It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Sunday, May 31, 2026
JMIR Analysis: Consumer Wearables Emerge as the New Health Care Gatekeepers
(Toronto, May 29, 2026) JMIR Publications today released a News and Perspectives expert analysis on consumer wearable platforms’ forays into the clinical health care space. Authored by MedTech expert Blythe Karow, MBA, “Meet the New Health Care Gatekeeper: Your Wearable” lays out the implications of wearable tech companies owning the first conversation about a patient's health, as well as the potential impacts on patient trust, policy, and regulation.
Owning the First Conversation
For decades, primary care physicians have served as the entry point to medical care, organizing referrals, tests, and treatments, writes Karow. Now, consumer wearable platforms are accumulating continuous physiological data—such as sleep patterns, heart rate variability, and blood pressure trends—allowing them to detect health changes before the user does. By incorporating artificial intelligence to interpret this data, these platforms effectively own the first conversation about a patient's health, positioning themselves to influence which specialists users see, which treatments they consider, and which care programs they enroll in.
The Shift Toward Clinical Routing
Major investments and strategic shifts signal that wearables are no longer just consumer tech plays. Karow notes that the fitness wristband company WHOOP recently closed a $575 million funding round with investments from Abbott and Mayo Clinic, and its newly created affiliate has been selected into a Medicare outcome-based chronic care model. Similar moves are occurring across the industry, with companies like Oura integrating with Medicare’s electronic health record infrastructure, and others such as Apple, Samsung, and Verily building clinical, regulatory, and reimbursement infrastructures. Wearables are now competing to become the routing layer for clinical care, helping to alleviate the strain on overworked doctors and assisting patients with proactive monitoring.
Navigating New Regulatory Risks
While there are clear benefits to continuous monitoring, Karow cautions that the rapid consolidation of these platforms raises significant regulatory and ethical concerns. Consumer technology companies operate on business models traditionally built on user attention, subscription revenue, and the monetization of user data. Unlike American physicians, who are legally prohibited from financially benefiting when referring patients to specific specialists, wearable platforms that control physiological monitoring, AI interpretation, clinical routing, and reimbursement under one roof have yet to face the same structural antitrust scrutiny. Policy and regulatory frameworks in the United States, writes Karow, are not yet ready to handle the risks brought on by integrating consumer wearable platforms into health care—and so far, consolidation hasn’t waited for policy to catch up.
Please cite as:
Karow B. Meet the New Health Care Gatekeeper: Your Wearable.
JMIR Publications is a leading open access publisher of digital health research. The News and Perspectives section is the newest addition to its portfolio, established to bring the rigor and integrity of academic publishing to scientific journalism. The section features well-researched, expert-driven content from the Scientific News Editor, Kayleigh-Ann Clegg, PhD, and a network of specialist JMIR Publications Correspondents to keep the digital health community informed, inspired, and ahead of the curve.
About JMIR Publications
JMIR Publications is a leading open access publisher of digital health research and a champion of open science. With a focus on author advocacy and research amplification, JMIR Publications partners with researchers to advance their careers and maximize the impact of their work. As a technology organization with publishing at its core, we provide innovative tools and resources that go beyond traditional publishing, supporting researchers at every step of the dissemination process. Our portfolio features a range of peer-reviewed journals, including the renowned Journal of Medical Internet Research.
Meet the New Health Care Gatekeeper: Your Wearable
Article Publication Date
29-May-2026
Brain scans reveal two distinct subtypes of autism with different underlying biology
The study has linked distinct patterns of brain connectivity in autism to different underlying molecular mechanisms, offering a biological foundation for precision medicine approaches
New York (USA) / Rovereto, Trento (Italy), May 29, 2026 – An international research team led by Istituto Italiano di Tecnologia (IIT Italian Institute of Technology) in Rovereto (Trento, Italy) and the Child Mind Institute in New York (USA), and in collaboration with researchers from the University of Trento, Italy, has shown that it is possible to identify at least two distinct subtypes of autism, defined by their patterns of brain connectivity. In the “hyperconnectivity” subtype, brain areas communicate more than usual; in the “hypoconnectivity” subtype, communication between brain areas is reduced. The study aims to develop tools for precise, personalized autism care and support. The research paper was published in the international journal Nature Neuroscience.
The research study was coordinated by Alessandro Gozzi, PhD, director of the Center for Neuroscience and Cognitive Systems (CNCS) at the IIT and Adriana Di Martino, MD, founding director of the Autism Center at the Child Mind Institute, and it represents the first systematic effort to decode human brain imaging patterns (via fMRI) by tracing them back to their molecular underpinnings in mouse models. By linking patterns of connectivity to specific biological pathways, the findings offer a foundation for precision medicine approaches.
Therefore, the researchers analyzed functional connectivity across 20 mouse models and brain scans from 940 children and young adults with autism and over 1,000 neurotypical individuals. The findings revealed two reproducible autism subtypes: one characterized by reduced brain connectivity (hypoconnectivity) linked to synaptic pathways, the other by increased connectivity (hyperconnectivity) associated with immune-related systems. Together, these subtypes accounted for approximately 25% of individuals with autism examined in the study.
"For decades, we’ve observed tremendous variability in how autism manifests, but we lacked direct evidence that these differences reflected distinct underlying biology," said Dr. Alessandro Gozzi, at Italian Institute of Technology. “Our approach enabled us to isolate specific genetic and immune factors, then translate those signatures to human brain scans, showing that different connectivity patterns encode different mechanistic pathways underlying autism.”
The team combined brain imaging with genetic and biochemical analyses in mouse models, linking connectivity patterns to specific alterations in cellular function. This revealed how specific molecular pathways, including synaptic and immune-related mechanisms, manifest as distinct connectivity patterns observable with fMRI. The study established biological reference patterns from mice that guided subtype identification in human brain scans.
"The mouse models gave us a biological 'Rosetta Stone," said Dr. Adriana Di Martino at the Child Mind Institute. "We could see which biological pathways drive which connectivity signatures, then search for those same patterns in humans."
The human data came from the Autism Brain Imaging Data Exchange (ABIDE) — a pioneering neuroimaging initiative co-founded by Dr. Di Martino that aggregates datasets from research laboratories worldwide — and the Child Mind Institute.
The analyses identified corresponding hypo- and hyperconnectivity subtypes in the human data. Gene expression analyses confirmed that human brain regions showing hypoconnectivity were enriched for synaptic genes, while hyperconnected regions showed enrichment for immune-related genes — mirroring the mechanisms identified in mouse models. Importantly, the subtypes were reproducible across independent datasets, validating their biological consistency.
"Finding the same subtypes reproducible across dozens of independent research sites was critical validation," added Dr. Gozzi.
The two subtypes exhibited different functional brain architecture and showed modest differences on standardized autism assessments, with the hyperconnectivity subtype scoring moderately higher on autism severity measures.
“Brain-based biological markers reveal distinctions that current behavioral assessments don't fully capture,"noted Dr. Di Martino.
The researchers emphasize that while the current findings capture two dominant patterns of brain connectivity in autism, the full diversity of the spectrum likely encompasses additional subtypes that larger datasets and refined analytical approaches may reveal.
The research was made possible by an international collaboration coordinated by the Italian Institute of Technology and the Child Mind Institute, with funding from the Simons Foundation Autism Research Initiative, the European Research Council through the #DISCONN and #BRAINAMICS projects, the Brain and Behavior Foundation, the Fondazione Telethon, and the US National Institute of Mental Health.
The paper, "Autism subtypes identified using cross-species functional connectivity analyses," is published in Nature Neuroscience and is available at https://doi.org/10.1038/s41593-026-02287-z.
Child Mind Institute
The Child Mind Institute is an independent nonprofit organization dedicated to transforming the lives of children and families struggling with mental health and learning disorders. Through cutting-edge research, evidence-based clinical care, and public education, the Child Mind Institute builds open science platforms and digital tools to accelerate discovery and improve youth mental health worldwide. Learn more at childmind.org.
ISTITUTO ITALIANO DI TECNOLOGIA
The Istituto Italiano di Tecnologia (Italian Institute of Technology – IIT) is a state-funded scientific research center that promotes technological development with the aim of supporting excellence in both basic and applied research and fostering the growth of the national economic system. The main headquarters is in Genoa (north-west Italy), with four Central Research Laboratories, complemented by a Network of Centers consisting of 12 hubs across Italy (Treviso, Turin, Aosta, two in Milan, Trento, Ferrara, Rome, Pisa, Pontedera, Naples, and Lecce) and two outstations abroad (MIT and Harvard in the United States).The total IIT staff exceeds 1,900 people, 50% of whom come from abroad, representing 62 countries worldwide. IIT’s research activity is characterized by strong multidisciplinary collaboration and focuses on four main scientific areas: robotics, nanomaterials, computational sciences, and technologies for the life sciences. To date, IIT’s output includes more than 23,000 publications, over 1,000 institutional projects — more than 70 of which are funded by the European Research Council —over 1,200 active patents, more than 1,000 commercial collaboration agreements signed, 41 start-ups established, and more than 50 currently in the launch phase.
Autism subtypes identified using cross-species functional connectivity analyses
Article Publication Date
25-May-2026
Brain scans reveal two distinct subtypes of autism with different underlying biology
The study has linked distinct patterns of brain connectivity in autism to different underlying molecular mechanisms, offering a biological foundation for precision medicine approaches
In the picture Alessandro Gozzi, PhD, director of the Center for Neuroscience and Cognitive Systems (CNCS) at the IIT in Rovereto (Italy) who coordinated the study with Adriana Di Martino, MD, founding director of the Autism Center at the Child Mind Institute in New York.
New York (USA)/Trento (Italy), 29 May, 2026 – An international research team led by Istituto Italiano di Tecnologia (IIT-Italian Institute of Technology) in Rovereto (Trento, Italy) and the Child Mind Institute in New York (USA), and in collaboration with researchers from the University of Trento, has shown that it is possible to identify at least two distinct subtypes of autism, defined by their patterns of brain connectivity. In the “hyperconnectivity” subtype, brain areas communicate more than usual; in the “hypoconnectivity” subtype, communication between brain areas is reduced. The study aims to develop tools for precise, personalized autism care and support. The research paper was published in the international journal Nature Neuroscience.
The research study was coordinated by Alessandro Gozzi, PhD, director of the Center for Neuroscience and Cognitive Systems (CNCS) at the IIT and Adriana Di Martino, MD, founding director of the Autism Center at the Child Mind Institute, and it represents the first systematic effort to decode human brain imaging patterns (via fMRI) by tracing them back to their molecular underpinnings in mouse models. By linking patterns of connectivity to specific biological pathways, the findings offer a foundation for precision medicine approaches.
Therefore, the researchers analyzed functional connectivity across 20 mouse models and brain scans from 940 children and young adults with autism and over 1,000 neurotypical individuals. The findings revealed two reproducible autism subtypes: one characterized by reduced brain connectivity (hypoconnectivity) linked to synaptic pathways, the other by increased connectivity (hyperconnectivity) associated with immune-related systems. Together, these subtypes accounted for approximately 25% of individuals with autism examined in the study.
"For decades, we’ve observed tremendous variability in how autism manifests, but we lacked direct evidence that these differences reflected distinct underlying biology," said Dr. Alessandro Gozzi, at Italian Institute of Technology. “Our approach enabled us to isolate specific genetic and immune factors, then translate those signatures to human brain scans, showing that different connectivity patterns encode different mechanistic pathways underlying autism.”
The team combined brain imaging with genetic and biochemical analyses in mouse models, linking connectivity patterns to specific alterations in cellular function. This revealed how specific molecular pathways, including synaptic and immune-related mechanisms, manifest as distinct connectivity patterns observable with fMRI. The study established biological reference patterns from mice that guided subtype identification in human brain scans.
"The mouse models gave us a biological 'Rosetta Stone,'" said Dr. Adriana Di Martino at the Child Mind Institute. "We could see which biological pathways drive which connectivity signatures, then search for those same patterns in humans."
The human data came from the Autism Brain Imaging Data Exchange (ABIDE) — a pioneering neuroimaging initiative co-founded by Dr. Di Martino that aggregates datasets from research laboratories worldwide — and the Child Mind Institute.
The analyses identified corresponding hypo- and hyperconnectivity subtypes in the human data. Gene expression analyses confirmed that human brain regions showing hypoconnectivity were enriched for synaptic genes, while hyperconnected regions showed enrichment for immune-related genes — mirroring the mechanisms identified in mouse models. Importantly, the subtypes were reproducible across independent datasets, validating their biological consistency.
"Finding the same subtypes reproducible across dozens of independent research sites was critical validation," added Dr. Gozzi.
The two subtypes exhibited different functional brain architecture and showed modest differences on standardized autism assessments, with the hyperconnectivity subtype scoring moderately higher on autism severity measures.
“Brain-based biological markers reveal distinctions that current behavioral assessments don't fully capture," noted Dr.Di Martino.
The researchers emphasize that while the current findings capture two dominant patterns of brain connectivity in autism, the full diversity of the spectrum likely encompasses additional subtypes that larger datasets and refined analytical approaches may reveal.
The research was made possible by an international collaboration coordinated by the Italian Institute of Technology and the Child Mind Institute, with funding from the Simons Foundation Autism Research Initiative, the European Research Council through the #DISCONN and #BRAINAMICS projects, the Brain and Behavior Foundation, the Fondazione Telethon, and the US National Institute of Mental Health.
Child Mind Institute The Child Mind Institute is an independent nonprofit organization dedicated to transforming the lives of children and families struggling with mental health and learning disorders. Through cutting-edge research, evidence-based clinical care, and public education, the Child Mind Institute builds open science platforms and digital tools to accelerate discovery and improve youth mental health worldwide. Learn more at childmind.org.
ISTITUTO ITALIANO DI TECNOLOGIA
The Istituto Italiano di Tecnologia is a state-funded scientific research center that promotes technological development with the aim of supporting excellence in both basic and applied research and fostering the growth of the national economic system. The main headquarters is in Genoa (north-west Italy), with four Central Research Laboratories, complemented by a Network of Centers consisting of 12 hubs across Italy (Treviso, Turin, Aosta, two in Milan, Trento, Ferrara, Rome, Pisa, Pontedera, Naples, and Lecce) and two outstations abroad (MIT and Harvard in the United States).The total IIT staff exceeds 1,900 people, 50% of whom come from abroad, representing 62 countries worldwide. IIT’s research activity is characterized by strong multidisciplinary collaboration and focuses on four main scientific areas: robotics, nanomaterials, computational sciences, and technologies for the life sciences. To date, IIT’s output includes more than 23,000 publications, over 1,000 institutional projects — more than 70 of which are funded by the European Research Council —over 1,200 active patents, more than 1,000 commercial collaboration agreements signed, 41 start-ups established, and more than 50 currently in the launch phase. www.iit.it
Autism subtypes identified using cross-species functional connectivity analyses
Article Publication Date
25-May-2026
Free contraception policy sharply reduces patient costs in B.C., especially for young adults
UBC researchers find out-of-pocket spending fell 83 per cent within two years of universal coverage
University of British Columbia
Researchers at UBC found that B.C.’s decision to provide universal, no-cost prescription contraception sharply reduced what patients pay, with the largest financial gains for people in their 20s. Unaffordable contraception is linked to higher rates of unintended pregnancy, which carries significant consequences for health, education and economic equality.
Published in JAMA Health Forum, the study is the first to quantify patient cost impacts after B.C. introduced free prescription contraception in April 2023.
The highest payers gain the most
Before the policy, the pill averaged about $25 per month, while IUDs ranged from $75 to more than $500 up front—and for long-term pill users, lifetime costs could reach $10,000.
Nearly 40 per cent of prescription contraception was not covered by insurance, but was paid out of pocket by patients—the highest rate in Canada and well above most other prescription drugs. Among young adults, that figure was even higher at about 45 per cent. After implementation, their out-of-pocket share fell by roughly 33 percentage points. Across all patient groups, the share of prescriptions with any patient cost dropped to under 10 per cent and to five per cent for prescription contraceptives that were fully covered.
Two years later, patient spending was 83 per cent lower than expected, translating to average savings of $43 per contraceptive user per year.
“People in their 20s are often in a coverage gap. They’re off a parent’s plan but not yet in jobs with benefits,” said lead author Dr. Elizabeth Nethery, a postdoctoral researcher at UBC’s faculty of pharmaceutical sciences. “This policy was particularly important for this group who were most likely to be paying out of pocket.”
System costs stable as access expands
The study analyzed pharmacy data from all 10 provinces, using jurisdictions without universal coverage as a comparison. While patient costs fell sharply, total contraceptive spending across patients, insurers and the public system remained essentially unchanged after two years. Researchers also found increased uptake of long-acting reversible contraceptives, including IUDs and implants.
“Universal coverage works,” said senior author Dr. Laura Schummers, an assistant professor at UBC. “Removing cost barriers increased uptake of the most effective methods, which helps reduce unintended pregnancy and inequality—adding to strong evidence that universal contraception coverage is essential in Canada.”
In Canada, roughly two out of five pregnancies are unintended, disproportionately affecting people with fewer financial resources.
Policy momentum across Canada
Manitoba introduced a similar program in October 2024, with early results consistent with B.C.’s. At the federal level, Canada passed pharmacare legislation in 2024 committing to public coverage of contraception, although implementation agreements currently involve only three provinces and one territory.
The study was funded by the Canadian Institutes of Health Research and included researchers from UBC, the University of Calgary, the University of Manitoba, Simon Fraser University and the University of Ottawa.
Interview language(s): English (Nethery, Schummers), French (Nethery)
Fukuoka, Japan—Sitting at the northwestern edge of North America, Alaska stretches across a vast Arctic land of wilderness, culture, and wealth beneath the surface. Among its resources is the Donlin Gold deposit, located in southwestern Alaska’s Kuskokwim River basin. As one of the world’s largest undeveloped gold mines, it holds an estimated 39 million ounces worth more than $170 billion at today’s prices.
A study recently published in the Journal of Anthropological Research analyzes the region’s complex debates surrounding resource development and cultural survival. It finds that Alaska Native communities hold multiple, often conflicting roles in the mine’s development.
“To understand the situation today, we have to go back to 1971,” says Hiroko Ikuta, Associate Professor at Kyushu University’s International Student Center and the study’s first author. That year, the U.S. Congress passed the Alaska Native Claims Settlement Act (ANCSA), transferring 11% of land and resource rights to Alaska Native peoples. The law, however, required them to organize as for-profit corporations, turning Indigenous individuals into shareholders.
With gold prices surging and most permits approved, the Donlin project is now closer to a final decision than ever. If the mine proceeds, Native corporations would receive billions in revenue while local residents gain priority access to jobs.
Yet alongside the cash economy runs a parallel system of culture and survival.
“Subsistence activities such as hunting and fishing are not hobbies in this region,” explains Ikuta, drawing on two decades of living in Alaska. In Western Alaska, these practices are essential to daily life, with annual harvests exceeding 172 kilograms per person—roughly three times the average annual meat and seafood consumption in Japan. “For them, salmon, moose, and other wild foods are as important as rice is across East Asia.”
One of the major concerns surrounding the Donlin project is its impact on this subsistence system. With limited road access, transportation would rely on barges along the Kuskokwim River, potentially disturbing salmon spawning grounds.
The extraction method adds another layer of risk. Cyanide leaching, used to separate gold from rock, leaves behind toxic waste stored in large tailing dams. Such dams have failed at mines elsewhere, and some residents fear the environmental risks are being understated. Several local communities have filed lawsuits demanding further review.
Yet community opinions cannot be easily divided into “support” or “opposition”, as they experience the risks differently. For example, downstream Yup’ik communities, who rely heavily on salmon for winter food storage, are most concerned about water contamination, while upstream Northern Dene communities focus more on land-based ecological impacts. Shareholders living in cities like Anchorage, meanwhile, stand to benefit from corporate dividends while relying little on subsistence practices.
These divisions can even run through a single person. “The same person can be a corporate shareholder, a subsistence harvester, and a parent worrying for future generations,” says Ikuta. “These identities do not cancel each other out. They collide and coexist.”
Ikuta is currently continuing her research on how mine tailings affect subsistence hunting and fishing, hoping to provide communities with more objective data for future decision-making.
As resource development and environmental pressures, including climate change, mount on traditional lands, Indigenous communities worldwide must increasingly navigate the tension between economic opportunity, sovereignty, and responsibility.
“In Alaska, there have been cases where communities successfully balanced development, cultural survival, and environmental stewardship,” says Ikuta. “I don’t have an answer on what sustainable development should look like for Indigenous peoples. However, any approach may need to consider the diversity of Indigenous communities, their perspectives on well-being, and how externally imposed frameworks shape outcomes.”
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For more information about this research, see “Donlin Gold and the Politics of Extraction: Navigating Indigenous Sovereignty, Native Corporations, and Subsistence in Southwestern Alaska,” Hiroko Ikuta, Ryo Kubota, Journal of Anthropological Research, https://doi.org/10.1086/740858
About Kyushu University Founded in 1911, Kyushu University is one of Japan's leading research-oriented institutions of higher education, consistently ranking as one of the top ten Japanese universities in the Times Higher Education World University Rankings and the QS World Rankings. Located in Fukuoka, on the island of Kyushu—the most southwestern of Japan’s four main islands—Kyushu U sits in a coastal metropolis frequently ranked among the world’s most livable cities and historically known as Japan’s gateway to Asia. Its multiple campuses are home to around 19,000 students and 8,000 faculty and staff. Through its VISION 2030, Kyushu U will “drive social change with integrative knowledge.” By fusing the spectrum of knowledge, from the humanities and arts to engineering and medical sciences, Kyushu U will strengthen its research in the key areas of decarbonization, medicine and health, and environment and food, to tackle society’s most pressing issues.
