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Improving breast cancer treatment; improving prostate cancer diagnosis; listen to your knee pain; plus other stories with Vanderbilt Health sources
WTVF News Channel 5’s “Morningline” program interviewed Denise Garcia, MD, Assistant Professor of Surgery, about new technology that helps surgeons identify cancer during surgery and improve breast cancer treatment. A Men’s Health story about PSA screening for prostate cancer quoted Kelvin Moses, MD, PhD, Professor of Urology. Men’s Health posted a story, “What Your Knee Pain is Trying to Tell You,” that quotes Charles Cox, MD, MPH, Associate Professor of Orthopaedic Surgery. William Schaffner, MD, Professor of Preventive Medicine, was quoted by several news outlets about public health issues, including: WSMV Channel 4 News (importance of flu shots); MedPage Today (mRNA flu shots); WTVF News Channel 5 (19 people sent to hospital after a sickness outbreak at Walmart facility in Lebanon); Prevention (West Nile virus); HuffPost (prevention pill for COVID); and Newsweek (measles cases continue to increase in the U.S.). Becker’s Hospital Review and Nashville Post covered the Vanderbilt Health News story from Rebecca Warren that Chief Communications Officer John Howser is retiring in March 2027, closing out a nearly 40-year career at Vanderbilt. A Healio story on research about OCT-A biomarkers and diabetic retinopathy quotes Vanderbilt University School of Medicine student Rachel Liu. WPLN Nashville Public Radio quoted Amanda Mixon, MD, MPH, Associate Professor of Medicine, in a story about adverse drug interactions.
Longtime Cincinnati and West Virginia men's basketball coach Bob Huggins dealing with 'progressive cognitive condition'
Huggins won nearly 400 games at Cincinnati and almost 350 games at West Virginia.
Medical Center Chief Communications Officer John Howser to retire
Howser, the Medical Center’s communications leader since 2012, will retire in March 2027 after nearly 40 years at Vanderbilt.
800 Guests, 40 Countries: Chongqing Forum to Unveil Top 10 Science and Tech Foresights
The 2026 World Science and Technology Development Forum will be held in Chongqing from October 21 to 23, bringing together about 800 guests from nearly 40 countries and regions, including leading experts, international science and technology organization heads, and high-tech executives, to discuss “Co-evolution: Shaping a New Ecosystem for Future Industries.”
Can AI solve our mental health access problem?
Last week I asked you what worries you most about AI in health. It was close, but your top answer was “AI giving bad health advice.” Last week’s poll results: You’re in good company. This concern was top of mind at a conference I joined at Stanford last week, where researchers, clinicians, and people who build AI systems spent a day debating trust and safety in health AI. Stepping back, I’m also hearing your emerging concerns about AI’s impact on our well-being generally. I see this as a matter of public health, and we’ll take it in pieces as we learn together. Today we’ll focus on AI chatbots used for therapy for mental health. Early this month, Governor Newsom vetoed Senate Bill 903, California’s most ambitious attempt to regulate AI use for mental health. It’s at the center of active debate, and raises the questions patients, family members, citizens, and voters will face as AI moves deeper into health care. Let’s work through it. What is “AI-based therapy”? It’s really two things: purpose-built mental health apps designed to deliver structured support, and general chatbots like ChatGPT, Claude, and Gemini that people increasingly use for emotional support—even if they weren’t built for it. Spoiler alert: I don’t know whether the shift toward AI therapy is good or bad. The evidence isn’t there yet. But I do know it’s already happening, and I have some ideas about how we can roll it out with safety in mind. The therapy dilemma, in a nutshell Mental health challenges are common, and strain health and well-being across populations. Therapy (interactive dialogue with a trained, empathetic practitioner) helps many people heal. The demand for licensed therapists far exceeds the supply in California, and AI-based therapy can narrow that gap. AI-based therapy remains novel, unproven, and not well tested. Right off the bat, we can see we’re dealing with trade-offs here. Since the main driver of demand for therapy from a robot is lack of access to therapy from a human, we’ll start there. It’s too hard to find and afford a human therapist California is short roughly 55,000 licensed, non-prescribing therapists and counselors, about 40% of what we need. Psychiatrists, who rely on talk therapy as a complement to prescribed medications, are even more scarce. Eight counties have none, and density ranges from 1.7 per 100,000 residents in San Benito County, to 68.1 in Marin County. My wife is a psychiatrist in Marin, and even here access is tight. If it’s hard in the best-supplied county, imagine rural Sierra County, or the San Joaquin Valley. In 2024, more than half of Californians who tried to make a mental health appointment struggled to find a provider who took their insurance, compared with 14% for physical health care. When Senate staff posed as “secret shopper” patients and called 120 mental health providers in Medicare Advantage networks, they landed an appointment less than once for every five tries. Insurers pay behavioral health clinicians about 22% less than medical and surgical clinicians for comparable office visits. On top of that, billing denials and prior authorizations hit hardest at the solo and small practices common in mental health. Psychiatrists opt out of Medicare at the highest rate of any specialty. In many places, a cash practice for therapy fills quickly with patients paying $250 or more an hour, with no insurance paperwork at all. Families who can pay cash find providers more easily. Those who rely on insurance, including Medi-Cal enrollees, older adults, rural residents, and non-English speakers, compete for what’s left. So we can’t pretend the human system works, and we can’t blame people for turning to AI for support when they’re in distress. AI is filling the gap It’s estimated that roughly a quarter of AI users use it for mental health support. If you have internet, it’s available 24/7, it’s cheap, and it speaks your language. Uninsured adults are about twice as likely as insured adults to do it (30% vs. 14%). It feels anonymous in ways that may enable people to ask things they’re unsure or embarrassed about. The largely hidden, personal use makes it hard to study whether it’s actually helping people with their mental health issues, but researchers are trying. Does AI therapy work? A 2026 analysis of nearly 40 randomized trials found chatbots showed a real but small reduction in depression symptoms. But most of these trials were compared to an alternative of no therapy, not a human therapist. So the benefit of AI therapy is probably real, but modest, and mostly untested against the alternative of human contact. We need more studies. Serious concerns OpenAI’s own estimate is that more than a million ChatGPT users each week show signs of suicidal planning or intent. These are high stakes encounters, and AI doesn’t always get it right. That’s partly because a chatbot can sound like a therapist, but it has no license, no duty of care, and it’s not clear who to hold accountable when it gets things wrong. AI is also designed to help users in whatever task they’re seeking to accomplish. People may feel like they’re getting therapy, but they’re mainly getting a convincing conversation. It’s easy for an AI companion to wander into gray areas, like playing along with “creative writing” that may be about the user’s own suicidal intent. Courts are driving safety conversations A wave of lawsuits have been filed on behalf of families claiming that chatbots pushed people they loved toward self-harm, including teens who died by suicide. The first settlements came this year. OpenAI is headquartered in San Francisco, and dozens of cases alleging that ChatGPT drove users to suicide or self-harm are now before a San Francisco judge. Character.ai has filed for bankruptcy after several states brought lawsuits accusing the chatbot of pushing dangerous content to kids. But the technology seems to be improving. Last month, an independent evaluation found that newer AI models “almost never endorse suicide.” That’s progress, but our societal appetite for even one preventable death is very low. So how do we move forward? Finding a middle ground Earlier this month the governor vetoed Senate Bill 903, a bill designed to place guardrails on the use of AI for therapy. The bill would have prohibited any AI-based platform from being advertised as psychotherapy, and would have required a licensed professional to review and approve each encounter where AI was used to support therapeutic decisions. Newsom called it overly broad, since even routine screening questions would have needed clinician sign-off. Knowing we’re already short on mental health providers, requiring human review of AI encounters may not relieve our access problems. Still, the answer isn’t no oversight. Here’s one feasible short term solution. Rather than reviewing each encounter, a licensed clinician can design the guardrails: what counts as a crisis, what triggers an immediate handoff to a human, and what gets sampled for audit each month. The AI runs inside that structure. Conversations get checked, failures get reported, and a real clinician owns the framework. Medicine already has models to learn from. The FDA process for rolling out newly approved medications is an example. After a product reaches patients, we keep watching for adverse events. Patient-facing AI needs the same “digital pharmacovigilance”: systematic tracking of harms, near misses, and the types of groups that get hurt and why. It’s also critical that users know that they can reach a human if they’re in crisis. Most chatbots now include messages like these: Bottom line The rush to use unproven AI tools for mental health support is mostly a workaround, a sign of a health system people can’t get into. We need better access to proven care from licensed clinicians. That takes reimbursement that makes accepting insurance viable, and a bigger workforce. But, built and tested well, AI could be part of the answer. It could be the 2 a.m. check-in when no one else is awake, or a way for patients to practice skills their therapist taught them. It could be the first step to get someone the right level of care, and take paperwork off clinicians’ plates so they spend more time with patients. None of this is simple. The SB 903 veto doesn’t end the debate, and the legislature will be back. In the meantime, those of us using these tools need to stay informed, ask hard questions, and hold the companies building them accountable. I’ll try to do my part, and we’ll keep learning together. Love,Matt P.S. If you or someone you know is struggling with mental health challenges, emotional distress, substance use problems, or just needs to talk, call or text 988- you’ll reach a real person— or chat at 988lifeline.org 24/7. Dr. Matt Willis is the author of Your Local Epidemiologist in California. A California native, he’s served as a primary care physician, CDC epidemiologist, and public health officer for Marin County, where he guided the pandemic response. He lives in Marin with his family and their dogs, Teddy and Ramona. Thank you Cynthia He, MD, PhD, and Parnika Saxena, MD, for their guidance in preparing this article. Cynthia works in an outpatient mental health clinic, treating patients who have Medi-Cal or, sometimes, no insurance. Parnika works in an inpatient psychiatric unit, treating patients with public or private insurance or self-pay ability. All opinions are their own and do not represent their employers.
Many GOP states have imposed voting rules mirroring Trump's midterm proposals
Nearly 40 laws are taking effect for the first time in this year's midterms, mostly in Republican-controlled states. Many of them mirror changes President Donald Trump tried but failed to implement at the national level.
Nashville health officials approved nearly 400 tattoo festival permits in 4 hours
Nashville health officials issued nearly 400 permits to tattoo artists, body piercers, and technicians in just four hours for the 2026 Villain Arts Tattoo Festival.
Family behind 'The Bold and the Beautiful' is trying out microdramas
The Bell family, behind "The Bold and the Beautiful" for nearly 40 years, is making microdramas on the soap's own set during its dark weeks.
Debt service and the Pentagon. Private equity and the politics of the US housing market. The return of black lung disease & the Franco-Prussian War in color.
Thank you for opening your Chartbook email. RALPH BALSON. 1890—1964. Oil and enamel, signed. Source: Gavekal This going to hurt - the two 7s in the US: diesel and mortgage rates Source: Gavekal In the US housing market, costs are soaring and the role of corporate, private equity-backed buyers is high on the mid-term election agenda. HEY READERS, THANK YOU for opening the Chartbook email. I hope it brightens your day. I enjoy putting out the newsletter, but tbh, what keeps this flow going is the generosity of those readers who clicked the subscription button. If you are persuaded to click, please consider the annual subscription of $60. It is both better value for you and a much better deal for me, as it involves only one credit card charge. Why feed the payments companies if we don’t have to. Subscribe It is striking how, since 2020, big banks have dropped out of the political spotlight in the US. For contributing subscribers only. Subscribe Rates of the lung disease pneumoconiosis among working US coal miners have risen to levels not seen in nearly 40 years Source: Bloomberg Chinese Clean Technology Exports For contributing subscribers only. Subscribe Ralph Balson (1939) Portrait of Grace Crowley Cole, G. O. & Haseman, S. M., (2023) “‘The Substance of Paint’: Class and Materiality in the Work of Ralph Balson”, Open Library of Humanities 9(2). Ralph Balson (1890–1964) was an English plumber and house painter who emigrated to Australia in 1913 and subsequently became a key member of Sydney’s artistic avant-garde. He is credited with having the first solo exhibition of purely abstract painting in Australia in 1941. Despite his role in developing Australian non-objective painting, Balson remained principally a house painter, working on his art practice at weekends. In 1955 he retired on a state pension and became a full-time artist. Balson’s artistic education and methods were critically shaped by his working-class background. He did not travel abroad until 1960 and was an avid auto-didact. His materials, palette, techniques and compositional strategies were likewise informed by his trade. Balson’s profession as a painter-decorator made him conspicuous within the predominantly middle-class Sydney art scene, though his painting partner Grace Crowley considered it an advantage in their pursuit of constructive painting. This paper explores the impact of Balson’s trade on his trajectory towards pure abstraction. While his art was at odds with the predominantly figurative mode of class-conscious art in Australian Modernism, we argue that it is embedded in the experience of class through its creative adaptation of labour into aesthetics. Source: OLH Svetlana Alexievich, The Art of Oral History No. 1 Paris Review Issue 257, Fall 2026 Interviewed by Elena Kostyuchenko INTERVIEWER How were you able to go to Chernobyl? Did you need special papers? ALEXIEVICH It was a time of chaos. They let me right into the zone. … More than anything, there was confusion. Adamovich [Ales Adamovich, the Soviet Belarusian writer], I remember, persuaded Gorbachev to send in the scientists, who showed up without even bringing their shaving kits. They were told that there had been an explosion at a nuclear power plant, but for some reason they thought that they’d be there for only a day or two. The first time I went was several months later, and people kept telling me about things they didn’t understand—how the fishermen couldn’t find worms, because they’d burrowed deep into the earth, how the milk wouldn’t curdle at the cheese factories. The honeybees wouldn’t come out of their hives. The evacuations started, I think, in the first month. The old women hid, they wouldn’t leave. I mentioned radiation to one of them and she said, “I’ve seen that radiation, all right! It’s yellow with green in it. I saw puddles of it in my garden, and I told the other women, and we ran and looked, and she had it in her garden, and the other one, too!” God, it was wild, the way the mind made sense of it. There was a story going around about Gorbachev telling the scientists to show him the radiation. “We can’t, it’s invisible.” “But I want to see it!” I also ran into the soldiers who’d been flown in on helicopters from Afghanistan. I asked them, “What are you doing here with your machine guns?” They said, “We’re collecting the radiation, that’s what.” So you had some of them running around with their guns, others out in the village washing off firewood or burying soil in the soil. These were the kinds of things that exploded our worldview. They made you realize that culture was just a chest filled with old manuscripts. There were no books in there that could help me. Our philosophers turned out to be useless when faced with the unprecedented. Derrida, Baudrillard—philosophy fell silent. What was happening? How would we live with it? That’s when I decided it simply needed to be witnessed. Which is what I did. INTERVIEWER I wanted to ask about how you talk to people. … ALEXIEVICH Yes, we sit and we talk—about what interests me and about life in general. About love, about everything in the world. That way, what comes out is three-dimensional. If you cut straight to the part you need, which is what journalists do, it won’t be interesting, and it won’t be the truth, either. Not the whole truth. INTERVIEWER Do people always open up when you ask questions, or can questions get in the way? ALEXIEVICH You have to ask questions, of course. Your job is to scour away the banality and return people to their true selves, to make them face what they rarely tap into. With every new person, you have to find a new way to do it. When you ask an interesting question or you share what happened to you, you help people really think about what they’re saying and not just repeat whatever they’ve picked up from the newspaper. But not everybody is capable of it, not everyone wants to put themselves through that. Either the chemistry starts to kick in or it doesn’t. A person might be wonderful, but you can tell that the conversation just isn’t going to happen. You can try to push it, but it will be a product of your own intellect, rather than of that mysterious connection. Life doesn’t come from the mind. Some people I can call two years after our last conversation, and they’ll say, “Oh, Svetochka! I think of you all the time,” and we’ll start talking again. With others, that won’t happen. That doesn’t mean they’re not extraordinary people, just that you can’t connect with them. They might have some insight, but you don’t have the right antenna to pick up their signal. Source: The Paris Review Colorized Franco-Prussian war … the ruins of Strasbourg with a French photographer and his mobile dark room. Ralph Balson (1961) Matter Painting If you’ve scrolled this far, you know you want to click: Subscribe
Nearly 40% of global population exposed to dangerous ozone pollution in 2026: Report
Ground-level ozone harms human health, ecosystems and crop yields.
Nearly 40% of disease burden in the Americas could be averted, PAHO report finds
Health in the Americas 2026 shows that millions of years of healthy life are being lost to preventable conditions and calls for stronger primary health care and smarter health investments
SBA Loan Defaults Surged at 2 Nonbank Lenders. $1.3 Billion Entered Liquidation
The Small Business Administration stopped non-bank lender exams just one week before lifting a nearly 40-year moratorium on admitting more of them into the program.
Calling all current and future scientists: Kiel is the place to be this week
This week, Kiel has become a meeting place for science in Europe. Researchers, school pupils, young scientists and members of the public are coming together through a series of major events led or co-organised by Kiel University.At the centre of it all are around 150 of Europe’s most talented young researchers, aged 14 to 20, who have travelled to Kiel from nearly 40 countries for the 37th European Union Contest for Young Scientists (EUCYS). Running from 22 to 27 September, the European Union’s flagship competition for young scientists brings together winners of national science competitions to present around 100 original research projects across fields ranging from engineering and computer science to medicine, environmental research and the social sciences. The winners will be announced at the Award Ceremony on Saturday.For Kiel University, hosting EUCYS is both an honour and a natural extension of a much longer story. Germany’s northernmost comprehensive university has invested for many years in supporting young scientific talent and bringing research into dialogue with society. The Kiel Science Factory gives school pupils opportunities to experience research first-hand, while programmes such as Rent-a-Scientist send researchers directly into local classrooms. Major annual public events including Kiel Week and the European Researchers’ Night take science beyond the campus through talks, exhibitions and hands-on activities.That long-standing commitment has increasingly taken on a European dimension – and this week, many of those efforts are coming together.One of the foundations for this success is the European Researchers’ Night (ERN), which celebrates its tenth edition in the Kiel region this year. The initiative is funded through the Marie Skłodowska-Curie Actions, with Kiel University developing the successful EU proposals and securing the funding, while regional partner KielRegion coordinates the many activities on the ground. Together with research institutions, schools, companies, local authorities and civil society, they have built ERN into a major platform for public engagement.Over the years, Kiel’s ERN programme has grown far beyond a single evening into a whole “Science Summer”, beginning with “Science Shopping” in spring and culminating tomorrow, 25 September, in Science Day.“We have developed a wide range of public engagement formats, often together with the other research institutions in the region, the city and regional authorities, schools, companies and civil society,” says Eckhard Quandt, Kiel University’s vice president for research, academic infrastructure and transfer. “Over the past decade, we have increasingly taken this commitment to the European level.”That combination of European funding expertise and strong regional partnerships also helped Kiel University take the next step. Drawing on its experience with ERN and its European networks, including the SEA-EU University Alliance, the university brought together Brest in France and Split in Croatia for a successful bid to the EU’s new Science Comes to Town initiative. Throughout 2026, the three cities are serving as Europe’s first Science Ambassadors, with more than one thousand activities bringing science into schools, public spaces, cultural venues and everyday life.EUCYS is perhaps the clearest example of how Kiel University is using Science Comes to Town to create new connections between major European initiatives. From the outset, the university deliberately planned the contest for the week of European Researchers’ Night and opened the EUCYS exhibition to the wider Science Day audience. Tomorrow, that means thousands of visitors can encounter the next generation of scientific talent first-hand, while the young researchers themselves gain a much bigger public stage.“Because we opened EUCYS up for European Researchers’ Night, there will be a lot of people actually visiting the exhibition,” says organiser Stefanie Altemark of Kiel University.“We wanted Europe’s most talented young scientists not only to compete with one another, but also to become visible to the wider public. At the same time, people in Kiel will have the opportunity to see what the next generation of scientists are already capable of,” says Quandt.“We’ve shown over the last years that science is a big part of Kiel, and it’s always been the goal to not only show that to people in Germany, but also to show it to people all over Europe. Thanks to Kiel University’s expertise in European funding programmes, we have been able to turn that ambition into reality,” says Sünje Fock, who is coordinating the Science Summer at KielRegion.The model is characteristic of Kiel University’s approach: combining European funding expertise and international networks with strong regional partnerships to give major initiatives greater reach and visibility.This year also marks the 30th anniversary of the Marie Skłodowska-Curie Actions, giving Kiel University the special opportunity to welcome Vanessa Debiais-Sainton, Head of Department for the Marie Skłodowska-Curie Actions at the European Research Executive Agency, to Kiel tomorrow. Her visit brings together two priorities that have shaped Kiel University’s work over the past decade: supporting researchers and bringing science closer to society. Debiais-Sainton emphasises how closely the two are connected: "For thirty years, the Marie Skłodowska-Curie Actions (MSCA) have given more than 150,000 researchers the chance to pursue their dreams and open up new fields. Doctoral Networks and Postdoctoral Fellowships give them the freedom to move, to connect, to train and to follow their curiosity across borders, sectors and disciplines. But excellence cannot live only in laboratories. Researchers’ Night takes science out of the lab and into the city, to the families, the schoolchildren and the curious minds who will become the next generation. Kiel shows what that looks like at its best. That is the MSCA promise: open science, open borders, open doors."For Kiel University, these activities are not separate endeavours. They are part of a broader understanding of academic excellence in which outstanding research, talent development, international cooperation, knowledge transfer and engagement with society strengthen one another.“For me, one of the most important lessons from the past decade is that scientific excellence, knowledge transfer, talent development and engagement with society cannot be treated as separate tasks,” stresses vice president Quandt. “They reinforce one another.”That philosophy is also reflected in Kiel University’s current bid for Germany’s Excellence University status. The designation is part of Germany’s national Excellence Strategy, which provides substantial long-term funding to selected universities to strengthen internationally competitive research and their overall institutional development. A successful outcome would provide new opportunities to build on what has already been created: deepening international cooperation, creating more opportunities for knowledge exchange and public engagement, and extending the university’s reach across the region and beyond. “If we are successful, it would allow us to take what we have built in Kiel considerably further – including expanding our networks and transfer activities beyond the region and increasingly across the Baltic area,” says Quandt.This week’s events offer a glimpse of what that could mean in practice: a university using its research strength, European expertise and regional partnerships to create opportunities for scientists at every stage of their careers while making science more visible, accessible and exciting to the wider public.
Scott Gardner: We were outstanding
Leeds United Under-21s boss Scott Gardner spoke of his pride in his ‘special group’ after a 4-3 EFL Trophy victory over Sky Bet League One Barnsley.Cheered on by nearly 400 travelling fans, the Ac...
MTA boss Lieber says agency’s targeting ‘kooky’ work rules, health insurance contributions in labor talks with transit union
In the MTA's contract negotiations with the union representing nearly 40,000 New York City Transit workers — Transport Workers Union (TWU) Local 100 — the
Women of Sutter Health: Shaping the Future of Medicine
The face of medicine is changing. Women now make up nearly 40% of practicing physicians in the United States, up from 26% in 2004 and comprise a majority of U.S. medical school students. At Sutter Health, women are helping shape the future of healthcare through research, specialized care and medical education — making a lasting […]
Latest impressive defensive performance helps undefeated Cedar Ridge stuff Rouse
After allowing nearly 40 points per game last year, Cedar Ridge's defense has dominated so far this season. The Raiders are 4-0 for the first time since 2017.
17 cats found dead, 20 rescued from extreme heat at Walker business; woman faces 66 charges
A Walker woman faces dozens of animal cruelty charges after authorities say they discovered nearly 40 cats and kittens suffering in extreme heat without food or water inside a local business.
17 cats found dead, 20 rescued from extreme heat at Walker business; woman faces 66 charges
A Walker woman faces dozens of animal cruelty charges after authorities say they discovered nearly 40 cats and kittens suffering in extreme heat without food or water inside a local business.
17 cats found dead, 20 rescued from extreme heat at Walker business; woman faces 54 charges
A Walker woman faces dozens of animal cruelty charges after authorities say they discovered nearly 40 cats and kittens suffering in extreme heat without food or water inside a local business.
Police: 17 cats found dead in extreme heat at Walker business; woman arrested
A Walker woman faces dozens of animal cruelty charges after authorities say they discovered nearly 40 cats and kittens suffering in extreme heat without food or water inside a local business.
Non-gaming entertainment brings huge tax revenue to Nevada
The state of Nevada is reporting a nearly 400% increase in tax revenue that can be traced to a surge of live events and shows across the Las Vegas Valley.
🚨 Nearly 40, Jamie Vardy is back in England 🏴
Out of contract, Jamie Vardy has officially signed for Burnley until the end of the season.A signing full of experience and character for the Clarets, who have secured one of the most illustrious stri...
Iowa State’s new president talks about university’s role in state
During his first months as president of Iowa State University, David Cook has traveled to nearly 40 Iowa communities, listening as residents, community leaders, business owners and others talked about their hopes for the future and challenges they face. One concern has surfaced again and again: finding and keeping workers. “Workforce and talent are a…
gamescom 2026’s Steam wishlist winners
gamescom wrapped up last weekend, and it was bloody fantastic. It really felt like the industry had a spring in its step again. The show itself was BUZZING, with 368K attendees (+3% over last year), maxed-out exhibit space, and Opening Night Live pulling over 78M online views (+7.5%). Let’s have a look at the games at the event that brought in the most new Steam wishlists between August 23 and 30. One quick thing before we start, and stop me if you’ve heard this one before, but wishlists are NOT a barometer for launch sales (they’re bookmarks, not baskets is what we always say over here at Alinea). With that aside, wishlists are a nice gauge of hype, so let’s dive in. Witche(r)s and Warlocks take the top two spots The biggest game of the event (by new wishlists, anyways) wasn’t a game at all. It was an expansion. The Witcher 3: Wild Hunt’s upcoming expansion, Songs of the Past, nabbed 451K Steam wishlists by the end of the weekend. It’s a big example of something we bang on about constantly: proven IP with built-in fandom is the most powerful force in this market. But said IP can also ripple into other external success stories (more on that later!). Anyway, Songs of the Past debuted at Opening Night Live, and it’s the first Witcher 3 expansion in over a decade, landing next year after a full Witcher 3 remaster (free for existing owners!) arrives next month. The Witcher 3 has sold around 66M copies, and I’ll be one of those owners jumping back in to refresh myself on the core game (like there isn’t enough to play!), then play the expansion next year. This is all part of CDPR’s plan. The studio is clearly whetting everyone’s appetite for The Witcher 4 in 2028 via a classic bridge strategy. Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe Releasing a free 4K remaster next month – followed by a proper expansion in 2027 – keeps IP top-of-mind across a huge gap between content (games-wise, anyway). It kind of echoes Capcom’s evergreen catalogue strategy. And outsourcing co-development to Fool’s Theory (a studio led by trusted Witcher 3 veterans) keeps CDPR’s internal headcount focused on The Witcher 4. #2 by wishlists between Aug 23 and 30 went to another giant IP: Warlock: Dungeons & Dragons, published by Wizards of the Coast and developed by Invoke Studios (a team of ex-Far Cry, Watch Dogs, and Splinter Cell devs). It’s due to launch in 2027, and it looks brilliant so far. It’s a dark-fantasy open world with third-person spell-slinging. It’s a very Witcher-ish aesthetic. As you might expect, 48% of Warlock’s Steam wishlisters have played Baldur’s Gate 3, and 46% have played The Witcher 3. One to watch. For sure! Mash-ups: Anime GTA (!?) and a city-builder for kids (and adults) Ananta took #3 with 302K new wishlists. It’s an open-world game that looks like GTA and Persona had a baby. It was published by NetEase, developed by Naked Rain, and got a trailer at Opening Night Live. I got hands-on at the show, and it wears its influences openly; there’s literal web-slinging (very Spider-Man) and a LOAD of mini-games (Like a Dragon). It’s free-to-play and out in January. For Ananta, Naked Rain is taking the free-to-play, cosmetics-only route. That’s certainly a choice for a single-player open-world game. Without gacha mechanics driving high ARPU, Ananta is betting purely on top-of-funnel reach and long-term retention. This puts pressure on skin appeal when there’s no multiplayer lobby to flex in (although, co-op is reportedly coming later). Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe Then there’s Lego Skylines (273K wishlists between Aug 23 and 30), which does exactly what it says on the tin. It’s a cosy Lego twist on the city-builder genre, as shallow or as deep as you fancy (five min quick sesh or ten-hour no-lifer session; latter for me). There’s some family-friendly stuff in there like couch co-op, which is only really viable on console. Iceflake Studios, which Paradox acquired back in 2020 is developing this one. So Paradox is probably looking for a family-friendly onramp to its rad Cities: Skylines games. The overlap there is plain, with 33% of Lego Skylines wishlisters having played Cities: Skylines and 16% Skylines II. There’s no doubt plenty of parents here (and uncles, ahem) planning to indoctrinate the next gen of city-builders. I’ll definitely be playing with my youngest nephew. This one could be big and educational. I’m very curious to see more. Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe Mature IP, new and old, rounds out the list As for the rest of the list of gamescom games by new wishlists between Aug 23 and 30: Heroes of Might & Magic III Remake got 189K new wishlists. It remakes the iconic 1999 turn-based-strategy classic in full 3D and 4K. It follows this year’s Heroes of Might & Magic: Olden Era (~1.8M copies sold, as per our estimates), and around a quarter of the III Remake wishlisters have played Olden Era, including 7% of them this month. Wardogs – a $40 PvP shooter – added another 146K to an already massive pile (nearly 1.6M total). It’s published by Team17 and made by Bulkhead. It plays somewhere between the tactical squad stuff of … Squad and the all-out-chaos battlefield of … Battlefield. It’s up to 100 players, and it’s out in about 10 days. It’s already pre-sold over 500K copies on Steam ($16.6M), boosted by a pre-order-only beta. It sold another 70K copies during gamescom, too. Afterworld managed 121K new wishlists. It’s a Paradox-made post-apocalyptic grand-strategy game, and it was announced at the show. It’s a departure from Paradox’s usual historical stuff, and the studio’s first new setting in over a decade. The Paradox purists are into it, with over half its wishlisters having played Hearts of Iron IV (19% this month) and 41% Crusader Kings III (17% this month). Metro 2039 got 110K during the show, tunnelling its total past 1.3M. Nearly 40% of wishlisters have played 2020’s Metro Exodus, the previous mainline title in the series. The Metro novels are Russian, dev 4A Games is Ukrainian, and it’s set in Moscow, so it’s unsurprising that – after the US (17.3% of wishlisters) – the next two countries are Russia (12.7%) and Ukraine (10.0%). The Blood of the Dawnwalker drew in (the blood of) 108K new wishlisters, now totalling an impressive 1.7M (at a $70 price point, though). It’s an open-world dark-fantasy action-RPG set in 14th-century Europe (with vampires!), made by some former Witcher devs at Rebel Wolves. Again, it shows. Over half of Blood of the Dawnwalker’s wishlisters have played The Witcher 3, and its #2 market is Poland, home of Rebel Wolves. That’s that hometown-hero effect we keep banging on about again! And Blood of the Dawnwalker plays very well, by the way. While it looks like a Witcher clone on the surface, it actually brings a lot to the table mechanics-wise. I love the whole time-as-a-currency spin on RPG gameplay. It gives the game a different, refreshing pace. Essentially, you start Blood of the Dawnwalker with a pool of 480 action points spread across 30 days and 30 nights. As for how the game performs, we’ll be posting some numbers next week, so hit subscribe below to get that in your inbox when it’s ready. Subscribe The Witcher’s legacy ripples Make no mistake: on a high level, this was The Witcher‘s gamescom. The #1 game by wishlisters was a Witcher 3 DLC. Warlock is clearly Witcher-inspired – as is Blood of the Dawnwalker, which was made by ex-Witcher devs. There was a lot of other cool stuff on the floor that we’ll no doubt be covering in subsequent newsletters, though! As always, wishlists went through the roof for sequels, remakes, DLC, and licensed IP. As always, though, these wishlists will likely convert to about 5% to 10% of launch-day buyers, with the probable exception of The Witcher DLC – the exception that proves the rule. Either way, we’ve got a nice, diverse list here – one that is very Witcher-y, Paradox-y, and – if you’re a fan of great games on Steam – a bloody good list. We even got a bunch of new IP to get excited for. Great gamescom! Even if we are still processing that unfathomable number of mini Kölsch beers! One more thing: GTA 6 broke the internet (again) Move aside, Spider-Man and The Odyssey (I love you both, really). But the decade’s defining entertainment zeitgeist is round the corner. Unless you’ve been living under a rock, you’ll know that Rockstar dropped an extended look at GTA 6 last week. It was INSANE, the most impressed I’ve ever been by a showcase like this. You can see the budget seeping through every second of the extended look, and this level of game is unobtainable for any other publisher. Everyone’s going nuts, and rightly so. GTA 6 is out in holiday 2026, and it’ll be the biggest entertainment release ever, full stop. For those without a PS5 or Xbox Series console, a $500-$900 console is a big ask in this economy, but GTA will pull a lot of last-generation-console fence sitters over the current-gen fence either way: The autumn timing puts GTA 6 on (digital) shelves for the holidays, meaning a PS5 or Xbox (let’s be honest, mostly the former) will be on many a Christmas and Hanukkah list. Demand will outweigh the struggling supply, though, and PS5 Pros are already sold out and being sold at a markup via scalpers. Every console that isn’t on a shelf is a sale deferred or lost, and worse, it hands scalpers the margin. GTA has cultural clout that reaches everyone. It’s been a mainstream fixture since 2001’s GTA III and its clout has only grown exponentially since then. There’s a touchpoint for every generation alive. The FOMO-word-of-mouth double punch does the rest. Loading... It’ll reactivate the lockdown cohort, the millions who picked up gaming in 2020-21 and churned. GTA 6 will bring them back. Remember when College Football 25 brought a bunch of US gamers to current-gen consoles? GTA will do that globally. Once they’re back (or upgraded), and all GTA’d out, the fresh current-gen-console folks will check out the rest of the current-gen catalogue they missed. GTA Online, if not free to play, will also lead to a boost for PS+ and Xbox Game Pass, another boost for the ecosystem players. Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe Even some of the smug PCMR 60FPS crew won’t be able to resist their FOMO and will bite the bullet on a console to play this one early (then double dip). The consoles cost the same as a decent stick of RAM these days anyway lmao… Don’t get me wrong, though. GTA 6 is no silver bullet for the mature console market, but it does prime the current gen for a couple of strong swan-song years. And it’ll also give the consoles more users from which to maximise ARPU. ‘’We are in the latter half of the lifetime cycle of [the PS5],’’ said Sony President and CEO Hiroki Totoki in a Wall Street Journal interview. ‘’That means we do not need to aggressively sell the console today; rather than that, we are focusing on the current revenue from the current user base.’’ The biggest, best premium games always arrive late in a console cycle, so getting more players aboard now, ahead of that content storm (the new current-gen-only Call of Duty included), is a clear win for the platforms. On the Netflix thing, though: let’s all chill out a bit, like. Half my LinkedIn feed was going bonkers treating the reveal debuting on Netflix like it’s the future of entertainment. It wasn’t. It was a six-hour head start, and Netflix left that detail out of the “first-of-its-kind partnership” press release. The extended look hit Netflix at 3pm ET on 27 August, then went up on YouTube and Rockstar’s site for everyone six hours later. And it was all over social immediately, anyways. This reveal was going to reach an untold number of people whether it debuted on Netflix, YouTube, a Times Square screen, or a group chat. The last trailer did nearly half a billion views in a day with no gatekeeper at all. Netflix just stood next to that audience for six hours, borrowing it. It’s was a tidy deal for Netflix, sure. But every outlet on earth was breaking the thing down frame by frame by the evening anyway. Anyway. I’m hype. And we’ll be covering some GTA numbers on the newsletter soon. So hit subscribe below to get that in your inbox when it’s ready! Subscribe The last word Reply to this email – or reach out here – if you have any feedback for the newsletter – or want to request a game for us to cover. [Alinea Analytics boasts the most accurate PC and console estimates in the business. Game makers use our platform to understand their audience, keep an eye on the competition, monitor sales trends, and spot new opportunities. We equip game studios and financial institutions with accurate data and the confidence to make smarter, data-driven decisions. Want to talk about all things games market data? We’d love to chat!]
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Mental health solutions for the digital age
Ask the digital natives of Gen Z about the source of their biggest mental health challenges, and most will say social media and AI.Several of the nearly 400 guests at the third annual Gen Z Wellness Summit, presented by the Friends of Semel Teen Advisory Council at UCLA on March 8, explicitly named the endless stream of content on their phones as serious stressors. “Everybody is addicted to (Tik Tok) as if they were addicted to substances,” said Jantin Asmar, 17, a senior at Virtual Academy in Antelope Valley. “We’re always chasing that dopamine. We’re expecting that dopamine rush and it’s really decaying our interactions with others.” High school student Jantin Asmar was among nearly 400 people who attended the third annual Gen Z Wellness Summit. (Photo by Sandy Cohen) Even young teens feel pressure to be on social media constantly, both to consume content and collect “likes,” said 13-year-olds Chloe and Sophia, both students at Brentwood School. “Everyone’s always on, and you miss stuff if you’re not on it,” Chloe said, adding that social media’s emphasis on appearances is leading to eating disorders: “That’s a big thing for our generation.”The incessant influx of images and updates creates expectations that “weigh teenagers down,” said Linda Kou, 16, a junior at San Gabriel High School.Even though digital spaces allow people to connect with others beyond their immediate surroundings, it doesn’t always translate to real-life community, said Kelah Morgan, 17, a senior at Animo South Los Angeles Charter High School. High school students Kelah Morgan, left, and Linda Kou, shared about the challenges presented by social media. (Photo by Sandy Cohen) “Even if you see people saying that they relate to you online, it might be hard to find people in your personal life who you see every day who you feel comfortable enough to say, ‘You see me online, but this is me in real life and what I’m actually going through,’” she said.Solutions for our digital timesThe Gen Z Wellness Summit was intentionally designed as a free, in-person gathering where young people interested in mental health from across the southland could meet in person. “Peer support is the most important element of maintaining our mental health in community,” said Helena Hansen, MD, PhD, director of UCLA’s Semel Institute for Neuroscience and Human Behavior.Keynote speakers at the summit addressed AI, social connection and self-empowerment, while breakout sessions included discussions about eating disorders, dating, substance use, phone detox and breathwork. Here are some of the day’s top takeaways:Beware of FOPO: Scott Barry Kaufman, PhD, a psychology professor at Columbia University, said that rather than FOMO, or fear of missing out, we ought to be more aware of FOPO: fear of people’s opinions. “Just think about how much your FOPO might be holding you back in your life,” Dr. Kaufman said. “And just that inner contemplation should be enough for you to change your life, because there’s so many things we don’t go after because we have debilitating FOPO.”We don’t need to feel like we’re the best – or what he called “narcissistic self-esteem” – but it’s helpful to acknowledge our own worth, recognize our good qualities and develop self-belief in the skills and talents we’ve cultivated. When we have that – dignity and self-respect, without needing everyone to like us – FOPO is less of a concern.Self-reflection is most effective in community: “When we try to self-reflect alone, we sometimes ruminate,” said Ira Bedzow, PhD, executive director of the Emory University Purpose Project. “But when we self-reflect with people that we trust … (it) allows us to hold ourselves accountable to different ways of seeing and different ways of hearing and different ways of being.”Opening up about our experiences and listening to others are skills we can develop, Dr. Bedzow said.He invited students to participate in what he called a “fishbowl exercise,” where four students sat in a small circle, surrounded by a dozen or so students forming a larger circle. Those in the inner circle answered such questions as: “What stops you from being you today?” and “What helps you feel most like you?”Within minutes, the group in the small circle (the fishbowl), were sharing intimately about their life challenges as those in the outer circle nodded in understanding.After the exercise, one participant said, “I felt like I wasn’t alone, that it wasn’t just me who feels that way.”Another remarked on how “personal” it felt to share face-to-face with others, even strangers.Don’t let AI crush your creativity: Theoretical neuroscientist Vivienne Ming, PhD, has been studying artificial intelligence for more than 20 years. And while she said “it’s reasonable to be concerned” about the fast-growing technology, it can also help humans become better problem-solvers when used strategically.“The smartest thing on the planet today are humans and machines working together creatively,” Dr. Ming said. “What gets more valuable in humans as machines get smarter? Our ability to explore the unknown.“Your unique voice is literally your value to the world … but most of us for most of our lives have been taught to not be unique,” she continued. “Be your own person. Celebrate being different. It is genuinely, measurably, truly valuable.”In a breakout session called “Phone Detox? IYKYK: Living Your Story IRL” led by Don Grant, PhD, students shared their frustrations with AI compromising academic work, art and creativity.“Art is a translation of human experience,” one participant said. “When people use AI, they diminish their own human experience.”Dr. Grant urged them, as “the last generation to remember a world before AI,” to remember the power of imagination and creativity – and to act on it.Remember that social media distorts perceptions: Stuart B. Murray, PhD, PsyD, who directs the Eating Disorders Program and Translational Research in Eating Disorders Program at UCLA, asked the students in his breakout session to take a spontaneous selfie and edit it to conform with society’s beauty standards. All 20 girls in the room immediately got to work, thickening their hair, slimming their faces, plumping their lips.“The pressure to look like what we present on social media can be crippling,” Dr. Murray said. “We now know that social media use is part of a causal pathway into an eating disorder.”Adolescents and young adults are most at risk of developing an eating disorder, he said, with one in three students on college campuses exhibiting clinically meaningful eating-disorder symptoms. More than 4 million people in California will have an eating disorder in their lifetime.Even for those who don’t develop anorexia or bulimia, the ubiquity of modified images online distorts what we consider normal, making us feel worse about ourselves. Remembering that, he and other speakers said, might inspire us to log off occasionally and spend time in the real world with people who love us as we are.
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