Tag: nevin manimala

J Gastrointestin Liver Dis. 2025 Sep 26;34(3):309-316. doi: 10.15403/jgld-6433.

ABSTRACT

BACKGROUND AND AIMS: Small bowel neuroendocrine neoplasms (SB-NENs) are a rare type of tumor that is clinically challenging and is often diagnosed in advanced stages. This retrospective study aimed to characterize the clinical presentation, diagnostic workup, and therapeutic strategies, as well as to evaluate the prognosis of patients managed in a tertiary care center in Bucharest, Romania, over five years.

METHODS: We conducted an observational, retrospective cohort study on 42 cases of SB-NEN evaluated at our center between January 1, 2020, and March 31, 2025. Data regarding clinicopathological characteristics, treatments, and disease evolution were summarized. Overall survival was estimated at 1, 3, and 5 years.

RESULTS: Computed tomography was the most frequently used imaging method for diagnosis (52.4%). Surgery was the most adopted method for obtaining the pathological specimen, used in 70.7% of cases. The majority of tumors were well-differentiated (85.6%). The overall survival distribution showed a median survival time of 94 months. The cumulative proportion of patients surviving at 1 year was 97.6%, at 3 years was 89.3% and at 5 years was 75.7%. There was a significant difference in overall survival stratified by tumor grading (p=0.006), indicating that this was a significant prognostic factor; the metastatic status and large tumors showed a trend toward statistical significance, but they did not meet the conventional threshold (p=0.068 and 0.103, respectively).

CONCLUSIONS: SB-NEN showed favorable outcomes, with surgery improving survival even in some metastatic cases. Lower tumor grade was associated with a better prognosis, while somatostatin analogues (SSA) therapy showed no survival benefit. Patients with large tumors and metastatic disease also showed a trend towards reduced survival.

PMID:41004806 | DOI:10.15403/jgld-6433

J Glob Health. 2025 Sep 26;15:04122. doi: 10.7189/jogh.15.04122.

ABSTRACT

BACKGROUND: Sleep problems are common among children and mothers. However, little is understood about sleep behaviours in low- and middle-income countries. Here we examine sleep behaviours and predictors among black, low-income, South African mothers and their eight-year-old children over time.

METHODS: We administered standardised measures of sleep behaviours at eight years post-birth to a population cohort of mothers and children in 24 neighbourhoods of Cape Town, South Africa, in 2009-10. We assessed mothers and children six times over eight years with 84% retention since pregnancy. While 71% remained in Cape Town, about 29% of households moved to the profoundly rural Eastern Cape of South Africa. Mothers completed the Pittsburgh Sleep Quality Index and rated their children on the Children’s Sleep Habits Questionnaire.

RESULTS: Among mothers, 29.5% reported sleep difficulties based on their global sleep score, with a mean sleep quality score of 3.72 (standard deviation (SD) = 2.6). Children’s sleep scores were 64.4 (SD = 4.0), with subscale scores on sleep difficulties higher than documented in high-income countries (HICS). There was a relatively low inverse relationship between the quality of maternal and child sleep (r = -0.201; 95% confidence interval (CI) = -0.264, -0.136), which resulted in an R² value of 0.041 in the simple linear regression model. Problematic maternal sleep was associated with living in the rural Eastern Cape (P = 0.034), experiencing intimate partner violence (P = 0.052), and a higher score on the Edinburgh Postnatal Depression Scale (P < 0.001), but not alcohol use. Children’s sleep difficulties decreased by 0.191 points (95% CI = -0.229, -0.152) with a one-unit increase in aggressive behaviour and, similarly, cognitive scores decreased by 0.035 points (95% CI = -0.063, -0.006). Household resources, such as formal vs. informal housing, income, and having water on the premises, were unrelated to sleep difficulties.

CONCLUSIONS: Counter to hypotheses, a small, inverse relationship existed between mothers’ and children’s sleep behaviours. Alcohol use, HIV status, and socioeconomic markers were unrelated to sleep, but intimate partner violence and depressive symptoms affect sleep negatively, similar to HICS.

PMID:41004805 | DOI:10.7189/jogh.15.04122

JMIR Ment Health. 2025 Sep 26;12:e58891. doi: 10.2196/58891.

ABSTRACT

BACKGROUND: There has been an increase in the use of online mental health forums to support mental health. These forums are often moderated by trained moderators to ensure a safe, therapeutic environment. While the moderator role is rewarding, it can also be challenging. There is a need to understand the impact of the role on moderators and how they can best be supported to maintain psychological well-being.

OBJECTIVE: This study aimed to understand how, why, and in what contexts moderator well-being is affected by the moderator role and produce actionable recommendations for how moderators can best be supported to maintain workplace psychological well-being.

METHODS: We conducted realist synthesis of (1) published and gray literature from 2019 to 2023, (2) stakeholder interviews with forum moderators and hosts, and (3) moderator training manuals developed by organizations that host online mental health forums. Self-determination theory was used as the theoretical basis for this synthesis.

RESULTS: We developed 24 context-mechanism-outcome configurations from our realist analysis of 9 published papers, 18 interviews, and 5 training manuals. The findings highlight the specific ways in which moderator well-being can be supported through meeting the psychological needs for autonomy, competence, and relatedness. Forums that allow moderators to work in alignment with their personal motivations can increase moderator well-being. Forum organizations should support moderator competence through initial expectation setting, especially around moderator responsibility for user well-being, and ongoing support, such as meaningful supervision and peer support. Co-designed training, reflective practice, and experiential learning are all key to increasing moderator competence and satisfaction in the workplace. Working within a diverse team with access to innovative forum design can increase moderator psychological well-being. Organizational support for moderators’ well-being through monitoring and encouraging self-care is vital to ensure moderators can effectively carry out their role. Making and supporting meaningful relationships in the forum can boost psychological well-being and the therapeutic value of the moderator role. Key challenges for moderators were dealing with conflicts between supporting open discussion and ensuring a safe community environment, sharing lived experiences in positive ways for both moderator and user, and supporting people within the limitations of an anonymous forum.

CONCLUSIONS: This realist synthesis is the first to examine the impacts on well-being of being a moderator of an online mental health forum. Recommendations to support moderator psychological well-being are proposed, targeted at specific stakeholder groups to aid implementation. Organizational-level endorsement and facilitation of support are particularly important for the realization of recommendations and interventions to support moderator well-being.

PMID:41004804 | DOI:10.2196/58891

JMIR Mhealth Uhealth. 2025 Sep 26;13:e79238. doi: 10.2196/79238.

ABSTRACT

BACKGROUND: The mental health app sector in India is expanding rapidly, driven by increasing smartphone usage, growing internet penetration, the popularity of digital initiatives, and heightened recognition of mental health challenges in public discourse. This growth is also influenced by both supply- and demand-side barriers to seeking professional help and the rise of mental health tech startups. While digital mental health solutions provide scalable ways to address unmet needs, concerns persist regarding app quality, privacy, and safety due to rapid market expansion, regulatory challenges, and limited empirical research. We conducted a comprehensive and systematic review of smartphone-based mental health apps accessible to Indian users through app stores.

OBJECTIVE: This study aims to describe apps in terms of characteristics such as the nature of their functions, involvement of mental health professionals in development, reference to an empirical basis, and inclusion of nudges to seek professional help, as well as to evaluate app quality.

METHODS: This systematic review of mental health apps was conducted using the TECH (Target user, Evaluation focus, Connectedness, and Health domain) approach, along with the PASSR (Protocol for App Store Systematic Reviews) checklist. Fifteen search terms covering mental health conditions and therapies were applied to both Google Play and Apple App Store. Identified apps were screened according to predefined inclusion and exclusion criteria and subsequently downloaded for detailed review. Data were extracted based on prespecified parameters. Additionally, app quality was evaluated using the Mobile Application Rating Scale (MARS).

RESULTS: The initial search identified 5827 apps, of which 350 were reviewed in detail after removing duplicates and applying eligibility criteria. Common search terms such as “depression” and “anxiety” yielded nearly a quarter of relevant apps (128/495, 25.9% to 133/497, 26.8%); 62 (17.7%) of the 350 reviewed apps originated from Asia, and 131 (37.4%) focused on a single mental health condition. Multifunction apps (eg, those combining assessment and intervention) constituted the largest category (230/350, 65.7%). Privacy concerns were notable; for example, 54 (15.4%) apps did not mention a data-sharing policy. Most apps were developed by commercial organizations, and 228 (65.1%) did not report involvement of mental health professionals, while 45 (12.9%) mentioned it only cursorily. Only 38 (10.9%) apps referenced empirical research, and more than half did not indicate an empirical basis for their content. Pointers to seek professional help were present in 139 (39.7%) apps, mostly in the form of disclaimers, whereas nudges or motivational prompts to seek help appeared in slightly less than a quarter. Only 105 (30%) apps attempted to dispel mental health myths. Functionality and aesthetics ratings on the MARS were relatively high, but 50 (14.3%) apps scored 3 or lower on the information subscale.

CONCLUSIONS: This study is among the first systematic evaluations of mental health apps accessible to Indian users on Google Play and Apple App Store. The findings provide insights to guide future research, app development, and policy making in the digital mental health space.

TRIAL REGISTRATION: International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY2024100035; https://inplasy.com/inplasy-2024-10-0035/.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/71071.

PMID:41004798 | DOI:10.2196/79238

Phys Rev Lett. 2025 Sep 12;135(11):113401. doi: 10.1103/6jsr-f8q1.

ABSTRACT

Modulational instability (MI) is a fundamental phenomenon in the study of nonlinear dynamics, spanning diverse areas such as shallow water waves, optics, and ultracold atomic gases. In particular, the nonlinear stage of MI has recently been a topic of intense exploration and has been shown to manifest, in many cases, in the generation of dispersive shock waves (DSWs). In this Letter, we experimentally probe the MI dynamics in an immiscible two-component ultracold atomic gas with exclusively repulsive interactions, catalyzed by a hard-wall-like boundary produced by a repulsive optical barrier. We analytically describe the expansion rate of the DSWs in this system, generalized to arbitrary intercomponent interaction strengths and species ratios. We observe excellent agreement among the analytical results, an effective 1D numerical model, full 3D numerical simulations, and experimental data. Additionally, we extend this scenario to the interaction between two counterpropagating DSWs, which leads to the production of Peregrine soliton structures. These results further demonstrate the versatility of atomic platforms toward the controlled realization of DSWs and rogue waves.

PMID:41004759 | DOI:10.1103/6jsr-f8q1

Phys Rev Lett. 2025 Sep 12;135(11):111803. doi: 10.1103/zfxr-dlzg.

ABSTRACT

We report a study of the semileptonic decay D^{0}→K[over ¯]^{0}π^{-}μ^{+}ν_{μ} based on a sample of 7.9 fb^{-1} of e^{+}e^{-} annihilation data collected at a center-of-mass energy of 3.773 GeV with the BESIII detector at the BEPCII collider. The branching fraction of the decay is measured for the first time to be B(D^{0}→K[over ¯]^{0}π^{-}μ^{+}ν_{μ})=(1.373±0.020_{stat}±0.023_{syst})%, where the first uncertainty is statistical and the second is systematic. Based on the investigation of the decay dynamics, we find that the decay is dominated by the K^{*}(892)^{-} resonance with the branching fraction measured to be B(D^{0}→K^{*}(892)^{-}μ^{+}ν_{μ})=(1.948±0.033_{stat}±0.036_{syst})%. We also determine the hadronic form factors for the D^{0}→K^{*}(892)^{-}μ^{+}ν_{μ} decay to be r_{V}=V(0)/A_{1}(0)=1.46±0.11_{stat}±0.04_{syst}, r_{2}=A_{2}(0)/A_{1}(0)=0.71±0.08_{stat}±0.03_{syst}, and A_{1}(0)=0.609±0.008_{stat}±0.008_{syst}, where V(0) is the vector form factor and A_{1,2}(0) are the axial-vector form factors evaluated at q^{2}=0. The A_{1}(0) is measured for the first time in D^{0}→K^{*}(892)^{-}μ^{+}ν_{μ} decay. Averaging the form factor parameters that we reported previously in D^{0}→K^{*}(892)^{-}(→K[over ¯]^{0}π^{-})e^{+}ν_{e} and D^{0}→K^{*}(892)^{-}(→K^{-}π^{0})μ^{+}ν_{μ} decays, we obtain r_{V}=1.456±0.040_{stat}±0.016_{syst}, r_{2}=0.715±0.031_{stat}±0.014_{stat}, and A_{1}(0)=0.614±0.005_{stat}±0.004_{syst}. This is the most precise determination of the form factor parameters to date measured in D→K^{*}(892) transitions, which provide the most stringent test on various theoretical models.

PMID:41004751 | DOI:10.1103/zfxr-dlzg

Phys Rev Lett. 2025 Sep 12;135(11):116903. doi: 10.1103/41k6-yp2l.

ABSTRACT

The classic lattice XY model is one of the universal models of statistical mechanics appearing in a broad variety of optical and condensed matter systems. One of its possible realizations is a system of tunnel-coupled spinor polariton condensates, where phases of individual condensates play a role of the two- dimensional spins. We show that the account of the polarization degree of freedom of cavity polaritons adds a new twist to the problem, modifying in particular the structure of the ground state. We formulate the corresponding classical spin Hamiltonian, which couples phase and polarization dynamics, and consider several particular geometries, demonstrating the principal differences between the scalar and spinor cases. Possible analog of spin Meissner effect for coupled condensates is discussed.

PMID:41004739 | DOI:10.1103/41k6-yp2l

Medwave. 2025 Sep 26;25(8):e3105. doi: 10.5867/medwave.2025.08.3105.

ABSTRACT

INTRODUCTION: Small-scale and artisanal mining are historical activities in Chile that are deeply rooted in the region and economically significant. However, their workers face high levels of exposure to occupational hazards in informal conditions, with no adapted tools for occupational health surveillance. The available instruments are designed for formal companies and do not consider the operational context of artisanal miners.

OBJECTIVE: To adapt and validate the content of a battery of questionnaires designed to identify working conditions affecting artisanal and small-scale mining workers in Chile.

METHODS: An instrumental study was conducted in four phases: document review of national and international protocols; participatory risk identification with union leaders; development of thematic questionnaires; content validation through the judgment of 25 experts in occupational health, mining, psychometrics, and statistics. One hundred and fifty-five items were evaluated according to criteria of clarity, relevance, sufficiency, and coherence, using Aiken’s V coefficient (threshold ≥ 0.80).

RESULTS: 87% of the items met the threshold in all four criteria. Aiken’s scores ranged from 0.77 to 0.98. The diesel exposure module obtained the highest scores, while the working conditions module showed less clarity (0.77), justifying the modification or elimination of 41% of its items. A new questionnaire on exposure to chemical agents was created by integrating modules. As a result of the adjustment process, the final battery consisted of six thematic questionnaires.

CONCLUSIONS: This is the first questionnaire set with favorable content validity to assess working conditions in Chilean artisanal mining, a sector with high labor informality. It represents an initial validation step. Further studies should evaluate reliability, construct validity, and field applicability.

PMID:41004721 | DOI:10.5867/medwave.2025.08.3105

Neurology. 2025 Oct 21;105(8):e214141. doi: 10.1212/WNL.0000000000214141. Epub 2025 Sep 26.

ABSTRACT

Multiple sclerosis (MS) is a clinically diverse and unpredictable CNS disorder. The considerable heterogeneity in disease course between people with MS is believed to reflect the varying magnitude and extent of the pathologic processes present at different stages of the disease. Genetic factors are known to contribute to the risk of developing MS and are emerging as predictors of clinical outcomes. They may also offer insights into the biological processes influencing disability. In this review, we evaluate the role of genetic factors in MS from disease susceptibility to disease severity. We consider how understanding of the genetic contribution to the risk of developing MS has evolved to recognize over 230 genetic variants that implicate peripheral immune cells at disease onset. Although MS-risk genes have shown little association with disease severity outcomes, we re-evaluate associations of the main MS-risk allele, HLA-DRB1*1501, with disease activity using observations from long-term longitudinal cohorts. We summarize progress identifying genetic variants associated with clinical phenotypes, including the discovery of the first genetic variant associated with age-related MS severity, rs10191329, and its pathologic associations. We assess the challenges faced by replication studies, including low statistical power, methodologic variations in disability outcomes, and the potential impact from differences in treatment and disease temporality. Reconciling these findings, in contrast to MS-risk genes, MS severity variants appear enriched in CNS tissues, suggesting at least in part distinct genetic architectures for MS risk and severity. Despite advances in our understanding of MS genetics, there remain significant gaps in our knowledge that reflect the elaborate genetic architecture underlying disease progression. Potential gains are to be made from exploring rare variants and ancestrally diverse populations, while the causality of variants may be interrogated through analyses of gene sets and recognized biological pathways. However, further work is required to improve phenotyping of disease severity beyond physical disability measures and to disentangle complex genetic interactions, which may vary with environmental factors and time. Resolving these challenges is crucial if genetic analyses are going to be able to power clinically useable predictive models and inform mechanistic targets for novel treatments in progressive MS.

PMID:41004698 | DOI:10.1212/WNL.0000000000214141

JMIR Form Res. 2025 Sep 26;9:e57523. doi: 10.2196/57523.

ABSTRACT

BACKGROUND: Instagram and other social media platforms provide a unique environment for people with chronic illnesses to share experiences, but posts with higher engagement may also shape behavior. The hashtag #ChronicIllness appears in over 5 million posts, reflecting the large digital community where users seek validation, connection, and support. Frameworks such as social cognitive theory, self-presentation theory, and illness identity theory suggest that highly engaging content can shift social norms and drive behavior change via observational learning. Despite the strong theoretical basis for this behavioral impact, little is known about what chronic illness-related content is the most engaging.

OBJECTIVE: The aim of this study is to identify the content of Instagram posts related to chronic illness and determine if health care content is associated with higher engagement.

METHODS: This study is a mixed methods content analysis of 279 publicly available Instagram posts tagged with #chronicillness, #chronicallyill, or #spoonie. Posts were selected via convenience sampling and included if they featured original, nonvideo content. Photos, hashtags, and captions were coded for themes including location, medical equipment, health care experience, and illness identity. Quantitative metrics, such as likes, comments, and overperforming scores (a normalized metric of engagement), were extracted using CrowdTangle. Multivariate analyses assessed if health care content (posts featuring health care experiences or photos in a medical setting or with medical equipment) was associated with a higher odds of overperforming.

RESULTS: Posts had a median of 25 (IQR 0-14,936) likes, 3 (IQR 0-525) comments, and 20 (IQR 1-31) hashtags. A total of 222 (80%) posts were created by women, and 110 (40%) were overperforming. Photo analysis (260 posts with 406 photos) showed 27 (10%) in health care settings, and 49 (19%) included medical equipment, with 10 (4%) featuring invasive devices (eg, intravenous lines and feeding tubes), which were strongly associated with higher engagement. Hashtag analysis revealed that 243 (87%) posts referenced a medical condition, most commonly chronic pain (n=101, 36%), fibromyalgia (n=56, 20%), and Ehlers-Danlos syndrome (n=38, 14%), while 57 (20%) included medical interventions. Captions reflected 4 main themes: medical experience, illness journey, connection, and nonillness experiences. In multivariate regression analysis, longer captions (odds ratio [OR] 2.44, 95% CI 1.05-5.67), health care content (OR 1.85, 95% CI 1.00-3.42), and invasive medical equipment (OR 6.19, 95% CI 1.16-32.99) were independently associated with overperforming.

CONCLUSIONS: Posts featuring health care content and invasive medical equipment were associated with significantly more engagement, suggesting that medicalized portrayals of illness may be amplified on Instagram. This visibility may offer support but also risks reinforcing illness-centered identities and overmedicalization through the influence of observational learning and identity formation. Medical professionals must be aware of these trends and promote balanced, evidence-based content. Future research should explore how social media shapes health behaviors, identity, and utilization to mitigate potential harms while preserving support.

PMID:41004680 | DOI:10.2196/57523