The predictive power of polygenic scores (PGSs) for lithium treatment response in bipolar disorder remains limited.

To enhance the prediction of lithium responsiveness by developing a multi-trait PGS (mt-PGS) combining genetic information from multiple phenotypes implicated in lithium response and/or bipolar disorder aetiology.

We analysed data collected from bipolar disorder patients who had received lithium treatment for at least 6 months and participated in the International Consortium on Lithium Genetics study (N = 2367). The Alda scale was used to assess lithium responsiveness, and treatment outcome was defined as continuous total Alda score (0–10) and categorical outcome (favourable ≥7 versus unfavourable response). PGSs were calculated for 60 phenotypes grouped into 5 clinical–biological clusters: psychiatric and behavioural (#23 phenotypes), cardiometabolic (#17), autoimmune/inflammatory (#5), neurocognitive (#8) and renal function (#7). We applied cross-validated machine learning regression approaches in both outcomes within each cluster, with the selected features from each cluster subsequently combined to construct the final mt-PGS models. Model performance was assessed using explained variance (R2) for the continuous outcome, and both McFadden’s pseudo-R2 and standard classification model parameters for the categorical outcome.

mt-PGS explained between 5.70% (continuous outcome) and 9.11% (categorical outcome) of the interindividual variability in lithium responsiveness. Classification accuracy (area under the curve) for the categorical outcome was 68.24% (95% CI: 64.98–71.66), with a Brier score of 0.257. Of the 5 clusters, the PGSs for psychiatric and behavioural phenotypes were most strongly associated with lithium responsiveness, accounting for 3.67–6.52% of its variability.

By integrating PGSs for multiple relevant phenotypes, predictive accuracy for lithium response improved substantially compared with single-trait methods. Future research incorporating larger, more diverse populations and combining genetic scores with clinical data holds promise for further enhancing prediction and advancing clinical implementation.

Self-reported dietary assessments have long been a limiting factor in advancing the field of precision nutrition. This is due to challenges such as unrecorded eating episodes, recall bias and portion-size estimation errors(1). We developed a system using customised wearable cameras and reasoning-enabled large vision–language models (LVLMs) to create a fully automated pipeline facilitating scalable and objective dietary assessment. Beyond reducing user burden, passive capture can record brief or opportunistic eating episodes that are typically missed, while the use of LVLMs improves identification across heterogeneous contexts. However, the feasibility, privacy safeguards, and quantitative performance of such systems remain underexplored. This study aims to evaluate the LVLM-enabled passive system’s performance in real-world deployments, focusing on its ability to accurately capture and analyze dietary intake.

A feasibility study was conducted at two centres, Hammersmith Hospital and the University of Reading(2), where thirty UK participants wore customised cameras side-mounted on glasses (STM32 microcontroller; 128-GB SD card; rechargeable) throughout waking hours whilst consuming two highly-controlled, standardised diets; one of which was compliant with UK healthy eating guidelines and the other was not. Each diet was consumed over four study days, during which participants remained in the facility and consumed meals provided by the study team. The model outputs were benchmarked against a dietitian-verified reference menu and the weights of food portions consumed. The preprocessing pipeline was first applied to blur faces and screens in captured images for privacy protection. The LVLM-based pipeline then performed three tasks: (i) extracting eating episodes; (ii) recognising food items across heterogeneous settings; and (iii) context-aware portion-size estimation, using cues from containers, utensils, and hands to mitigate monocular visual scale ambiguity(3). Any eating sessions lacking captured images were excluded from subsequent analyses.

Data passively captured with wearable cameras from 30 participants (Hammersmith, n=15; Reading, n=15) over eight study days yielded 2.08 million raw images at Hammersmith and 2.15 million at Reading. After privacy filtering and removal of redundant frames, 0.49% and 0.46% of images were retained from each site, respectively. Overall, food-item recall from passively captured imagery was 82% (95% CI 81–84%). Portion-size estimation showed a mean absolute error of 44.7 g (95% CI 42.2–47.3 g) for food items and 70.4 mL (95% CI 67.4–73.4 mL) for beverages against weighed consumed portions.

This feasibility study provides foundational evidence for LVLM-enabled, passive, camera-based dietary monitoring and supports progression to real-world deployment. These feasibility results support further multi-site validation, inclusion of metrics beyond recall (e.g., energy and macronutrient assessment), and assessment of performance across settings (home vs out-of-home) and subgroups to capture nutrient intake at population-level and enhance precision nutrition approaches.

Children are frequently victims of disasters. However, gaps remain in pediatric disaster preparedness. The New York City Pediatric Disaster Coalition (NYCPDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to prepare NYC for mass casualty events involving children. In the fall of 2022, there was a significant

increase in pediatric emergency department visits and hospitalizations due to Rhinovirus, Enterovirus, COVID-19, Influenza, and RSV throughout many areas of the United States. This, coupled with underlying staffing and other shortages, created a strain on the healthcare system. In many facilities, surge capacity was exceeded, Emergency Departments and Pediatric Intensive Care Units were closed to new patients, and inter-hospital transports were denied.

In response, the NYCPDC rapidly (over four days) developed a one-hour webinar focused on: epidemiological data sharing, impacts on patient care, a review of prevention, treatment, and supply issues, and a discussion on current and future strategies to respond to the outbreak. The one-hour webinar included a total of four presenters with representation from the NYCPDC, DOHMH, as well as two major NYC children’s hospitals and a national audience.

Over 400 healthcare workers registered for the webinar from around the United States. Prior to the conclusion of the webinar, participants had the opportunity to ask questions and contribute to the session by sharing their firsthand surge experiences, including capacity expansion, challenges, and best practices. Following the session, a recording of the webinar as well as a curated listing of resources developed in cooperation with the National Pediatric Disaster Coalition were distributed to every participant.

This presentation will provide a summary of the webinar and highlight effective strategies to respond to future outbreaks. This includes managing a large influx of pediatric patients in the emergency department and pediatric intensive care unit, as well as effective transfer strategies.

Children are frequently victims of disasters. However, gaps remain in pediatric disaster preparedness. The New York City Pediatric Disaster Coalition (NYCPDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to prepare NYC for mass casualty events that involve large numbers of children. On May 23, 2024, the NYC PDC conducted a pediatric disaster full-scale exercise testing surge, communications, and secondary transport. Participants included three NYC pediatric hospitals and the NYC Pediatric Intensivist Response Team (PIRT).

The full-scale exercise was prospectively designed with specific goals: to test and improve communications with staff and city agencies; to test and improve hospitals’ pediatric surge capacity plans and response; to identify space, staffing, and equipment needs for pediatric disaster; and for hospitals to identify and triage patients requiring secondary transport to another facility.

In collaboration with the DOHMH, PDC designed a Master Scenario Events List (MSEL) along with other tools to measure strengths and weaknesses to be identified at each institution at a system level. PDC created an exercise evaluation guide to assess: Communications, Emergency Operation Plans, Surge, Patient Tracking, Patient Transfer, Supplies, and Staffing, utilizing a performance rating scale from 1-4 and qualitative reporting.

This information was used to report lessons learned and challenges to the participants and DOHMH in an after-action report. An after-action report was written based on information from evaluation guides, site-specific and group hot-washes, and an after-action meeting.

This presentation will highlight the strengths, challenges, and lessons learned from the exercise. Conducting a multi-hospital pediatric disaster full-scale surge exercise produced lessons learned to address exercise gaps that can improve surge capabilities during future exercises and real-time events.

The concept partnership has developed since Sherry Arnstein first created the ladder of citizen participation. Within mental health discourse, this was first acknowledged by “A Vision for Change” (2006) and later, through adopting co-production (2017). In 2011, the College of Psychiatrists of Ireland, created a collective called Recovery Experience Forum of Carers and Users of Services (REFOCUS) which became a leading example of partnership between stakeholders in the organisation. However, REFOCUS’s impact on stakeholders needs to be examined.

A qualitative investigation using an autoethnography methodology is proposed. The approach allows for the interweaving of personal experiences with culture to create new knowledge. A focus group was conducted, and transcripts were subject to reflexive thematic analysis.

Seven out of fourteen participants, representing all three stakeholders, were available at time of interview. From the process of reflexive thematic analysis, five themes were constructed. Each with a number of sub-themes attached, which in turn represented stakeholder perspectives regarding REFOCUS.

This paper highlights several issues that need addressing in future research on REFOCUS. The paper demonstrates the continuous presence of stigma within Irish mental health services. However, it also highlights a number of beneficial aspects to REFOCUS including informal peer support, service users, and family member involvement in college activities as well as increasing meaning and purpose in one’s life along with a renewed identity different to that of the service user or family member.