further, Corbett and team conducted a study involving 174 people, of whom 146 had normal cognition and 28 had dementia.
All were participants in the PROTECT study, a larger investigation of more than 30,000 adults that aims to understand how healthy brains age and why people develop dementia.
Blood samples were collected at home using self-administered capillary blood tests, which were sent for p-tau 217 and GFAP lab testing. Venous blood samples were also available for 40 patients.
p-tau217 has previously been highly accurate at detecting Alzheimer’s disease pathology and is approved by U.S. regulators for symptomatic patients undergoing investigation for cognitive complaints.
GFAP is associated with broader cognitive decline and has been shown to be associated with Aβ deposition and progression of mild cognitive impairment to Alzheimer’s disease.
Brain performance tests were found to correlate with levels of both proteins, with p-tau217 showing the strongest association.
Capillary p-tau217 was significantly higher in people with dementia compared to those without and was significantly associated with cognitive performance and function.
A combination of an 85% specificity threshold for capillary p-tau217 85% and episodic memory performance one standard deviation (SD) below benchmarked norms identified 9% of participants who were at potentially high risk, and who also showed significantly higher impairment in cognition and function.
Importantly, this threshold for impairment of episodic memory indicated a much milder level of impairment than the 1.5 SD change required to identify people with mild cognitive impairment, revealing its potential ability to spot signs at a preclinical stage.
Unexpectedly, even though ptau217 and GFAP both identified individuals with cognitive impairment, there was only a modest overlap in individuals who were positive for both GFAP and p-tau217, with GFAP identifying a different group of at-risk individuals. GFAP biomarker appeared to be associated with vascular risk, unlike p-tau217.
Researcher Clive Ballard, MD, PhD, also at Exeter, said: “Our approach of combining our robust cognitive testing with measuring proteins via a postal blood test could provide a straightforward, efficient and cost-effective method to reach large numbers of people in the community who would not otherwise be prioritized for the next steps of diagnosis or support and to optimize the clinical pathway to enable early detection of those at highest risk.”
WASHINGTON — The Trump administration on Tuesday released the most detailed look to date at its drug pricing policy and its purported impact, claiming huge future savings from the program.
The report, from the administration’s own Council of Economic Advisers, lays out the definition of “most-favored nation” pricing. That’s the definition pharmaceutical giants agreed to in their confidential deals with the administration, a White House spokesperson told STAT in an email. The most-favored nation pricing calculation represents a key underpinning of one of the White House’s top election-year talking points — though many key details of the deals remain private, and their ultimate impacts for consumers uncertain.
The analysis estimated the drug companies’ pledge to offer all new drugs at most-favored nation pricing would save the U.S. $529 billion over the coming decade — though the projection comes with big caveats.
Background: Major depressive disorder (MDD) affects millions of Americans each year and is often diagnosed and treated in primary care. Evidence shows that self-management techniques, shared decision-making (SDM), and goal setting are effective strategies for managing MDD, but the required collaboration between patients and primary care clinicians can be difficult. Primary Care Path is a program for supporting depression management in primary care that includes a patient-facing mobile app and an accompanying care team–facing web interface. Leveraging programs that provide clinician-facing software with companion patient-facing mobile technology may help patients and physicians align depression treatment and management goals, support effective SDM, alleviate barriers, and improve both clinical care and patient outcomes. Objective: To pilot-test the use of Primary Care Path for MDD management in primary care and evaluate the impact of its use on depression treatment, symptoms, goal setting and attainment, and SDM. Methods: Four primary care clinical practices in the United States were assigned to program use (2 practices; intervention) versus usual care (2 practices; control). Intervention practices used the Primary Care Path program in their clinics and engaged patient participants in app use for 18 weeks. Clinical care teams engaged with the patient-informed program portal primarily during patient encounters (in-person, virtual or calls). Patient participants were smartphone users aged 18 years and older who were being treated for MDD. Patient participants received online surveys (medication changes, Patient Health Questionnaire-9 [PHQ-9], goal setting and attainment questions, and Shared Decision-Making Questionnaire-9 [SDM-Q-9]) at baseline, 6, 12, and 18 weeks. Results: A total of 76 patient participants (34 intervention; 42 control) were enrolled; the majority were female (27/34, 79%; 32/42, 76%), White (31/34, 91%; 40/42, 95%), non-Hispanic/Latino/a (29/34, 85%; 40/40, 100%), and employed (26/34, 77%; 34/42, 81%). Control patient participants’ conversations with their medical providers increased over the study period, while intervention patient conversations with their medical providers decreased over time. At week 18, intervention participants felt more successful than control in achieving their personalized treatment goals. More intervention patient participants initiated antidepressant medication by weeks 12 (=.03) and 18 (=.04) and switched medications by weeks 6 (=.009) and 12 (=.04) versus control. All patient participants demonstrated significant improvement in PHQ-9 scores throughout the study period (<.001), with no difference in change by group. Clinicians and patients indicated using the program to support SDM, but no significant differences were observed in SDM-Q-9 between intervention and control. Conclusions: Preliminarily, the use of this digital health program related to earlier medication optimization, earlier conversations between patients and medical providers, and patient attainment of goals that matter most to them, indicating that coordinated use of the program by both patients and clinical team members may enhance MDD management in primary care clinical settings.
Researchers from Japan are calling for increased cross-disciplinary collaboration after showing that people with advanced cardiovascular-kidney-metabolic (CKM) syndrome are at increased risk for cancer.
They explain in Circulation: Population Health and Outcomes that CKM syndrome is a conceptual framework, proposed by the American Heart Association (AHA) in 2023, that captures the interconnected nature of cardiovascular, kidney, and metabolic diseases and reflects the shared risk factors and pathophysiological mechanisms of these diseases.
The current study findings suggest that this framework could also “serve as a valuable, non-invasive stratification tool in precision oncology and preventive medicine,” said Hidehiro Kaneko, MD, PhD, the study’s lead author and associate professor in the department of cardiovascular medicine at the University of Tokyo in Japan.
He told Inside Precision Medicine: “By identifying individuals with advanced CKM (particularly stages 3 and 4), clinicians could tailor and potentially intensify cancer screening protocols for these high-risk patients. This enables more personalized surveillance and early detection strategies that bridge the gap between cardiometabolic management and cancer prevention.”
According to AHA statistics, nearly nine out of 10 adults in the United States have at least one component of CKM syndrome, which includes high blood pressure, abnormal cholesterol, diabetes, obesity, and reduced kidney function.
Although these components of CKM syndrome have each been associated with an increased risk for certain cancers, the relationship between CKM stage and the risk for incident cancer is unclear, as current knowledge is largely derived from studies of individual components rather than the integrated syndrome.
To address this, Kaneko and team analyzed administrative claims data for more than 1.3 million people living in Japan. Of these, 12.5% had CKM stage 0, 9.8% had stage 1, 31.7% had stage 2, 36.3% had stage 3, and 9.8% had stage 4.
The researchers report that, over a median follow-up of 3.4 years, increasing baseline CKM stages were associated with significantly greater cancer incidence.
Specifically, the incidence of cancer was 81.2 cases per 10,000 person–years in people with CKM stage 0, increasing to 97.2, 105.1, 250.9, and 257.7 cases per 10,000 person–years in those with CKM stages 1, 2, 3, and 4, respectively.
After adjustment for age, sex, alcohol consumption, and physical inactivity, individuals with CKM stage 1 or 2 at baseline did not have a significantly increased risk for cancer relative to those with CKM stage 0. However, people with CKM stages 3 and 4 had significant 25% and 30% higher risks for cancer, respectively, than those with stage 0.
When the team analyzed the data by cancer type, they found that the incidence of colorectal, stomach, lung, renal pelvis and ureter, pancreatic, non-Hodgkin lymphoma, bladder, liver, kidney, thyroid, leukemia, and gallbladder cancers increased progressively with higher baseline CKM stages. There was a similar pattern for prostate cancer in men and for breast, cervical, and uterine cancers in women.
Conversely, there was no clear association between baseline CKM stage and the incidence of esophageal cancer, malignant melanoma, or Hodgkin lymphoma.
The associations between CKM stage 3 or 4 and cancer risk were stronger in men than in women and in people younger than 65 years of age relative to older individuals. However, people aged 65 years and older were also at increased risk for cancer even when they had CKM stage 1 or 2 relative to stage 0, whereas younger individuals were not.
Kaneko said that the study highlights a critical need for increased awareness of the link between CKM syndrome and cancer.
“While physicians and the public generally understand that interconnected metabolic and kidney conditions lead to heart disease and stroke, the integrated CKM syndrome is rarely viewed as a significant driver of cancer,” he remarked. “Our study demonstrates a clear, stage-dependent increase in incident cancer risk as CKM progresses, underscoring the need to recognize cancer as a major potential consequence of this multisystem syndrome.”
Kaneko suggested that “this can be addressed by shifting public health messaging to emphasize that proactive lifestyle modifications—such as weight management, a healthy diet, and regular exercise—provide dual protection against both cardiovascular events and cancer.”
He added: “Within the medical community, we should promote the CKM staging framework as a comprehensive health assessment tool, encouraging cross-disciplinary collaboration among cardiologists, nephrologists, endocrinologists, and oncologists to manage these overlapping risks holistically.”
