Tag: nevin manimala

Psychiatr Danub. 2025 Sep;37(Suppl 1):213-223.

ABSTRACT

BACKGROUND: Early recognition of autoaggressive tendencies in young people is essential for diagnostic screening and reducing suicidality risks. This can be achieved through psycholinguistic approaches such as corpus analysis and eye-tracking studies. Corpus research helps to develop generalized speech patterns of those at risk of suicide, while oculographic methods examine perceptual cues linked to suicidal tendencies.

METHODS: We formulated an algorithmic framework for constructing verbal, visual, and multimodal material to identify autoaggressive tendencies among youth. The stimuli material was created following the idiolect paradigm of forensic authorship attribution. The first stage involved analyzing corpus data including materials from social networks and social media, the Rusentiment database, and a text collection from the Privolzhsky Research Medical University. Python’s NLTK and SpaCy libraries for automated text processing were used to extract corpus statistics, n-grams, keywords, and collocations for identifying linguistic markers of autoaggression. Keywords were statistically ranked using Log-likelihood, T-score, and mutual information, while collocations were derived via T-score analysis. Sentiment analysis for the Dostoevsky Python library and stylistic indices (lexical diversity, readability) were also applied. The total analyzed material comprised more than 100 million tokens. We next integrated, stimulus and filler materials into an eye-tracking application (developed by LLC Lad IT Group) using standard laptop video cameras. Oculographic data quantified gaze delay differences via a percentage excess formula to pinpoint the most diagnostically relevant stimuli. In two iterations of the pilot experiment, 66 youths from the control group and 29 from the target group participated in the oculographic experiments.

RESULTS: In multimodal texts, most stimuli derived from corpus statistics were relevant, and all individuals in the target group showed a prolonged gaze delay; visual stimuli (pseudo-self-portraits, anime/game characters) elicited 26-36% longer gaze delay in the target group. Verbal stimuli analysis revealed prolonged gaze fixations on self-referential pronouns (12-25%) and metaphorical death expressions, although direct terms, like “suicide” showed the gaze avoidance (-11.9 to -129% deviation). We then developed a system of weighted coefficients for an automated diagnostic model. The algorithm showed 72 % accuracy in identifying autoaggression, presenting a promising tool for early diagnostic screening of this phenomenon.

CONCLUSIONS: The present methodology focuses on creating and employing a novel selective dataset consisting of visual, linguistic, and multimodal text stimuli integrated into the oculographic examination protocol. The oculographic detection of eye movement perceptual cues in response to exposure to the stimuli dataset may identify objective markers for evidence-based diagnostics of mental disorders (e.g., depression) and fundamental psychopathological phenomena (e.g., suicidality), including at-risk states (e.g., autoaggression). Furthermore, this approach may contribute to the enhancement of suicide prevention programs, particularly targeted interventions for the vulnerable population of young people who experience autoaggressive tendencies (i.e., self-aggression).

PMID:40982917

Psychiatr Danub. 2025 Sep;37(Suppl 1):207-212.

ABSTRACT

The explosion of the use of artificial intelligence (AI) in medical practice has shaken the foundations of clinical assessment and management. In our study, we conducted structured interviews with 43 patients (23 female, 15 male) affected by MMD (DSM-5-TR criteria). We sent the recorded and transcribed semi-structured interviews to the analysis of appropriately trained AI programs. We evaluated the predictive weight of symptoms described by patients beyond those present among the DSM-5-TR diagnostic criteria. We also analyzed the relationship with forgiveness, hopelessness, and diminished drive. The results revealed a positive predictive factor in patients with higher levels of somatization and physical oppression, ambivalent and blocked anhedonia, distress and agitated restlessness, mixed states, and subthreshold symptomatic oscillations.

PMID:40982916

Psychiatr Danub. 2025 Sep;37(Suppl 1):201-206.

ABSTRACT

This study examined individual and relational predictors of cyberbully-victim involvement among young adults, focusing on social connectedness (offline, mixed offline-online, and exclusively online), parasocial relationships (PSRs) with social media influencers (SMIs), and social media addiction. Using a generalized logistic regression model, results revealed that being female and younger significantly increased the likelihood of dual-role involvement. Offline social connectedness emerged as a significant protective factor, while offline-online and exclusively online ties were not associated with cyberbully-victim status. Notably, stronger PSRs with influencers were linked to a decreased likelihood of dual-role involvement, suggesting a possible compensatory or protective role for vulnerable individuals. Social media addiction was confirmed as a strong risk factor, more than doubling the odds of cyberbully-victim involvement. These findings underscore the complex interplay between psychosocial vulnerabilities and digital relational dynamics, highlighting the need for prevention strategies that foster offline relationships, promote digital resilience, and address problematic social media use among young adults.

PMID:40982915

J Holist Nurs. 2025 Sep 22:8980101251377481. doi: 10.1177/08980101251377481. Online ahead of print.

ABSTRACT

Purpose: Using the holistic nursing perspective as a guide, this study aimed to explore nursing students’ self-care practices in Indonesian nursing educational institutions. Design: A cross-sectional study. Methods: Nursing students enrolled in undergraduate programs across 13 institutions in Indonesia were recruited using proportionate stratified random sampling. A total of 1,071 students participated in an online survey. Data were analyzed using univariate, bivariate, and multivariate statistics. Findings: Overall, students took care of themselves. Self-care scores were highest in the emotional and spiritual dimensions, while physical self-care was lowest. Students’ self-care practices differed significantly based on their age, self-care education, self-care perception and health status. Educational background, self-care education, self-care perception and health status were all significant predictors of students’ self-care practices. Conclusion: Indonesian nursing students demonstrated satisfactory scores in the total Integrated Health and Wellness Assessment, but strategies to support students’ positive self-care practices beyond their nursing education should be established, alongside a focus on self-care dimensions that scored low. Centrally regulating nurse self-care education could ensure uniformity in curriculum integration and maximize long-term benefits for nursing students, the profession and the healthcare system in general.

PMID:40982315 | DOI:10.1177/08980101251377481

BJS Open. 2025 Sep 8;9(5):zraf091. doi: 10.1093/bjsopen/zraf091.

ABSTRACT

BACKGROUND: The aim of this meta-analysis was to elucidate the effects of prehabilitation (PR) on outcomes after surgery for upper gastrointestinal tract cancer.

METHODS: PubMed, Web of Science, Embase, and Cochrane databases were searched from inception up to 21 May 2024 for randomized clinical trials (RCTs) and cohort studies investigating PR interventions in patients with upper gastrointestinal tract cancer. Data were synthesized using standardized mean differences (SMDs) and risk ratios (RRs) with corresponding 95% confidence intervals. Sensitivity and subgroup analyses were used to examine the robustness of the results and find possible sources of heterogeneity. Statistical analyses were performed using Review Manager 5.4 and Stata 16.0.

RESULTS: Eight RCTs and eight cohort studies were included in the meta-analysis. Compared with the control group (no PR), the PR group had a significantly shorter postoperative length of hospital stay (SMD -0.27; 95% confidence interval (c.i.) -0.47 to -0.07; P = 0.008), a significant reduction in the occurrence of pneumonia after the surgery (RR 0.71; 95% c.i. 0.50 to 1.00; P = 0.005), and a greater improvement in the 6-minute walk distance (SMD 0.95; 95% c.i. 0.68 to 1.22; P < 0.00001). However, there were no significant differences between the control and PR groups in overall postoperative complications, anastomotic leakage, overall pulmonary complications, operative time, intraoperative blood loss, wound infection rate, in-hospital mortality, or recurrence rate (all P > 0.05).

CONCLUSION: For the population with upper gastrointestinal tract cancer, PR can partially lower the risk of postoperative pneumonia and promote faster postoperative recovery. Given the inherent limitations in the included studies, more large-scale RCTs are needed to verify these findings.

PMID:40982301 | DOI:10.1093/bjsopen/zraf091

Thyroid. 2025 Sep 22. doi: 10.1177/10507256251382559. Online ahead of print.

ABSTRACT

Background: Graves’ disease is the leading cause of hyperthyroidism in children and adolescents, with recent studies indicating a rising incidence. Epidemiological data on trends and determinants influencing this rise remain limited. This study aims to assess the trends in incidence of pediatric Graves’ disease in the United States and stratify incidence patterns based on patient sex, age, geographic region, urban vs. rural setting, and insurance plan type. Methods: This retrospective cohort study utilized the Merative™ Marketscan® outpatient insurance claims database from 2007 to 2022. Pediatric patients diagnosed with Graves’ disease were identified using International Classification of Diseases (ICD)-9 and ICD-10 codes. Annual incidence rates were analyzed over the study period to detect temporal trends. Incidence rates were further stratified by demographic variables including sex, age, geographic region, community setting (urban vs. rural), and insurance plan. Statistical methods included chi-square, ANOVA, and linear regression models to identify significant trends and differences across subgroups. Results: 3377 total new diagnoses of pediatric Graves’ disease were identified during the 16-year study period. The average annual incidence rate was 3.33 per 100,000 (SD = 0.33), with an annual increase of 0.042 per 100,000 (p = 0.39). Marked differences in average annual incidence rates were observed across sex and age group; female patients exhibited greater average annual incidence rate (5.04 per 100,000) compared with male patients (1.67 per 100,000). Adolescents, patients 13-17 years of age, had the highest average annual incidence rate (5.72 per 100,000) compared with other age groups. On multivariable regression analysis, female patients had a significant increase in annual incidence by 1.69 cases per 100,000 compared with male patients [CI: 0.82-2.56]. Adolescents also saw a significant increase in adjusted annual incidence by 4.92 cases per 100,000 compared with the other age groups [CI: 3.80-6.04]. No significant change in annual incidence rate was observed across insurance plan, geographic region, or rural status. Conclusions: This study quantifies and delineates trends in pediatric Graves’ disease incidence in the United States. The greatest average incidence rate was observed among female and adolescent patients. This study underscores the importance of monitoring Graves’ disease trends to facilitate early disease detection and management. Further research is needed to elucidate the genetic and environmental factors underlying these epidemiological trends.

PMID:40982291 | DOI:10.1177/10507256251382559

JAMA Netw Open. 2025 Sep 2;8(9):e2532650. doi: 10.1001/jamanetworkopen.2025.32650.

ABSTRACT

IMPORTANCE: Major depressive disorder (MDD) is among the most prevalent mental health disorders, causing substantial disability and economic burden. Although several first-line treatments exist with mild adverse effects, up to 50% to 60% of patients do not tolerate or respond to them. Ammoxetine, a novel selective serotonin and norepinephrine reuptake inhibitor, has been found to reduce adverse effects and hepatotoxicity and more potent inhibition of serotonin and norepinephrine transporters, making it more tolerable and effective.

OBJECTIVE: To evaluate the efficacy and safety of ammoxetine in treating adults with MDD.

DESIGN, SETTING, AND PARTICIPANTS: This phase 2 randomized clinical trial was a multicenter, double-masked, placebo-controlled, parallel-group, fixed-dose study of ammoxetine treatment in patients with MDD in China. Patients aged 18 to 65 years from 15 study centers were randomized into daily ammoxetine or placebo groups between March 27, 2023, and June 13, 2024, and followed up for 10 weeks.

INTERVENTIONS: Participants were randomized 1:1:1 to 3 treatment groups: ammoxetine 40 mg/d, ammoxetine 60 mg/d, and placebo.

MAIN OUTCOME AND MEASURES: The primary outcome was change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to 8 weeks. Efficacy analyses were performed on both the full-analysis and per-protocol sets using least-squares (LS) mean differences. The safety set analysis was performed using descriptive statistics.

RESULTS: Among 239 enrolled patients (mean [SD] age, 30.4 [10.0] years, 158 female [66.1%]), 80 were randomized to the ammoxetine 60 mg/d group, 80 to the ammoxetine 40 mg/d group, and 79 to the placebo group. In the full-analysis set, both ammoxetine doses led to statistically significant improvements in MADRS total scores at week 8 compared with placebo. The LS mean changes (SE) from baseline were -16.7 (1.3) for ammoxetine 40 mg/d, -16.6 (1.3) for ammoxetine 60 mg/d, and -13.5 (1.3) for placebo. The differences vs placebo were -3.3 (97.3 CI, -6.3 to -0.3) for ammoxetine 40 mg/d and -3.1 (97.3% CI, -6.2 to 0.0) for ammoxetine 60 mg/d. Consistent results were observed in the per-protocol set analysis at week 8 for ammoxetine 40 mg/d (LS mean change, -3.2; 97.3% CI, -6.2 to -0.2) and ammoxetine 60 mg/d (LS mean change, -3.18; 97.3% CI, -6.2 to -0.2), both superior to placebo. Treatment-emergent adverse events were reported in 68 participants (85.0%) receiving ammoxetine 60 mg/d, 63 (78.8%) receiving ammoxetine 40 mg/d, and 48 (60.8%) receiving placebo; most were mild to moderate in severity.

CONCLUSIONS AND RELEVANCE: This randomized clinical trial demonstrated superiority over placebo of ammoxetine treatment at both 40 mg/d and 60 mg/d in patients with MDD. In addition, all doses of ammoxetine were generally well tolerated.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05762458.

PMID:40982284 | DOI:10.1001/jamanetworkopen.2025.32650

JAMA. 2025 Sep 22. doi: 10.1001/jama.2025.15185. Online ahead of print.

ABSTRACT

IMPORTANCE: Levodopa enhances dopaminergic signaling and may stimulate neuroplasticity, which could potentially enhance motor recovery after stroke. Levodopa is used in stroke rehabilitation despite mixed evidence for its effectiveness.

OBJECTIVE: To determine whether levodopa compared with placebo, administered in addition to standardized rehabilitation based on active task-oriented training, is associated with enhanced motor recovery in patients with acute stroke.

DESIGN, SETTING, AND PARTICIPANTS: A double-blind, placebo-controlled randomized clinical trial at 13 stroke units and centers and 11 collaborating rehabilitation centers in Switzerland. Between June 14, 2019 (first patient, first visit), and August 27, 2024 (last patient, last visit), 610 patients with acute ischemic or hemorrhagic stroke with clinically meaningful hemiparesis (ie, a total score of ≥3 points on the following National Institutes of Health Stroke Scale items: motor arm, motor leg, or limb ataxia) were randomized 1:1 to receive levodopa or placebo. Statistical analyses were conducted from November 2024 to August 2025.

INTERVENTION: Patients received levodopa/carbidopa (100 mg/25 mg; n = 307) or placebo (n = 303) 3 times daily for 39 days, alongside standardized rehabilitation therapy based on active task-oriented training.

MAIN OUTCOMES AND MEASURES: The primary outcome was the adjusted mean between-group difference in the Fugl-Meyer Assessment (FMA) total score (range, 0-100 points; fewer points indicate worse motor function; 6-point difference considered patient-relevant) at 3 months.

RESULTS: Among the 610 participants (median [IQR] age, 73 [64-82] years; 252 [41.3%] female; median baseline FMA total score, 34 [14-54]), 28 participants died by 3 months, leaving 582 (95.4%) participants eligible for the primary analysis. At 3 months, the median (IQR) FMA total score was 68 (42-85) points in the levodopa group and 64 (44-83) points in the placebo group. The mean difference in the FMA total score between the levodopa and placebo groups was -0.90 points (95% CI, -3.78 to 1.98; P = .54). There were 126 serious adverse events in the levodopa group and 129 in the placebo group; the most common was infection (levodopa, n = 55; placebo, n = 44).

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, among patients receiving inpatient rehabilitation for acute stroke, levodopa added to standardized rehabilitation did not significantly improve motor function at 3 months compared with placebo plus standardized rehabilitation. These results do not support the use of levodopa as an adjunct to rehabilitation therapy for enhancing motor recovery after acute stroke.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03735901.

PMID:40982270 | DOI:10.1001/jama.2025.15185

Phys Chem Chem Phys. 2025 Sep 22. doi: 10.1039/d5cp01690h. Online ahead of print.

ABSTRACT

The formation of complex organic molecules (COMs) in the interstellar medium (ISM) is central to astrochemistry and prebiotic chemistry, as these species may act as precursors to biomolecules essential for life. Among COMs, glyceraldehyde (HOCH₂CH(OH)C(O)H, GCA) has attracted attention as a potential building block in early biochemical pathways. Although GCA has not yet been detected in the ISM, the presence of structurally related compounds in various astronomical environments suggests that it may form under interstellar conditions. In this study, we employed the automated reaction discovery tool AutoMeKin to systematically explore the gas-phase chemical reaction networks (CRNs) of C₃H₆O₃ (GCA), C₃H₇O₃ (a hydrogenated analog), and C₂H₅O₂. Reaction pathways were characterized at the ωB97XD/Def2-TZVPP level of theory, and rate coefficients for key processes were computed using the competitive canonical unified statistical (CCUS) model, which accounts for multiple dynamic bottlenecks. Our analysis revealed several barrierless pathways leading to GCA or to GCA and a leaving group. Notably, the reaction between glyoxal (HCOHCO) and the HOCHCH₂OH radical, though neither has yet been detected in the ISM, was found to efficiently produce GCA and a formyl radical, with rate coefficients on the order of 5.4-7.9 × 10^-10 cm³ molecule^-1 s^-1 across the 10-100 K temperature range. However, aside from the aforementioned exception, most GCA formation channels result in highly vibrationally excited intermediates that are more likely to undergo rapid unimolecular decomposition than to be stabilized by radiative emission under typical ISM conditions. These results suggest that while gas-phase GCA formation is chemically feasible, it is likely transient and difficult to detect directly. In contrast, alternative products such as formaldehyde, glycolaldehyde, and (Z)-ethene-1,2-diol dominate many pathways and align better with current astronomical observations. This work provides detailed mechanistic and kinetic insights that enhance astrochemical modeling and advance our understanding of molecular complexity in star-forming environments. Furthermore, it highlights the utility of automated CRN exploration for uncovering viable synthetic routes to prebiotic molecules in space.

PMID:40982266 | DOI:10.1039/d5cp01690h

J Glaucoma. 2025 Sep 22. doi: 10.1097/IJG.0000000000002637. Online ahead of print.

ABSTRACT

PRECIS: This study identifies visual acuity and intraocular pressure at 3- and 5-year follow-ups, along with other variables such as media opacity and nystagmus, as key predictors of long-term outcomes in childhood glaucoma, aiding better management and prognostication.

PURPOSE: This study aims to identify key predictive variables of visual acuity (VA) and intraocular pressure (IOP) outcomes in childhood glaucoma. By understanding these factors, the study seeks to improve prognostication and management strategies for pediatric patients.

METHODS: A retrospective analysis was conducted on pediatric glaucoma patients across multiple centers within the Childhood Glaucoma Research Network (CGRN). The study included patients with at least 5 years of follow-up. Variables such as sex, race, ethnicity, age of onset, laterality, and clinical measures including VA and IOP at various stages (initial visit, 3-year, 5-year, and final visits) were evaluated. Additional factors considered were anisometropia, media opacities, nystagmus, anterior segment dysgenesis (ASD), strabismus, and angle closure.

RESULTS: The study included 396 eyes from 243 patients, with a mean age at presentation of 1.5 months. Several variables showed statistically and clinically significant correlations with final outcomes including IOP and VA at both 3-year and 5-year visits, as well as the presence of media opacities, unilateral glaucoma, nystagmus, and ASD. Based on multivariable prediction model analysis the two statistically significant predictors for visual acuity (n=31) were VA at 5-year visit and presence of angle closure. As for IOP outcomes (n=31), significant predictors included were IOP at 5-year visit and presence of nystagmus.

CONCLUSIONS: This multicenter study highlights that VA and IOP measurements at 3 and 5 years post-diagnosis, along with the presence of specific ocular conditions such as media opacity and nystagmus, are crucial in predicting long-term outcomes in childhood glaucoma.

PMID:40982256 | DOI:10.1097/IJG.0000000000002637