Bioniks CEO Anas Niaz says each prosthetic arm costs about $2,500, significantly less than the $10,000 to $20,000 for alternatives made in the United States.
As soon as eight-year-old Sidra Al Bordeeni returned from the clinic with her prosthetic arm, she jumped on a bicycle in the Jordanian refugee camp where she lives, riding for the first time since a missile strike in Gaza took her arm a year ago.
Sidra was injured while sheltering at Nuseirat School, one of several Gaza schools converted into makeshift refuges from Israeli strikes. Her mother, Sabreen Al Bordeeni, said Gaza’s collapsed health services and the family’s inability to leave at the time made it impossible to save her hand.
“She’s out playing, and all her friends and siblings are fascinated by her arm,” Al Bordeeni said on the phone, repeatedly thanking God for this day. “I can’t express how grateful I am to see my daughter happy.”
The arm was built over 4,000 kilometres away in Karachi by Bioniks, a Pakistani company that uses a smartphone app to take pictures from different angles and create a 3D model for custom prosthetics.
CEO Anas Niaz said the social enterprise startup had fit more than 1,000 custom-designed arms inside Pakistan since 2021 — funded through a mix of patient payments, corporate sponsorship, and donations — but this was its first time providing prosthetics to those impacted in conflict.
A technician works on computers with prosthetic limb diagram at Bioniks in Karachi, April 29, 2024. — Reuters
Sidra and three-year-old Habebat Allah, who lost both her arms and a leg in Gaza, went through days of remote consultations and virtual fittings. Then Niaz flew from Karachi to Amman to meet the girls and make his company’s first overseas delivery.
Sidra’s device was funded by Mafaz Clinic in Amman, while donations from Pakistanis paid for Habebat’s. Mafaz CEO Entesar Asaker said the clinic partnered with Bioniks for its low costs, remote solutions and ability to troubleshoot virtually.
Niaz said each prosthetic arm costs about $2,500, significantly less than the $10,000 to $20,000 for alternatives made in the United States.
While Bioniks’ arms are less sophisticated than US versions, they provide a high level of functionality for children and their remote process makes them more accessible than options from other countries such as Turkiye and South Korea.
“We plan on providing limbs for people in other conflict zones too, like Ukraine, and become a global company,” Niaz said.
Globally, most advanced prosthetics are designed for adults and rarely reach children in war zones, who need lighter limbs and replacements every 12–18 months as they grow.
A technician checks a prosthetic limb at the Bioniks in Karachi, April 29, 2024. — Reuters
Niaz said they were exploring funding options for Sidra and Habebat’s future replacements, adding the cost wouldn’t be too high.
“Only a few components would need to be changed,” he said, “the rest can be reused to help another child.”
Bioniks occasionally incorporates popular fictional characters into its children’s prosthetics such as Marvel’s Iron Man or Disney’s Elsa, a feature Niaz said helps with emotional acceptance and daily use.
‘Finally hug my father’
Gaza now has around 4,500 new amputees, on top of 2,000 existing cases from before the conflict, many of them children, making it one of the highest child-amputation crises per capita in recent history, the UN humanitarian agency OCHA said in March.
An April study by the Palestinian Bureau of Statistics found at least 7,000 children have been injured since Israel’s war on Gaza began in October 2023. Local health authorities say more than 50,000 Palestinians have been killed, nearly one-third of them children.
A technician uses a mobile phone for 3D scan of a patient before developing a prosthetic limb at Bioniks, in Karachi, April 29, 2024. — Reuters
The World Health Organisation has said Gaza’s health system is “on its knees” with Israel’s border closures drying up critical supplies, meaning the wounded cannot access specialised care, especially amid waves of wounded patients.
“Where it’s nearly impossible for healthcare professionals and patients to meet, remote treatment bridges a critical gap, making assessments, fittings, and follow-up possible without travel or specialised centres,” said Asadullah Khan, Clinic Manager at ProActive Prosthetic in Leeds, UK, which provides artificial limbs and support for trauma patients.
Anas Niaz, mechatronic engineer and CEO of Bioniks, speaks with Reuters in Karachi, April 29, 2024. — Reuters
Bioniks hopes to pioneer such solutions on a large scale but funding remains a roadblock and the company is still trying to form viable partnerships.
Sidra is still adjusting to her new hand on which she now wears a small bracelet. For much of the past year, when she wanted to make a heart, a simple gesture using both hands, she would ask someone else to complete it. This time, she formed the shape herself, snapped a photo, and sent it to her father, who is still trapped in Gaza.
“What I’m looking forward to most is using both my arms to finally hug my father when I see him,” she said.
Header image : A technician checks a prosthetic limb at the Bioniks, in Karachi, April 29, 2024. — Reuters
An international research team led by the University of Southern Queensland (UniSQ) has discovered two new planets performing a cosmic tango – orbiting their star in perfect rhythm.
The findings, published in Nature Astronomy, reveal the two giant planets appear to be “dancing” around KOI-134, an F-type star 3,500 light-years from Earth.
The remarkable discovery is the first planetary system of its kind ever found.
The planets – dubbed KOI-134 b and KOI-134 c – are locked into a 2:1 orbital resonance, meaning the inner planet, KOI-134 c, completes two full orbits for every single orbit of the outer planet.
What makes the system even more intriguing is that, unlike the planets in our Solar System, the giants don’t share the same orbital plane – they are tilted about 15 degrees relative to each other.
Emma Nabbie, a UniSQ PhD student and lead author of the new research, said the discovery challenges long-held theories on planet formation.
“The two planets are linked in a rhythmic orbit – drifting apart, then slowly coming back together, like dancers weaving around each other on a cosmic stage,” Ms Nabbie said.
“While their orbital planes tilt back and forth over time, the gravitational pull from KOI-134 c causes KOI-134 b’s orbital period to shift by up to a day – speeding up and slowing down as the faster-orbiting KOI-134 c overtakes it from the inside.
“This is the first time a system with such strong gravitational interactions and misaligned orbits has been observed – presenting a major puzzle for planet formation theories, as none currently explain how a system like this could form.”
Using four years of data from the Kepler Space Telescope, the researchers discovered KOI-134 b to be a giant roughly the size of Jupiter and KOI-134 c to be slightly smaller than Saturn.
KOI-134 c is considered an ‘invisible planet’ because it doesn’t pass in front of its host star, which makes it difficult for scientists to spot its presence using traditional detection methods.
“The only way we could determine its mass was through its gravitational effect on KOI-134 b,” Ms Nabbie said.
“KOI-134 b’s average orbital period is about 67 days – but it can vary between 66 and 68 days due to the gravitational influence of KOI-134 c.
“That’s a remarkably large effect for a planet so close to its star. The variation was so extreme that it was initially denied to be a planet by the Kepler team.
“If we scaled this to Earth’s orbit, it would be like our year fluctuating between 360 and 370 days.”
As far as the researchers could tell, KOI-134 b and KOI-134 c are the only two planets orbiting KOI-134, which was first observed by NASA’s Kepler mission in 2009.
The study, ‘A high mutual inclination system around KOI-134 revealed by transit timing variations’, was co-authored by Emma Nabbie, Professor Robert Wittenmyer, Dr Chelsea Huang, Associate Professor George Zhou and Alexander Venner from UniSQ and researchers from Lund University, University of Geneva, University of La Laguna, Chinese Academy of Sciences, Harvard and Smithsonian, Georgia Institute of Technology, University of California and Tsinghua University.
/Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.
Spare a thought for luxury property concierge Heaven, who thinks her job is a way to “live vicariously” through her billionaire guests. She is so disorganised that the bosses have brought in five-star hotel expert Jasmin. Cue plenty of competitive drama in this icky (but undeniably watchable) reality series about running a mansion on Sydney Harbour. Disasters include lost bottles of vintage champagne, an unwelcome dog guest and a pair of disgruntled hunky chef brothers. Hollie Richardson
Heatwaves: The New Normal?
7pm, BBC Two
It’s a suffocating 31C at the time of writing, so the question posed here is enough to make a nation sob – and reach for another fan. BBC weather expert Sarah Keith-Lucas delivers some hard truths as she looks at what rising temperatures are doing to all industries. HR
Scrublands: Silver
9pm, BBC Two
As the second season of this gripping, slightly sinister Aussie noir continues, Mandy is in trouble. She’s been arrested for Jasper’s murder and doesn’t have an alibi. However, while the police wander down a blind alley, journalist Martin has other ideas: could a system of sexual exploitation around tourist visas offer him a way in? Phil Harrison
Carrie Coon and Morgan Spector in The Gilded Age. Photograph: HBO/Sky Atlantic
The Gilded Age
9pm, Sky Atlantic
Busybody Bertha’s (Carrie Coon) “vision” for her daughter has started to interfere with business, and George (Morgan Spector) can’t have that, especially with the Duke’s deal beginning to fall apart. Meanwhile, Peggy Scott (Denée Benton) makes an eligible acquaintance and Agnes (Christine Baranski) is adjusting to life on the outside. Ellen E Jones
Elsbeth
9pm, Sky Witness
When a young motorist is suspiciously found dead in his vehicle, Elsbeth (Carrie Preston) goes undercover at his pricey wellness retreat to ferret out a lead and, as one does, ends up confronting her own emotional repression. Accused of covering up past abuse, she unravels, just as the retreat leader’s shady past resurfaces. Ali Catterall
Crime Scene Cleaners
10pm, Channel 4
A frankly stomach-churning documentary series that most of us could do without. But, for those with strong dispositions, it follows the experts who clean up crime scenes, which this week include a London spot where a teenager has been stabbed to death in a rental car. Over in Louisiana, a potentially explosive meth lab is discovered. HR
This cross-sectional study reports the prevalence and genotype distribution of human papillomavirus infection among women in Yangpu District, Shanghai, China from 2020 to 2024. The overall HPV infection rate detected in this study was 23.10%. Compared with similar studies in China, this infection rate is higher than the 21.0% reported in Beijing [11], 21.97% in Jinshan District Shanghai [12], 22.82% in Luoyang Henan Province [13], and 17.92% in Zhoupu District Shanghai [14], but lower than the 41.04% in Hangzhou Zhejiang Province and 50.64% in Tianjin [15, 16]. This discrepancy may be associated with variations in regional epidemiological characteristics or demographic composition of study populations [17]. Previous studies have reported substantial heterogeneity in HPV prevalence across China, ranging from 6.2–50.64% [16, 18]. Prevalence rates in clinical populations significantly exceed those in community-based screening cohorts, likely reflecting health-seeking behaviors related to symptomatic presentation that differ fundamentally from asymptomatic screening populations [19]. In the present study, an HPV prevalence of 10.5% was observed among general screening populations, lower than the 13.6% rate reported in routine screening cohorts from Zhejiang Province [20].
This regional analysis identified HPV-52 as the predominant high-risk genotype, followed by HPV-53, -58, -51, -39, and − 68, aligning with patterns reported in other Chinese studies. HPV-52, -16, -58, -51, and − 66 represent predominant subtypes in Beijing [11], while HPV-52, -16, -58, -51, and − 53 dominate in Jinshan District, Shanghai [12]. Similarly, HPV-52, -58, -16, -53, and − 51 constitute major subtypes in the Golden Triangle region of Fujian, China [3]. Substantial evidence confirms that beyond HPV-16 and − 18, genotypes including HPV-52, -58, -51, and − 53 significantly contribute to cervical carcinogenesis [21]. This study’s findings exhibit discrepancies in subtype prevalence rankings compared with certain Chinese regions [22], indicating significant geographical heterogeneity in high-risk HPV genotype distributions. This epidemiological variation likely originates from multifactorial mechanisms: Firstly, socio-behavioral patterns—including number of sexual partners, marital/reproductive history, and sexual health literacy—fundamentally shape subtype distributions by modulating viral transmission routes and exposure frequency. Secondly, molecular interactions between HPV genotypes and region-specific host immunogenetic backgrounds may establish distinct infection profiles in defined populations [23].
From the perspective of infection patterns, HPV infections exhibit a phenomenon of multi-subtype coexistence. Beyond single-subtype infections, mixed-infection modes are particularly prominent, with dual infections being the predominant form. It remains unclear whether co-infection with multiple HPV genotypes involves competitive or synergistic relationships. However, existing studies indicate that mixed infections with multiple types increase the risk of cervical cancer more significantly than single-genotype infections [24, 25]. A study conducted in Mexico observed a correlation between multiple HPV infections and high viral load as well as infection persistence [26]. Research from South Korea demonstrated that patients with multiple HPV infections had longer viral clearance cycles compared to those with single-type infections [27]. The mechanisms and potential carcinogenic effects of multiple infecting genotypes require further investigation. Fig. 2 results revealed that HPV-52, HPV-53, and HPV-58 were the most common genotypes in co-infections among women in this study, with HPV-52 + HPV-53 and HPV-52 + HPV-58 co-infections being the most frequent combinations. In Shanghai, China, HPV vaccination began in 2017, and Yangpu District started the program in 2018. Initially, the bivalent vaccine targeting HPV-16 and − 18 and the quadrivalent vaccine covering HPV − 6, -11, -16, and − 18 were mainly provided. In October of the same year, the nine-valent HPV vaccine, which covers more high-risk types including HPV − 6, -11, -16, -18, -31, -33, -45, -52, and − 58, was officially made available for vaccination. Vaccination mainly relies on the principle of self-payment and voluntary participation, and the overall vaccination rate remains relatively low. Among the HPV vaccines available on the market, only the nine-valent vaccine covers HPV-52 and HPV-58, making it more suitable for women in Yangpu District, Shanghai.
Given that the HPV-53 vaccine is still in the preclinical research stage, its high prevalence in certain regions further highlights the insufficiency of the existing vaccine’s coverage. Currently available vaccines are all based on HPV L1 self-assembled virus-like particles (VLPs), which can prevent HPV infection by inducing the production of specific neutralizing antibodies in the body [28]. Although these vaccines have shown significant efficacy, they still have several limitations, including a limited coverage of HPV types, the need to produce VLPs of different types separately before mixing them, and a high dependence on cold chain transportation and storage. The high prevalence of HPV-53 indicates the insufficiency of the current vaccine strategy in terms of protection spectrum. Therefore, in the future, it is urgent to expand the vaccine coverage through technological innovation, such as developing cross-protective vaccines based on L2 protein or constructing new multivalent vaccine systems using DNA and mRNA platforms. Although these emerging technologies face challenges in terms of research and development difficulty and cost control, they have significant potential in improving the broad-spectrum and accessibility of vaccines. The development of vaccines targeting HPV-53 is expected to provide more targeted prevention measures for regions with high prevalence.
Multiple studies have confirmed that HPV infection rates in China exhibit a U-shaped curve distribution with age, characterized by two distinct peaks [11, 24]. In this study, the first peak occurred in the under-20 age group, which may be associated with evolving sexual attitudes among youth in the current social context. A large-scale cross-sectional survey of Chinese women aged 15–24 revealed that the median age of first sexual intercourse in this cohort was 17 years [29]. Another epidemiological study demonstrated that within two to three years after initial sexual activity, HPV infection rates among adolescents can reach 50–80%, with a corresponding 2.41-fold increase in infection risk [30]. Although the sample size of the under-20 population in this study was limited, their significant disease risk profile indicates the necessity of HPV screening for this age group. The second peak emerged in the 61–70 age group, likely attributed to age-related declines in immune function and hormonal changes, which increase HPV susceptibility and reduce viral clearance capacity [31, 32]. The differential infection patterns across age groups underscore age as a critical influencing factor for HPV infection, necessitating age-specific screening strategies. Particularly in the 61–70 cohort, the marked elevation in HPV infection rates suggests these individuals should be prioritized as key surveillance targets..
Figure 3 results show that HPV-52, HPV-53, and HPV-58 were the predominant subtypes, with their infection rates maintaining high levels across all age groups. The peak infection rates occurred in the ≤ 20 years and 61–70 years age groups, but positive infections for various HPV types were primarily concentrated in the 31–40 years, 51–60 years, and 61–70 years age groups. This indicates that the population actively undergoing gynecological examinations is mainly composed of middle-aged and elderly women, which is associated with increased awareness of HPV infection among this demographic due to the introduction and promotion of HPV vaccines in recent years [22]. From a prevention and control strategy perspective, HPV vaccination and screening are core measures to reduce cervical cancer risk. Data demonstrate that the earlier young women receive the HPV vaccine, the higher the antibody titer and the better the protective effect of the vaccine [33]. However, HPV vaccination coverage in China remains critically low at approximately 2.64–11.0%, significantly below immunization rates observed in most other countries [8, 34, 35]. Multiple obstacles have led to this low vaccination rate. Among female college students, insufficient awareness of the risk of HPV infection and concerns about the safety and efficacy of the vaccine are the main obstacles [36]. Concurrently, current vaccine shortages and exclusion from the national immunization program likely impede or delay individual vaccination decisions [37]. Consequently, stratified immunization and screening strategies informed by age-specific prevalence patterns should be implemented to address differential HPV exposure across age cohorts.
This study constitutes a cross-sectional analysis based on HPV testing data from 2020 to 2024 at Shanghai Yangpu District Shidong Hospital, systematically elucidating the epidemiological characteristics of HPV in Yangpu area. It supplements the multi-center epidemiological database of Shanghai and provides scientific evidence for regional prevention policies. However, the following limitations exist: Firstly, the study cohort solely comprised hospital patients within this five-year timeframe, which is not representative of the typical local population. Secondly, HPV vaccination history was not incorporated into the dataset, whereas existing evidence indicates that vaccination status significantly influences the infection spectrum distribution of high-risk HPV subtypes. Finally, the absence of synchronized collection of cervical cytology or histopathological diagnosis results restricted the analysis of associations between HPV genotype distribution patterns and cervical lesion severity. As a retrospective single-center study, our research sample included only patients seeking hospital care. This design excludes potentially infected individuals within the community who did not present for medical attention. This may limit the generalizability of our findings to the broader community population. Therefore, caution is warranted when extrapolating these conclusions to wider populations. Future investigations should expand sample size, enhance data dimensionality, and adopt multi-center collaborative models to systematically explore the association mechanisms between HPV infection and cervical lesions in Yangpu area..
US President Donald Trump welcomes Israeli Prime Minister Benjamin Netanyahu to the White House in April
After 21 months of war, there are growing hopes of a new Gaza ceasefire announcement as Israel’s Prime Minister Benjamin Netanyahu meets US President Donald Trump in Washington.
Trump previously told reporters he had been “very firm” with Netanyahu about ending the conflict and that he thought “we’ll have a deal” this week.
“We are working to achieve the deal that has been discussed, under the conditions we have agreed,” the veteran Israeli PM said before boarding his plane. “I believe that the conversation with President Trump can definitely help advance this outcome, which we all hope for.”
Indirect talks between Israel and Hamas on a US-sponsored proposal for a 60-day ceasefire and hostage release deal resumed in Qatar on Sunday evening.
However, it is unclear whether key differences that have consistently held up an agreement can be overcome.
Only cautious optimism is being expressed by weary Palestinians living in dire conditions amid continuing daily Israeli bombardment, and the distressed families of Israeli hostages still held by Hamas.
“I don’t wish for a truce but a complete stop to all war. Frankly, I’m afraid that after 60 days the war would restart again,” says Nabil Abu Dayah, who fled from Beit Lahia in northern Gaza to Gaza City with his children and grandchildren.
“We got so tired of displacement, we got tired of thirst and hunger, from living in tents. When it comes to life’s necessities, we have zero.”
On Saturday evening, large rallies took place urging Israel’s government to seal a deal to return some 50 hostages from Gaza, up to 20 of whom are believed to be alive.
Some relatives questioned why the framework deal would not free all captives immediately.
“How does one survive under such conditions? I’m waiting for Evyatar to return and tell me himself,” said Ilay David, whose younger brother, a musician, was filmed by Hamas in torment as he watched fellow hostages being released earlier this year during the last, two-month-long ceasefire.
“This is the time to save lives. This is the time to rescue the bodies from the threat of disappearance,” Ilay told a crowd in Jerusalem.
“In the rapidly changing reality of the Middle East, this is the moment to sign a comprehensive agreement that will lead to the release of all the hostages, every single one, without exception.”
AFP
The Israeli hostages’ families are urging the US president to broker a deal that secures the release of all of those held in Gaza
Netanyahu is visiting the White House for the third time since Trump returned to power nearly six months ago.
But the leaders will be meeting for the first time since the US joined Israeli attacks on Iranian nuclear sites and then brokered a ceasefire between Israel and Iran.
There is a strong sense that the recent 12-day war has created more favourable circumstances to end the Gaza war.
After months of low popularity ratings, the Israeli PM has been bolstered by broad public support for the Iran offensive and analysts suggest he now has more leverage to agree to a peace deal over the strong objections of his far-right coalition partners, who want Israel to remain in control of Gaza.
Hamas is seen to have been further weakened by the strikes on Iran – a key regional patron – meaning it could also be more amenable to making concessions needed to reach an agreement.
Meanwhile, Trump is keen to move on to other priorities in the Middle East.
These include brokering border talks between Israel and Syria, returning to efforts to normalise relations between Israel and Saudi Arabia, and completing unfinished business with Iran, involving possible negotiations on a new nuclear deal.
For months, ceasefire talks between Israel and Hamas have been deadlocked over one fundamental difference.
Israel has been ready to commit to a temporary truce to return hostages but not an end to the war. Hamas has demanded a permanent cessation of hostilities in Gaza and a full pullout of Israeli troops.
The latest proposal put to Hamas is said to include guarantees of Washington’s commitment to the deal and to continued talks to reach a lasting ceasefire and the release of all the hostages.
Nothing has been officially announced, but according to media reports the framework would see Hamas hand over 28 hostages – 10 alive and 18 dead – in five stages over 60 days without the troubling handover ceremonies it staged in the last ceasefire.
There would be a large surge in humanitarian aid entering Gaza.
After the return of the first eight living hostages on the first day of the agreement, Israeli forces would withdraw from parts of the north. After one week, the army would leave parts of the south.
On Day 10, Hamas would outline which hostages remain alive and their condition, while Israel would give details about more than 2,000 Gazans arrested during the war who remain in “administrative detention” – a practice which allows the Israeli authorities to hold them without charge or trial.
As seen before, large numbers of Palestinians would be released from Israeli jails in exchange for hostages.
Reuters
The Israeli military’s chief of staff said last week that it was nearing the completion of its war goals
President Trump has described this as the “final” truce proposal and said last week that Israel had accepted “the necessary conditions” to finalise it.
On Friday, Hamas said it had responded in a “positive spirit” but expressed some reservations.
A Palestinian official said sticking points remained over humanitarian aid – with Hamas demanding an immediate end to operations by the controversial Israeli and American-backed Gaza Humanitarian Foundation (GHF) and a return to the UN and its partners overseeing all relief efforts.
Hamas is also said to be questioning the timetable for Israeli troop withdrawals and operations of the Rafah crossing between southern Gaza and Egypt.
Netanyahu’s office stated on Saturday that the changes wanted by Hamas were “not acceptable” to Israel.
The prime minister has repeatedly said that Hamas must be disarmed, a demand the Islamist group has so far refused to discuss.
EPA
The humanitarian situation in Gaza is continuing to deteriorate
In Israel, there is growing opposition to the war in Gaza, with more than 20 soldiers killed in the past month, according to the military.
The Israeli military’s chief of staff, Lt Gen Eyal Zamir, said last week that it was nearing the completion of its war goals and signalled that the government must decide whether to move ahead with a deal to bring home hostages or prepare for Israeli forces to re-establish military rule in Gaza.
Polls indicate that two-thirds of Israelis support a ceasefire deal to bring home the hostages.
In Gaza, some residents express fears that the current wave of positivity is being manufactured to ease tensions during Netanyahu’s US trip – rationalising that this happened in May as Trump prepared to visit Arab Gulf states.
The coming days will be critical politically and in humanitarian terms.
The situation in Gaza has continued to deteriorate, with medical staff reporting acute malnutrition among children.
The UN says that with no fuel having entered in over four months, stockpiles are now virtually gone, threatening vital medical care, water supplies and telecommunications.
Israel launched its war in Gaza in retaliation for the Hamas-led attacks on 7 October 2023, which killed about 1,200 people and led to 251 others being taken hostage.
Israeli attacks have since killed more than 57,000 people in Gaza, according to the Hamas-run health ministry. The ministry’s figures are quoted by the UN and others as the most reliable source of statistics available on casualties.
Follow the twists and turns of Trump’s second term with North America correspondent Anthony Zurcher’s weekly US Politics Unspun newsletter. Readers in the UK can sign up here. Those outside the UK can sign up here.
The UK’s financial sector is at a defining inflection point. As banks, regulators, and fintechs pursue transformation at scale, there is growing recognition that digital finance must be more than efficient—it must be transparent, collaborative, and resilient. Open source finance offers a compelling model to achieve just that.
At its core, open source finance involves building financial infrastructure through shared, non-proprietary frameworks—codebases, APIs, standards, and protocols that are open to scrutiny and improvement by the broader ecosystem. Far from being a niche developer concern, open source is now a strategic lever that can redefine how trust is engineered into our digital economy.
The urgency for open systems is not abstract. The Covid-19 pandemic revealed fragilities in closed financial architectures: siloed data, vendor lock-in, and slow responsiveness to public needs. Meanwhile, consumer expectations have shifted irrevocably—real-time access, data portability, and inclusive service design are now baseline requirements.
The UK’s own Open Banking initiative, established through the Competition and Markets Authority, was among the first regulatory frameworks to embrace open APIs. What began as a compliance requirement has since catalysed an entire ecosystem of fintech innovation. Yet this is only the beginning.
If open banking was the first act, open finance must be the second. A broader shift is underway, where financial services are designed around modular, interoperable platforms—platforms that allow banks to adapt faster, scale smarter, and collaborate across boundaries of institution, geography, and industry.
The benefits of open source finance
Open source finance brings measurable advantages:
Trust through transparency
When codebases are open, they can be independently reviewed, audited, and improved. This is especially important in an era of algorithmic decision-making, AI integration, and rising regulatory scrutiny.
Banks can plug into open frameworks without protracted vendor negotiations. Components can be iterated, tested, and deployed faster than with proprietary systems.
By removing licensing barriers and avoiding duplication, open solutions often lower total cost of ownership—freeing up resources for innovation.
Open platforms encourage collaboration among banks, startups, academics, and public institutions. This shared development accelerates progress and avoids siloed effort.
Openness also aligns with ESG imperatives
Open data standards, for instance, are vital for accurate climate risk disclosures, ethical AI oversight, and financial inclusion initiatives. When infrastructure is designed for accessibility and auditability, everyone benefits—not just shareholders, but society at large.
The UK is well positioned to lead the next wave of open finance—if it chooses to. The technical groundwork is already strong, but the governance frameworks, cultural alignment, and public-private collaboration must evolve accordingly.
The Open Banking Implementation Entity (OBIE) offers a working model. Its success was not merely technical—it was institutional. By convening banks, regulators, and fintechs around shared standards, OBIE laid a foundation of interoperability. The next step is to extend this model to pensions, insurance, investments, and credit scoring. In other words, open finance must become a cross-sectoral norm, not a product feature.
Equally important is education. Many financial institutions still treat open source with scepticism, worried about security, IP risk, or loss of competitive edge. Yet the reality is quite the opposite. Open systems, when well governed, are often more secure due to peer review and faster patching. And far from eroding competitive advantage, openness fosters agility and resilience—traits no institution can afford to ignore.
The barriers to open source finance
These are no longer technical—they are strategic.
Legacy institutions struggle to move from closed systems to open collaboration. Procurement processes, legal models, and compliance mindsets need to catch up.
Managing open frameworks requires specialised knowledge—around licensing, security auditing, and community governance. These capabilities are still emerging in mainstream finance.
Without leadership, open finance can fragment into disconnected initiatives. Coordinated effort is needed to ensure interoperability and prevent duplication.
Open projects thrive on contribution. Banks and fintechs must not only consume open tools but actively support their development through funding, engineering, and governance.
Leadership challenge
These are not reasons for inaction—they are reminders that the shift to open finance is as much a leadership challenge as a technical one.
To harness the full potential of open source finance, UK stakeholders must act deliberately. Financial institutions should build internal capacity around open development, prioritise API-based architecture, and engage with community governance. Regulators must provide clear guidance on open source use, especially in critical areas like AI governance, consumer data rights, and digital identity. Fintechs should document and contribute to shared codebases, avoiding black-box tools that hinder interoperability. Technology providers must ensure compatibility with open standards and offer licensing terms that support experimentation and scale.
Above all, the UK needs a national dialogue around open finance—not as a compliance issue, but as a cornerstone of digital sovereignty and innovation.
Open source finance is not about replacing banks with code. It’s about designing the financial infrastructure of the future—one that is inclusive, ethical, and built for long-term resilience. In a world of complex risks and rapid innovation, the institutions that succeed will not be those with the most proprietary control, but those with the most collaborative advantage.
The opportunity is here. For the UK to remain a global financial leader, it must now move decisively from open banking to open finance—and from passive adoption to proactive stewardship.
Dr. Gulzar Singh is Founder & CEO of Phoenix Thoughtworks
Want a high-end iPadOS experience that doesn’t break the bank? Well, the pricey iPad Pro M4 might be out of reach—but the latest iPad Air M3 fits the bill perfectly, especially at its current Amazon price. Right now, you can save a tempting $100 on the 11-inch variant, bringing it just under $500 from its original ~$600 price.
The iPad Air M3 is $100 off at Amazon
$100 off (17%)
The ultra-powerful iPad Air M3 is an excellent choice at Amazon right before Prime Day. Right now, you can grab the 11-inch variant with 128GB of storage for $100 off across colorways. At that discount, it’s an excellent pick for iPadOS fans looking for a powerful yet (relatively) affordable tablet.
Buy at Amazon
Sure, we’ve seen the promo before, but that doesn’t make it any less appealing. Even better, this Apple tablet has never received more substantial price cuts. In other words, you can grab it at its lowest price right before Prime Day.The M3-powered iPad Air offers solid performance in a sleek and lightweight form. It handles everyday tasks with ease and has more than enough power for demanding apps and games. Curious how it holds up in real life? Check out our iPad Air M3 review.
Aside from the ultra-powerful M3 SoC, this slate pretty much resembles its predecessor. You get an 11-inch Liquid Retina screen with a 60Hz refresh rate, and excellent brightness levels—just like the iPad Air M2. Still, the newer 128GB model offers better value at the moment, as the 11-inch M2-powered device sells at its standard price on Amazon in its base storage configuration.
When it comes to sound quality, the iPad Air M3 delivers a lot. It might only have two speakers (unlike the iPad Pro), but it offers a decently wide soundstage, clear highs, and even some bass.
Bottom line: the iPad Air M3 has it all. Granted, the display refresh rate is “stuck” at 60Hz, but visuals look great, performance is excellent, and battery life isn’t half bad. Add the top sound quality and some Apple AI features, and you’ve got a beast that’s hard to ignore at that price.
With Prime Day around the corner, there’s no telling if the iPad Air M3 will stay $100 off, drop even further, or bounce back to full price. So, if you’re looking to save big ahead of the event, now’s the perfect time to act.
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Two-time Oscar winner Michael Douglas has revealed he may be finished with acting, saying he has “no real intentions” to return to the industry.
Speaking at the Karlovy Vary international film festival in the Czech Republic for the 50th anniversary of One Flew Over the Cuckoo’s Nest – which Douglas co-produced – the 80-year-old actor and producer told a press conference that unless “something special came up” for him, he would not act again.
His last role was playing Benjamin Franklin in the Apple TV+ series Franklin, which was filmed in 2022 and released in 2024.
“I’ve had a very busy career. Now, I have not worked since 2022, purposely, because I realised I had to stop,” he said.
“I’d been working pretty hard for almost 60 years, and I did not want to be one of those people who dropped dead on the set,” he added.
“I’m very happy with taking the time off. I have no real intentions. But I say I’m not retired, because if something special came up, I’d go back. But otherwise, I’m quite happy. I just like to watch my wife [actor Catherine Zeta-Jones] work.”
He added that he was “trying to get a good script out” of a ‘“little independent movie”, but joked: “I’m not pursuing work. My golf game is getting better.”
In 2010 Douglas underwent chemotherapy and radiation for stage four throat cancer. At Karlovy Vary, he said he was “fortunate” to avoid surgery, which “would have meant not being able to talk and removing part of my jaw … that would have been limiting as an actor”.
Douglas also addressed the current state of US politics, saying that he felt his country is “flirting with autocracy”.
“I look at it generally as the fact of how precious democracy is, of how vulnerable it is and how it always has to be protected,” he said. “I hope that what we’re struggling with right now is a reminder of all the hard work the Czechs did in gaining their freedom and independence. Politics now seem to be for profit. Money has entered democracy as a profit centre. People are going into politics now to make money. We maintained an ideal, an idealism in the US, which does not exist now.”
However, he added that he would “not to go into too much detail” as “the news speaks for itself”.
“I myself am worried, I am nervous, and I think it’s all of our responsibility to look out for ourselves,” he added.
We are planning a monocentric, double-blind, sham-controlled, randomized clinical trial to evaluate the efficacy and safety of rTMS in in children and adolescents diagnosed with ASD. The study will involve 40 patients randomized into active rTMS and sham stimulation groups. The duration of the study will be 36 months. Participants will be assessed before rTMS (T0), immediately post-treatment (T1), and at a 1-month follow-up (T2) (Fig. 1). Assessments will evaluate neuropsychological function, mainly executive functions; the severity of ASD clinical symptoms; and safety and tolerability. Additionally, biological samples, including urine and blood, will be collected at each assessment to measure biomarker changes.
Fig. 1
Ethical issues
A participant information sheet will be provided, and informed consent will be obtained from the parents or caregivers of study participants (see Supplementary File 1). The study protocol has been reviewed and approved by the Independent Ethics Committee of Policlinico “Riuniti” of Foggia (reference number 50/CE/2023). The trial has been registered with ClinicalTrials.gov under the identifier NCT06069323. The study will be conducted in accordance with the Declaration of Helsinki, Good Clinical Practice, and applicable regulatory requirements. To ensure appropriate oversight, key study staff will meet monthly to review trial conduct, participant recruitment, protocol adherence, data quality, and any adverse events. Given the low-risk nature of the rTMS intervention, a formal independent Data Monitoring Committee was not established. Instead, trial oversight, including safety and data integrity, will be managed internally by the study team. Any serious adverse events or protocol deviations will be reported to the Ethics Committee in accordance with regulatory requirements. No formal interim analyses or independent audits are planned. Any significant amendments to the protocol will be reviewed by the Principal Investigator and submitted to the Ethics Committee for approval. Once approved, all relevant members of the study team will be informed, and the revised protocol will be stored with the local study documentation. Any deviations from the approved protocol will be documented using a breach report form, and the Clinical Trial Registry will be updated as required.
Study setting
Participants will be recruited through the Child and Adolescent Neuropsychiatry Unit at the General Hospital “Riuniti of Foggia”, community health clinics, and family associations supporting individuals with neurodevelopmental disorders. Initially, interested participants will receive detailed study information and undergo preliminary screening to assess eligibility based on age, confirmed ASD diagnosis, and absence of a personal history of seizures. Following this initial screening, eligible participants will be invited for an in-person assessment to further verify inclusion criteria. Those meeting the criteria will subsequently receive neurostimulation treatments as outpatients at the Department of Clinical and Experimental Medicine, University of Foggia. A detailed timeline of data collection is shown in Table 1. We used the SPIRIT checklist when writing our protocol (see Supplementary File 2) [27].
Table 1 Timeline of data collection
Eligibility criteria, sample size, and data collection
Participants will be eligible for inclusion in the study if they are between 7 and 18 years old and have a confirmed diagnosis of ASD based on DSM-5 criteria. Exclusion criteria for this study include any history of seizures, epilepsy, or repeated febrile seizures, as well as any severe or traumatic brain injury. Participants with comorbid neurological or genetic conditions that impact brain function or structure, such as brain tumors, fragile X syndrome, or tuberous sclerosis, will also be excluded. Additionally, those with known endocrine, cardiovascular, pulmonary, liver, kidney, or other significant medical diseases, or with any unstable medical condition, will not be eligible to participate. Participants will also be excluded if they are on an unstable medication regimen or using medications contraindicated for TMS. Vision or auditory impairments that could interfere with study participation will preclude eligibility. Participants will also be excluded if they demonstrate significant epileptiform activity on electroencephalogram (EEG), such as seizures or continuous epileptiform discharges. Furthermore, individuals with psychosis disorder and diagnosed chronic or acute inflammation or infection, or those unable to provide informed consent, will not be eligible for the study. To detect significant differences in outcomes between the active and sham groups with 80% statistical power and a significance level (α) of 0.05, the sample size calculation indicated that 20 participants per group (n = 40 total) would be required. We will use REDCap (Research Electronic Data Capture) as our clinical data management system. Personal information will be stored separately from study data, secured on password-protected systems, and pseudo-anonymized with unique numeric codes accessible only to authorized personnel.
Blinding and randomization
Participants, care providers, and clinical raters will be blinded to treatment assignment. Only the clinician who generates the treatment allocation and delivers the pulses will remain unblinded, without participating in any other study activities. Data analysis will be conducted independently by two statisticians who are not otherwise involved in the trial procedures. A stratified randomization approach with permuted blocks will be used. Clinical severity will be classified based on scores from the Autism Diagnostic Observation Schedule-2 (ADOS-2) and the Childhood Autism Rating Scale Second Edition (CARS-2). Participants will be stratified into mild-to-moderate and severe groups before randomization to ensure balanced allocation between treatment arms. This approach is intended to minimize baseline differences in symptom severity across groups. Randomization will be performed using a computer-generated allocation sequence (a function available in SAS software), with permuted blocks employed to prevent predictability of group assignments and maintain balance within each stratum.
Neuropsychological assessment and primary outcomes
A comprehensive neuropsychological assessment will be conducted using a battery of tests to confirm the ASD diagnosis and evaluate clinical severity. These assessments will be performed at baseline, post-treatment, and at a 1-month follow-up, representing the primary outcomes of the study. The ADOS-2 and Autism Diagnostic Interview-Revised (ADI-R) will be administered to evaluate social interaction, communication, play, and the imaginative use of materials across different age groups [28, 29]. The Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) will be used to evaluate intellectual functioning in verbal children, whereas non-verbal children will be assessed with the Leiter International Performance Scale-Revised (Leiter-R) [30, 31]. To measure neuropsychological functions, particularly executive functions, the NEPSY Second Edition (NEPSY-II) will be used. The Movement Assessment Battery for Children Second Edition (MABC-2) will assess motor skills in everyday activities [32]. The CARS2 will be administered to evaluate autistic symptoms, and the Vineland Adaptive Behavior Scales Second Edition (Vineland-II) will assess a range of adaptive behaviors [33,34,35]. Additionally, parents will complete the Conners Third Edition (Conners 3) to report attention-deficit/hyperactivity disorder (ADHD) symptoms in their children, the Child Behavior Checklist for Ages 6–18 (CBCL/6–18) to identify behavioral and emotional problems, and the Social Communication Questionnaire (SCQ), a tool used to evaluate communication skills and social functioning [36,37,38]. The Children’s Depression Inventory 2 for parents (CDI-2) and the Multidimensional Anxiety Scale for Children (MASC) will also be used to assess depressive and anxiety symptoms [39, 40]. A detailed patient and medication history will be collected to assess any potential impact on the efficacy of rTMS.
Electroencephalogram recording
A standard EEG, following the international 10–20 system, will be recorded at each study time point: at baseline (T0), after rTMS treatment completion (T1), and at a 1-month post-treatment follow-up (T2). This procedure will identify pre-neurostimulation epileptic discharges that may exclude participants from the study and monitor any electrical changes induced by rTMS.
Intervention and adherence to protocol
The intervention will consist of 18 sessions of 2 Hz rTMS over 9 weeks, targeting the DLPFC. Stimulation intensity will be set at 90% of the motor threshold, delivering 180 pulses per session consisting of 9 trains of 20 pulses each, with a 20-s inter-train interval. The selection of 2 Hz frequency and 180 pulses per session was based on prior studies demonstrating that low-frequency stimulation over the DLPFC can reduce gamma activity and enhance executive function in individuals with ASD [4, 5, 19]. These parameters were selected to ensure both safety and potential clinical benefit in a pediatric population, consistent with previous trials that reported good tolerability and modulation of cortical excitability using low-frequency, low-dose protocols [4, 18]. The first six sessions will target the left DLPFC, the next six the right DLPFC, and the final six both hemispheres. rTMS will be administered using a Magstim R2 stimulator (Magstim, Whitland, UK) with a 70-mm figure-eight coil positioned at a 45° angle from the midline. Anatomical landmarks corresponding to EEG sites F3 and F4 (10–20 system) will be used to accurately target the DLPFC and to minimize discomfort in pediatric patients with ASD. Motor thresholds for each hemisphere will be established by incrementally raising machine output by 5% until a visible twitch in the first dorsal interosseous (FDI) muscle is observed in 2 out of 3 trials [41]. A sham group will undergo identical procedures without magnetic field application. The sham stimulation will replicate the auditory and tactile sensations of active rTMS by using the same coil orientation and clicking sounds. The coil will be positioned against the scalp at the same angle and location, and the stimulator will be activated to produce the characteristic clicking noise and slight vibration. This is to ensure that the sensory experience remains comparable between active and sham conditions, thereby supporting effective blinding. Throughout and immediately after each session, participants will be monitored for well-being, with any reported side effects documented and reviewed post-study. All sessions will be conducted under standardized conditions, with participants seated comfortably in an armchair in a quiet room, and their elbows positioned at a 90° flexion angle.
All rTMS sessions will be scheduled at consistent times and on the same days to establish a routine for participants and their parents or caregivers. Reminders via phone calls or text messages will be sent to parents or caregivers before each session. Missed sessions will be promptly rescheduled within the same week whenever possible. Study staff will educate families on the importance of session attendance and protocol compliance. Reasons for missed sessions will be documented, and efforts will be made to re-engage participants. The rTMS clinician will complete a checklist at each session to confirm that all protocol steps (e.g., stimulation parameters, coil positioning) are followed.
Biochemical measures and secondary outcomes
Biochemical measures will be assessed as secondary outcomes to provide a more comprehensive understanding of the effects of rTMS on ASD. Tryptophan metabolites, including 3-hydroxykynurenine (3-HKYN), KYNA, and QUIN, will be measured in urine using
high-performance liquid chromatography with electrochemical detection (HPLC-ECD) (Ultimate ECD, Dionex Scientific, Milan, Italy) [42]. HPLC-ECD will be also used to measure systemic levels of neurotransmitters, such as glutamate, GABA, serotonin, and dopamine, in urine samples [43]. To measure circulating BDNF, serum samples will be collected, and an enzyme-linked immunosorbent assay (ELISA) (DBA Italia, Segrate, Italy) will be performed [44]. Additionally, BDNF gene polymorphism (Val66Met) will be genotyped using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR–RFLP). This approach amplifies the BDNF gene region containing the Val66Met variant, followed by restriction enzyme digestion to distinguish the Val and Met alleles based on fragment length analysis [45]. Inflammatory mediators, including IL-6, IL-10, IL-1β, TNF-α, and CRP, will be measured in serum using ELISA [46].
Follow-up
A follow-up visit will be scheduled 1 month after the final rTMS session to evaluate the persistence of rTMS effects and the need for possible booster sessions. Accordingly, neuropsychological assessments and biochemical sampling will be performed again at the follow-up visit. To enhance the response rate, the study coordinator will request contact information from both parents.
Safety
Before the enrollment, participants will undergo comprehensive screening to confirm they meet eligibility and rTMS safety criteria. Additionally, a qualified physician will review medical history and perform a general physical examination to confirm the absence of risk factors. After enrollment, a standard clinical EEG, reviewed by a neurologist, will be conducted to exclude participants with epileptiform discharges. To ensure safety, rTMS will be administered by a trained neuropsychiatrist equipped to promptly manage any seizures or adverse events. A stimulation intensity of 90% of the motor threshold will be used for ASD participants to minimize seizure risk. Before each rTMS session, participants will be asked about their current health status and any adverse events experienced since the previous session. All adverse events will be documented and reported. In the case of a serious adverse event, treatment will be suspended.
Statistical methods
Statistical analyses will be performed using SPSS (IBM Corp., Armonk, NY). Primary analyses will focus on evaluating differences between the active and sham rTMS groups across three time points: baseline (T0), immediately post-treatment (T1), and 1-month follow-up (T2). Changes in neuropsychological and clinical measures across time points will be assessed using repeated-measures analysis of variance (ANOVA), with group (active vs. sham) as the between-subjects factor. If assumptions of normality are not met, the Wilcoxon signed-rank test will be applied to evaluate within-group differences over time, while the Mann–Whitney U test will be used to compare between-group differences at each time point. Biomarker levels will be compared using generalized linear models to account for potential covariates, including age and baseline severity. Chi-square tests will evaluate categorical variables, and t-tests will be applied for continuous variables where applicable. Spearman’s rank or Pearson correlation coefficients, depending on data distribution, will be employed to examine relationships between neuropsychological scores and biochemical measures. All statistical tests will be two-sided, with p-values below 0.05 considered statistically significant.
