Kratom and 7-OH should be regulated, experts agree. They’re split on how

Kratom leaf products, often used to ease chronic pain, anxiety, or withdrawal from opioids, have been sold in the U.S. for decades, largely skirting any regulatory restrictions despite a known risk for physical dependence. But increasingly, Americans are turning to newer, more potent products made with a semi-synthetic kratom derivative, 7-hydroxymitragynine, or 7-OH. 

Clinicians and recovery advocates warn that highly-concentrated 7-OH could be even more addictive than kratom, though research is scarce. Most people agree that some sort of guardrails need to be put into place. They disagree, however, on what those regulations should be.

Read the rest…

Harnessing Data Warehousing for Precision in Off-Label Prescription Detection in Psychiatry (PSYHAMM): Retrospective Proof-of-Concept Evaluation Study

Background: Off-label drug prescribing is prevalent across medicine, including psychiatry, often due to unmet therapeutic needs and inadequate responses to standard treatments. The PSYHAMM (Psychotropes Hors Autorisation de Mise sur le Marché) project, funded by the French Research Agency, investigates these practices. To support this research, a clinical data warehouse (CDW) with advanced data analysis tools was developed and deployed. This system integrates both structured and unstructured data from electronic health records, facilitating comprehensive data analysis. The goal is to improve understanding, regulation, and safety of off-label drug use in psychiatry by providing insights into prescribing patterns and their impacts, ultimately contributing to better clinical guidelines and patient care. Objective: This study aimed to evaluate the precision (positive predictive value) of a CDW in identifying candidate off-label prescriptions in psychiatry among the cases automatically flagged by the system, rather than its overall accuracy, sensitivity, or specificity. Methods: The PSYHAMM data analysis involved a retrospective study of pathology-medication pairs to evaluate the precision of a computerized system among system-flagged cases. This system was compared with manual checks performed by a psychiatrist. The evaluation process included verifying if the condition identified by PSYHAMM was documented in the medical record, assessing diagnostic agreement with tolerance for schizoaffective disorders, and ensuring the identified treatment was current or prescribed in the past. Precision was measured as the number of relevant documents retrieved divided by the total number of documents proposed and was computed for the precise diagnosis, the broad diagnosis, and the identified treatment among the flagged cases. Results: The study analyzed 197 records, identifying 14 unique drug-pathology combinations. Bipolar disorder treated with sodium valproate represented the most cases (108/197, 54.8%), followed by schizophrenia treated with sodium valproate (37/197, 18.8%). The overall precision for detecting off-label situations was 51.3% (101/197). The precise diagnosis achieved a precision of 75.6% (149/197), while the broad diagnosis showed a higher precision of 84.8% (167/197). The identified treatment had a precision of 61.4% (121/197). The primary challenge was temporal discrepancies, such as distinguishing between acute and chronic conditions, which accounted for most of the 48.7% (96/197) of cases that were incorrectly classified. Conclusions: As a single-center, proof-of-concept evaluation, the PSYHAMM project demonstrates the potential of automated systems to support the identification of off-label prescriptions in psychiatry as a sensitive prescreening step requiring expert validation. The relatively high false-positive rate was driven mainly by temporal discrepancies (drugs prescribed before the index stay, discontinued during the stay, or only hypothetically mentioned) rather than by semantic errors. Future research should focus on integrating real-time data analytics and expanding to multiple institutions to improve the utility of off-label detection systems.
<img src="https://jmir-production.s3.us-east-2.amazonaws.com/thumbs/8d87a9ea2c1630ed8abd7abffad0ae5f" />

Multi-region social-emotional network underlying the effects of spine pinching therapy on empathy-like behavior in a rat model of autism spectrum disorder

BackgroundSpine pinching is a promising alternative for autism spectrum disorder (ASD), yet its effects on multi-region molecular coordination remain unclear. This study examined the effects of spine pinching on cellular Fos proto-oncoprotein (c-Fos) and Oxytocin Receptor (OXTR) expression in the prefrontal cortex, hypothalamus, and amygdala, and further analyzed expression patterns across these regions using profile analysis to explore the coordinated multi-region regulation underlying improvements in social and empathic deficits.MethodsAn ASD rat model was established by valproic acid (VPA) induction. After behavioral testing, rats were divided into the model group (MG), spine pinching group (SPG), and blank control group (BC). SPG received a 15-day intervention from postnatal day 22. Then, open field, three-chamber social, and fear empathy tests were performed; brain tissues were collected for immunohistochemistry and western blotting, and profile analysis was conducted.ResultsVPA-induced ASD rats showed developmental and ASD-like behavioral deficits. MG rats exhibited social and empathy deficits and reduced c-Fos and OXTR levels in the prefrontal cortex, hypothalamus, and amygdala versus BC. Spine pinching improved these ASD-like behavioral deficits. Immunohistochemistry revealed that c-Fos and OXTR expression increased significantly in all three brain regions after spine pinching. Western blot analysis further supported these findings, showing significant upregulation in most brain regions and consistent upward trends in the remaining regions. Profile analysis revealed parallel expression profiles across regions, suggesting coordinated multi-region regulation.ConclusionSpine pinching effectively improves core ASD-like behavioral deficits in ASD rats, potentially through coordinated regulation of the multi-regional social-emotional network.

Beyond illness severity: transdiagnostic cognitive vulnerabilities as independent predictors of psychological distress in parents of children with rare genetic disorders

IntroductionParents of children with rare genetic disorders are at increased risk of depression, anxiety, and stress symptoms. While previous research has primarily focused on illness-related factors, less is known about the contribution of transdiagnostic cognitive vulnerabilities to parental psychological distress.AimThis study examined whether intolerance of uncertainty, distress tolerance, and tendency to worry predict parental depression, anxiety, and stress symptoms beyond the severity of the child’s health status.MethodsThe study included 184 parents (92 mother–father dyads) of children with rare genetic disorders and 94 parents of healthy children (14 mother–father dyads and 66 unpaired parents). Measures assessed child health status severity, intolerance of uncertainty, distress tolerance, tendency to worry, and symptoms of depression, anxiety, and stress.ResultsParents of children with rare genetic disorders, particularly mothers, reported higher levels of depression, anxiety, and stress symptoms compared with parents of healthy children. Greater severity of the child’s health condition was associated with higher levels of psychological distress. Lower distress tolerance and greater tendency to worry independently predicted depression, anxiety, and stress symptoms beyond the severity of the child’s health status.ConclusionTransdiagnostic cognitive vulnerabilities, particularly lower distress tolerance and greater tendency to worry, together with female gender, were independently risk factors for parental psychological distress beyond the severity of the child’s health status severity. These findings suggest that preventive interventions and counseling programs for parents of children with rare genetic disorders should address not only illness-related burden but also modifiable cognitive vulnerabilities.

Smartphone addiction, physical activity engagement, and sleep quality in Chinese adolescents: a parallel and serial mediation model

IntroductionExcessive smartphone use has become a major public health concern among adolescents, particularly in China where smartphone use is widespread. Although smartphone addiction is consistently associated with poor sleep quality, the mechanisms underlying this association remain insufficiently understood. This study examined whether physical activity engagement and depressive symptoms operate as parallel and serial mediators linking smartphone addiction to sleep quality in Chinese adolescents.MethodsA cross-sectional survey was conducted among 612 adolescents (Mage = 14.2 years, SD = 1.6; 51.3% female) from four secondary schools in Hubei Province, China. Participants completed the Smartphone Addiction Scale–Short Version, the Physical Activity Questionnaire for Adolescents, the Pittsburgh Sleep Quality Index, and the Depression subscale of the Depression Anxiety Stress Scales-21. Path analysis of observed composite scores with robust maximum likelihood estimation and bias-corrected bootstrapping (5,000 resamples) was used to test the proposed parallel and serial mediation model.ResultsSmartphone addiction was positively associated with poor sleep quality (β = .38, p <.001). Both physical activity (indirect effect = .04, 95% CI [.01,.07]) and depressive symptoms (indirect effect = .14, 95% CI [.09,.19]) significantly mediated this association in parallel. In addition, the serial pathway from smartphone addiction to low physical activity, elevated depressive symptoms, and poor sleep quality was significant (indirect effect = .02, 95% CI [.01,.04]). The mediators collectively accounted for 52.6% of the total effect.DiscussionThese findings suggest that problematic smartphone use is associated with poorer adolescent sleep through behavioral and psychological pathways involving reduced physical activity and elevated depressive symptoms. School-based interventions that promote physical activity while reducing problematic smartphone use may help protect adolescent sleep and mental health. Longitudinal and experimental designs are needed to establish causal direction and inform intervention development.

Why MAHA wants to make health data much more accessible

WASHINGTON — The Make America Healthy Again movement wants your health data.

The MAHA Institute, a think tank formed by allies of Robert F. Kennedy Jr. after his appointment as health secretary, held an event on Monday that emphasized the benefits of opening up health data sharing in the United States. In particular, the event highlighted how sharing patients’ health records with federal researchers could benefit the study of the origins of chronic diseases.

Read the rest…

AI Tool Helps Link BRSK1 Variants to Neurodevelopmental Disorder

For many families affected by rare genetic conditions, genomic testing does not immediately deliver an answer. Now, researchers have combined artificial intelligence, human genetics, and fruit fly experiments to connect variants in BRSK1 with a complex neurodevelopmental disorder. The findings provide a potential diagnosis for several previously unexplained cases while offering clues about how reduced activity of the gene may disrupt nervous system development.

The study, “Monoallelic variants in BRSK1 are associated with a neurodevelopmental disorder with or without epilepsy,” was led by researchers at Baylor College of Medicine, the Duncan Neurological Research Institute at Texas Children’s Hospital, and the Texome Project, together with collaborating institutions. It was published in the American Journal of Human Genetics.

According to Hugo Bellen, PhD, who is co-lead author of the study, the work began with a child enrolled in the Texome Project, which provides genetic testing to medically underserved people with rare, undiagnosed conditions in Texas. Standard analysis of the child’s and parent’s genomes had not identified a cause. AI-MARRVEL, an artificial intelligence–based tool that analyzes genomic and clinical information to prioritize candidate disease variants, highlighted a rare change in BRSK1. Through GeneMatcher, the researchers identified nine additional affected individuals with rare heterozygous variants in the gene, bringing the group to 10 people from seven unrelated families. The team then modeled three patient-derived variants in Drosophila melanogaster to test their effects in a living organism.

The “affected individuals present with developmental delay and variable phenotypes including anxiety, attention-deficit hyperactivity disorder (ADHD), autism, and seizures,” the authors wrote, adding that the severity and symptoms varied. Symptoms differed even among relatives carrying the same variant, suggesting variable expressivity.

“We studied the fly equivalent of BRSK1, called sff (sugar-free frosting), and found that this gene is active primarily in neurons, mirroring the expression pattern seen in humans,” added Mingxi Deng, PhD, who is first author and a postdoctoral fellow in the Bellen lab. “When the fly gene was disabled, the flies developed difficulties moving, showed increased sensitivity to stressors that can trigger seizure-like behavior, became more vulnerable to heat-induced paralysis and lived shorter lives. These findings indicated that the gene is essential for normal nervous system function.”

Introducing normal human BRSK1 largely corrected the behavioral and neurological defects, whereas three variants (BRSK1p.Ile202Val, BRSK1p.Arg237Cys, and BRSK1p.Thr406Ile) found in affected individuals produced only a partial rescue. The patient variants also failed to normalize neuromuscular junction structure or levels of Futsch, a protein involved in organizing neuronal microtubules. Together, the experiments suggest that the variants partially reduce BRSK1 activity rather than eliminating it.

“Microtubule disruption has been linked to several neurodevelopmental and neurological disorders,” Deng said. “Our findings suggest that reduced BRSK1 function interferes with the cellular machinery needed for healthy brain development and communication between neurons.”

BRSK1 encodes a kinase involved in neuronal polarization, synaptic function, and the internal organization of nerve cells. Reduced activity may therefore interfere with the cellular machinery neurons need to develop and communicate. “This work improves our understanding of the genetic causes of neurodevelopmental disorders and highlights the power of combining AI-driven gene discovery with experimental studies in model organisms to uncover new rare diseases and their underlying biology,” Bellen said.

The diagnosis may help participating families understand the source of their condition and could guide recognition of additional cases. Future studies will be needed to determine why the same variant can produce markedly different symptoms and to define more precisely how altered BRSK1 activity affects the developing brain.

The post AI Tool Helps Link <i>BRSK1</i> Variants to Neurodevelopmental Disorder appeared first on GEN – Genetic Engineering and Biotechnology News.

Association of temporal and masseter muscle thickness with cognitive function and clinical severity in Alzheimer’s disease: a retrospective study

BackgroundTemporal muscle thickness (TMT) has emerged as an imaging marker of skeletal muscle status and may be associated with cognitive decline in Alzheimer’s disease (AD). However, its relationship with AD severity remains unclear, and the clinical relevance of masseter muscle thickness (MMT) is unknown.ObjectiveTo evaluate the associations of TMT and MMT with cognitive function and disease severity in AD.MethodsThis retrospective study included 242 patients with AD between December 2023 and April 2025. TMT and MMT were measured on axial T1-weighted MRI, cognitive function was assessed using standardized neuropsychological tests, and disease severity was determined by Clinical Dementia Rating (CDR).ResultsThe intraclass correlation coefficients (ICC) for the mean TMT and MMT were 0.868 and 0.896, respectively, indicating good consistency. As the severity of AD progresses, TMT tends to be thinner in severe AD than in mild AD. Spearman’s correlation analysis revealed that both TMT and MMT were correlated with the Mini-Mental State Examination (MMSE) and CDR. After adjusting for various confounding factors using ordered logistic regression and multiple linear regression, TMT was found to be independently associated with AD severity (OR: 0.424, 95% CI: 0.290–0.618, p < 0.001) and positively correlated with MMSE scores. MMT showed only a weak independent association with CDR staging (OR: 0.830, 95% CI: 0.724–0.952, p = 0.008), while no significant correlation was observed with the MMSE. Stratified analysis revealed that the TMT maintained a consistent association in both male and female patients, whereas the MMT achieved statistical significance only in females in ordered logistic regression; all other findings were not statistically significant.ConclusionTemporal muscle thickness is associated with cognitive impairment and clinical severity in patients with AD and may serve as a simple, noninvasive imaging marker; in contrast, the independent associations of MMT with disease severity were weak and sex-specific, suggesting that its clinical utility may be limited and requires further validation.

Trait, state, and behavior in adolescent NSSI addiction: a serial mediation model linking childhood trauma to NSSI addiction

BackgroundDespite growing recognition of non-suicidal self-injury (NSSI) as a potential behavioral addiction, the sequential mechanisms linking childhood trauma to NSSI addiction remain unclear. This study examined a serial mediation model testing whether trait impulsivity and depressive symptoms sequentially mediate this relationship, with NSSI function as a behavioral coping mechanism.MethodsThis cross-sectional study included 163 Chinese adolescents diagnosed with major depressive disorder and a history of NSSI. Participants completed the Childhood Trauma Questionnaire-Short Form, the Short UPPS-P Impulsive Behavior Scale, the Children’s Depression Inventory, and the Ottawa Self-Injury Inventory (Functions and Addictive Features subscales). Serial mediation analysis (PROCESS Model 6, 5,000 bootstrap resamples), controlling for demographic and clinical covariates, tested the hypothesized five-step sequential model.ResultsChildhood trauma was positively associated with NSSI addiction, and this association was predominantly mediated: the total indirect effect accounted for 56.2% of the total effect. Indirect effects involving NSSI function in combination with upstream mediators were significant, including the full sequential path (B = 0.0033, 95% CI [0.0007, 0.0083]), whereas simple mediations via impulsivity, depression, or NSSI function alone were not.ConclusionThese findings support a trait-state-behavior-addiction cascade in which childhood trauma is associated with trait impulsivity and depressive symptoms that, in combination with the reinforcing function of NSSI, are linked to addictive features of NSSI. The model advances theoretical understanding of NSSI addiction and offers actionable clinical targets for prevention and intervention. Longitudinal studies are needed to confirm causal directions.

Adolescent non-suicidal self-injury scale – short form: revision and evaluation of its reliability and validity

ObjectiveNon-suicidal self-injury (NSSI) is a clinically significant concern among adolescents, and its accurate yet efficient assessment is essential for research, early identification, and intervention. Existing Chinese instruments—most notably the 19-item Adolescent Self-Harm Questionnaire (ASHS)—are relatively lengthy and ill-suited to rapid, large-scale screening. The present study had two aims: (a) to develop a short form of the ASHS, the Adolescent Non-Suicidal Self-Injury Scale–Short Form (ANSSI-SF), by integrating classical test theory (CTT) item analysis with genetic algorithm (GA) cross-validation, and (b) to evaluate its reliability, validity, and screening utility relative to the parent scale.MethodsUsing a convenience sample of 1,090 primary and secondary school students, seven items—one for each of seven behavioral categories derived from a functional–typological framework of self-harm—were selected on the basis of CTT item statistics and GA cross-validation. The scale was evaluated through item analysis, internal-consistency and split-half reliability, exploratory and confirmatory factor analysis (EFA/CFA), correlations with theoretically related constructs, known-groups comparisons (gender; smartphone addiction), and consistency and screening-accuracy analyses against the full 19-item ASHS.ResultsIt indicated that all items demonstrated strong correlations with the total score, and both internal consistency and split-half reliability reached satisfactory levels.A unidimensional factor structure also exhibited good model fit. Additionally, scale scores were significantly positively correlated with related psychological indicators such as depression, anxiety, and sleep problems, and effectively differentiated differences in self-injurious behavior across gender and smartphone addiction groups.GA cross-validation confirmed that the selected items balanced parsimony with full coverage of all seven behavioral categories.DiscussionThese findings indicate that the ANSSI-SF is a brief, reliable, and valid instrument that preserves the content breadth of the parent ASHS while substantially reducing administration burden. It is well suited to rapid, large-scale screening and early identification of at-risk adolescents, facilitating timely referral and prevention. Limitations include convenience sampling from a single region and the absence of test–retest reliability; future research should validate the scale in clinical and diverse cultural samples and examine its predictive validity.