Defining and Assessing Empathic Communication in Patient Portal Secure Messages: Adapted Coding Framework Development Study

Background: Empathic communication in the clinical setting has been associated with improved clinical outcomes, decreased anxiety, and increased patient satisfaction, treatment adherence, and trust. Despite the recent growth in patient portal use, the expression of empathic communication through patient portal secure messages is not well understood. Objective: This study aimed to construct a coding schema to define and assess empathic opportunities initiated by patients and primary care clinicians’ responses to these opportunities within a patient portal messaging environment. Methods: Data for this study included adult patient secure messages and responding messages from clinicians working in family practice clinics within a regional health care system serving central and northeast Pennsylvania between January 2018 and December 2023. We conducted a manual review of messages using the Empathic Communication Coding System as a guiding framework, which defines empathic opportunities created by patients and corresponding empathic responses by clinicians. We double-coded 500 patient messages for 3 empathic opportunity types: statements of emotion, progress, and challenge. Coding definitions were iteratively updated to describe specific textual cues unique to the patient portal context. This procedure was repeated to code for empathy in clinician responses to empathic opportunities. An additional 100 patient messages were double-coded for interrater reliability testing, and 500 patient messages were single-coded using the finalized coding schema. Results: Among 1100 patient messages coded, 576 (52.4%) included an empathic opportunity. Of these messages, 100 (17.3%) included a statement of emotion, 85 (14.7%) included a statement of progress, and 539 (93.6%) included a statement of challenge. Statements of challenge were primarily characterized by patients explicitly describing physical or mental health issues, a barrier in care, or difficulties in their personal lives. Among the 576 patient messages with empathic opportunities, 446 (77.4%) received at least 1 response from a clinician. Clinicians sent 483 response messages, of which 64 (13.2%) expressed empathy. Conclusions: While patients created empathic opportunities in over half of patient portal secure messages, primary care clinicians infrequently responded with empathy. The findings of this study provide initial evidence of gaps in empathic communication within patient portal secure messages and lay the groundwork for using artificial intelligence models to systematically measure and improve this communication across the patient portal messaging system.
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Protein Protects Against Tau Tangles, Synaptic Loss in Mouse Model of Tauopathy

Alzheimer’s disease (AD) and many other forms of neurodegeneration share a common culprit. In these diseases, tau proteins that normally stabilize neuronal microtubule filaments within nervous system networks instead form noxious knots and gradually disrupt the circuits they would otherwise preserve.

Scientists at Sanford Burnham Prebys have now shown that a different protein known as SORLA offers protection against the effects of these lethal loops. The results of the researcher’s’ study in mice suggests that future research may yield new treatments capable of boosting this protein’s ability to defend the brain.

Timothy Huang, PhD, assistant professor in the Center for Neurologic Diseases at Sanford Burnham Prebys, is senior and corresponding author of the team’s published paper in Science Advances, titled “SORLA up-regulation suppresses pathological effects in aged tauopathy mouse brain,” in which they concluded “These findings reveal a protective role for SORLA in multiple aspects of tauopathy pathogenesis and highlight its potential as a  therapeutic target.”

Normally, tau proteins are found throughout the brain and nervous system, helping to maintain the shape and structure of our neuronal wiring. But in certain diseases, including Alzheimer’s disease, tau proteins clump together inside nerve cells, forming what are known as tau tangles. These toxic tangles are linked to cognitive impairment and nerve cell death in diseases known as tauopathies. “In AD, amyloid-β (Aβ) plaques and neurofibrillary tangles (NFTs) comprising hyperphosphorylated tau accumulate in brain,” the authors explained.

The new study focused on the safeguarding capabilities of protein known as SORLA. “A role for the trafficking receptor SORLA (Sortilin-related receptor containing LDLR class A repeats) in reducing Aβ levels has been well established,” the investigators continued. “… however, relatively little is known with respect to whether and how SORLA can potentially affect tau pathology in vivo.”

Timothy Huang added, “In the last 15 or 20 years, considerable data has come out from our lab and other groups showing that SORLA can suppress one of the hallmarks of Alzheimer’s disease—amyloid-beta generation and accumulation. Very little was known, however, about whether SORLA affected the tau tangles reflected on the other side of the coin in Alzheimer’s disease.”

SORLA is expressed in both neurons and glia in mouse and human brain, the authors noted. For their newly reported study the team began by crossbreeding mice that produce extra human SORLA protein, with PS19 (P301S) mice that develop tau tangles, brain atrophy and cognitive deficits. This new mouse model enabled experiments to determine SORLA’s effects on tau protein buildup and its resulting harms.

Their studies showed that an overabundance of SORLA protein protected against a number of biological processes linked to the formation of tau tangles and progression of neurodegeneration. These include reducing the addition of too many phosphate groups to tau—known as hyperphosphorylation—and the ability of misshapen tau to serve as “seeds” that attract more tau and form clumps. This protection also extended to preservation of the synapses at the junction between neurons and the brain’s ability to adjust these connection points—which is called synaptic plasticity. “Using complementary approaches, we show that SORLA overexpression attenuates ventricular enlargement, tau phosphorylation and seeding, synaptic loss, impaired synaptic plasticity, and glial hyperactivation in the PS19 mouse brains,” the team wrote in summary.

An overabundance of SORLA protein protects against a number of biological processes linked to the formation of tau tangles and progression of neurodegeneration. These include reducing the addition of too many phosphate groups to tau, known as hyperphosphorylation. In these biopsy images, less phosphorylated tau—stained to appear green—has accumulated in the bottom sample overexpressing SORLA. [Tim Huang, Huijie Huang, Sanford Burnham Prebys]
An overabundance of SORLA protein protects against a number of biological processes linked to the formation of tau tangles and progression of neurodegeneration. These include reducing the addition of too many phosphate groups to tau, known as hyperphosphorylation. In these biopsy images, less phosphorylated tau—stained to appear green—has accumulated in the bottom sample overexpressing SORLA. [Tim Huang, Huijie Huang, Sanford Burnham Prebys]

“When you upregulate SORLA, you can suppress the negative effects found in tauopathies,” said first author Huijie Huang, PhD, a staff scientist in the Huang lab at Sanford Burnham Prebys. “We found there was less brain atrophy and less tau accumulation, which was very exciting to see.”

Because some people have mutations that disable the gene carrying the code for SORLA, Sorl1, the scientists wanted to compare the outcome of having extra SORLA to having none of it at all. Tests of mice genetically modified to lack Sorl1 told a very different story. “The opposite turned out to be true when we deleted the ability to produce SORLA proteins,” said Timothy Huang. “A lack of SORLA exacerbated the harmful effects observed in tauopathies.”

To address how extra SORLA or a lack of SORLA were either ameliorating or aggravating diseases featuring tau tangles, the research team used a combination of sequencing techniques capturing the levels of all proteins and gene expression in each cell, as well as mapping the spatial relationship of RNA and proteins within brain tissue. The scientists found that upregulated SORLA prevented problematic protein production changes in the synapses between neurons while also suppressing other drivers of tauopathy disease progression. They also observed that extra SORLA tamped down on disease-related gene expression patterns in brain cells known as glial cells that support and protect neurons in many ways. “One particularly notable finding that we can build on is the upregulation of a member of the plexin-B family of receptors in the absence of SORLA,” said Huijie Huang.

“There are unique drugs that can target this class of receptors that we may be able to apply to tau-related dementia disorders,” suggested Tim Huang. “One potential future direction is to repurpose these drugs to target overactivation of glial cells and perhaps reverse some of the phenotypes in tauopathies.”

The scientists also want to better understand what happens in each individual cell type when they upregulate or downregulate SORLA. “While it is not possible to specifically determine how cell-specific modulation of SORLA can affect tau using the global transgenic overexpression/deletion models used here, we are interested in further characterizing specific effects of SORLA on tau in neurons, and the extent of SORLA modulation on glia in influencing overall tau pathology,” they stated. The team plans to graft human neurons or glial cells into the mouse brain to study the effects of different SORLA mutations.

“Mouse cells and human cells are different,” said Tim Huang. “Because we’re looking at human disease, it’s more informative if we can observe the modulation and dysfunction of SORLA in the context of a human cell inside of a diseased brain environment.”

This continued research will reveal more knowledge about the ability of SORLA to safeguard against the toxic effects of tau tangles, and how to develop new treatments or repurpose existing therapies to benefit patients suffering from Alzheimer’s disease and other tau-related dementia disorders.

The post Protein Protects Against Tau Tangles, Synaptic Loss in Mouse Model of Tauopathy appeared first on GEN – Genetic Engineering and Biotechnology News.

StockWatch: Lilly’s Up-to-$3.8B Deal for AtaiBeckley a Good Trip for Psychedelic Drugs, Analysts and Investors Agree

It wasn’t too long ago that biopharma giants stayed away from developing psychedelic drugs—but positive clinical data plus a friendlier regulatory climate in Washington have prompted the largest drug developers to embrace the field.

The latest and most telling example of pharma embracing psych drugs came when Eli Lilly (NYSE: LLY) announced that it agreed to acquire AtaiBeckley (Nasdaq: ATAI) for up to $3.8 billion—of which Lilly will pay $2.8 billion upfront. The deal, set to close in the third quarter, expands Lilly’s neuroscience portfolio by adding the pipeline of AtaiBeckley led by BPL-003 (mebufotenin benzoate), a Phase III candidate for treatment-resistant depression (TRD) that is a synthetic form of 5-MeO-DMT administered intranasally. BPL-003 has been granted the FDA’s Breakthrough Therapy designation.

BPL-003 wowed analysts and others back in April after AtaiBeckley published positive data from a Phase IIa trial (NCT05660642) showing that a single intranasal dose of BPL-003 led to rapid and sustained reductions in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline in 12 TRD patients who remained on stable SSRI therapy throughout the study. Both the six patients dosed at 10 mg and six at 12 mg showed a 66.7% antidepressant response rate (defined as ≥50% reduction from baseline MADRS score) at Day 2, with five of six participants in the 10 mg cohort (83%) and four of six in the 12 mg cohort (66.7%) maintaining their response at Week 12.

“Especially with progress on BPL-003, we see the company as positioning itself well to becoming a significant player in the mental health therapeutics space,” Sumant Kulkarni, a senior analyst covering biotechnology with Canaccord Genuity, wrote on news of the positive data, adding: “We also still see this space as large enough to accommodate multiple approaches/competitors.”

$3.7B in projected peak sales

Kulkarni also raised Canaccord Genuity’s peak unadjusted U.S. sales forecast for BPL-003 to $3.7 billion by 2036 from $2 billion, after revising the firm’s model by raising the list price from $20,000 to $30,000 per annual treatment course (not accounting for insurance coverage), about the same price as Spravato® (esketamine), also a nasal spray marketed by Johnson & Johnson (NYSE: JNJ) for TRD plus some depressive symptoms in adults with major depressive disorder (MDD).

Spravato, a noncompetitive N-methyl D-aspartate (NMDA) receptor antagonist, crossed the $1 billion sales threshold during the second quarter, as it generated $584 million, up 25% quarter-over-quarter from $464 million in Q1—and up 43% from $734 million in the first half of 2025.

“Sales are tracking to reach annual sales guidance of $3-3.5B+ by 2027–28,” Jefferies equity analyst Andrew Tsai wrote in a research note focused on J&J’s second-quarter results. “Spravato’s trajectory supports the notion psychedelics can be commercially viable in hard-to-treat mental health disorders, by leveraging JNJ’s infrastructure.”

Given the data for BPL-003, Lilly got a bargain, Tsai wrote in a separate note on the Lilly-AtaiBeckley acquisition.

“We think the deal heavily favors LLY, as ATAI’s lead asset BPL-003 (intranasal 5-MeO-DMT) should have multibillion dollar peak sales potential,” Tsai wrote, rather than the $1 billion-plus that he thinks was implied by the deal price.

Tsai and Jefferies had previously forecast peak sales of between $1 billion and $2 billion—a range he said was “arguably conservative” since BPL-003 could, if it aces its Phase III trial, show superiority to Spravato, which is on track to reach up to $5 billion-plus in peak sales.

Positive implications

“At the same time, we appreciate LLY has significantly more resources to maximize the long-term value of ATAI’s psychedelic assets. In any case, the deal has (+) [positive] implications for the entire psychedelic space,” Tsai added.

Among pharma giants joining J&J in embracing psychedelic drug development in recent years:

  • AbbVie (NYSE: ABBV), which last year acquired the lead pipeline program of privately held Gilgamesh Pharmaceuticals, the moderate-to-severe MDD candidate bretisilocin (GM-2505), for up to $1.2 billion.
  • Otsuka Holdings (Tokyo Stock Exchange: 4578), which in 2023 acquired Mindset Pharma, a Canadian psych drug developer focused on psychiatric and neurological disorders, for C$80 million ($56 million).

With its deal for AtaiBeckley, Lilly becomes the latest pharma giant to perceive the positive implications Tsai cited.

“Treatment-resistant depression persists even after multiple treatments have failed. Millions of people are still searching for relief and desperately need a therapy that works,” Carole Ho, executive vice president and president, Lilly Neuroscience, said in a statement. “Advancing AtaiBeckley’s investigational therapies gives us a real chance to change that.”

Investors agreed with Lilly, giving the pharma a 1% increase Thursday, the day the acquisition was announced, from $1,156.63 to $1,169.17—no small feat since buyers typically stay flat or see their shares slide after announcing an acquisition. And not surprisingly, AtaiBeckley investors were enthusiastic about the deal, as its stock leaped 33% from $5.36 to $7.15. On Friday, Lilly inched up 0.8% to $1,178.58 while AtaiBeckley rose 1% to $7.22.

The AtaiBeckley buyout is Lilly’s eighth announced acquisition of a smaller biopharma this year.

Lilly is acquiring three infectious diseases vaccine developers—Vaccine Company for up to $1.55 billion, Curevo for up to $1.5 billion, and LimmaTech Biologics for up to $780 million—as well as in vivo chimeric antigen receptor T-cell (CAR T) developer Kelonia Therapeutics for up to $7 billion); JAK inhibitor developer Ajax Therapeutics for up to $2.3 billion; next-generation dual-payload antibody-drug conjugate (ADC) developer CrossBridge Bio for up to $300 million; and nonviral DNA delivery-focused drug developer Engage Biologics for up to $202 million cash.

The deal spree reflects Lilly’s desire to capitalize on the billions of dollars it is generating from sales of its obesity and diabetes drugs based on glucagon-like peptide 1 (GLP-1) receptor agonists alone or in tandem with a glucose-dependent insulinotropic polypeptide (GIP).

“If we see great ideas that we think we can use to help people that need them, of course we’ll do deals,” Daniel M. Skovronsky, MD, PhD, Lilly’s chief scientific and product officer and president of Lilly Research Laboratories, said on CNBC.

“Positive development”

David Risinger, a senior managing director and senior research analyst covering diversified biopharmaceuticals at Leerink Partners, said his firm viewed Lilly’s buyout of AtaiBeckley “as a positive development because it enhances LLY’s pipeline of potential neuroscience blockbuster candidates.”

That pipeline is led by five Phase III programs involving four drugs, none of them a psychedelic. Two of the programs belong to brenipatide, a dual agonist of both the GIP and GLP-1 receptors. Brenipatide is being developed for both MDD and alcohol use disorder.

Also in Lilly’s late-stage neuroscience pipeline are:

  • Donanemab, which binds to deposited amyloid plaque in the brain and is being studied for the treatment of cognitively unimpaired Alzheimer’s disease.
  • Ixoberogene Soroparvovec (Ixo-Vec), an intravitreal gene therapy being studied as a single one-time treatment for vision loss associated with neovascular (wet) age-related macular degeneration (AMD).
  • Remternetug (LY3372993), which also binds to deposited amyloid plaque in the brain and is under study as a treatment of cognitively unimpaired/mild cognitive impairment due to Alzheimer’s disease, with potential for subcutaneous delivery.

In addition, AtaiBeckley “would provide ​differentiated exposure in psychiatry and reinforce [Lilly’s] ​broader effort to diversify beyond ​its cornerstone cardiometabolic franchise,” observed Evan David Seigerman, a managing director and head of healthcare research at BMO Capital Markets, as reported by Reuters.

AtaiBeckley was formed last November by the merger of atai Life Sciences and Beckley Psytech. The company’s stock has nearly doubled, soaring 98% over the past six months from $3.64 on January 16.

“Going mainstream”

“Psychedelic Medicine is going mainstream,” declared Steve Jurvetson, co-founder of Future Ventures, in a post on X. Jurvetson and Future were among early investors, along with Peter Thiel in atai Life Sciences.

AtaiBeckley is one of numerous psychedelic drug developers to show significant six-month gains since January: As of Friday’s closing bell, Compass Pathways (Nasdaq: CMPS) shares jumped 68% to $12.35, GH Research ballooned 69% to $28.71, while Definium Therapeutics (Nasdaq: DFTX) nearly tripled, zooming 194% to $44.29.

Interestingly, those three companies did not get a solid bounce from AtaiBeckley’s acquisition by Lilly. Since the deal was announced Thursday, Compass fell 7% from $13.31 pre-announcement, Definium dipped 3% from $45.66. GH rose 8% Thursday from $26.92 to $29.13, before sliding 1.4% the following day.

Bucking the trend was Cybin, d/b/a Helus Pharma (Nasdaq: HELP), which has climbed 11% since the Lilly-AtaiBeckley announcement, from $6.51 to $7.25. Its shares have slumped 6% since January—but soared 58% over the past month on positive news, such as the 88%+ enrollment rate of patients in Helus’ Phase III APPROACH pivotal trial (NCT06564818) of HLP003 in MDD, on track for topline data readout in Q4 2026.

“We see the potential for 150–200% upside [jump in stock price] if Phase III data in 4Q26 are positive,” Kulkarni wrote, making it the largest potential jump among psychedelic drug developers.

In addition to favorable data, the stock surges also reflect actions by President Donald J. Trump’s administration to encourage psychedelic drug development. In April, President Trump signed Executive Order 14401, directing the FDA and other federal agencies to accelerate research and improve access to psychedelic drugs, citing their potential as promising treatments for serious mental illnesses.

And on July 13, the FDA published “Psychedelic Drugs: Considerations for Clinical Investigations,” a final guidance designed to provide general considerations for developers of psych drugs, with recommendations for how to conduct clinical trials for the treatments.

“Rather than providing specific recommendations on study design, this guidance will present foundational constructs that all sponsors studying the therapeutic potential of psychedelic drugs, including sponsors without commercial drug development as primary interest (e.g., academic researchers), should consider,” the FDA wrote in the final guidance. “Sponsors are encouraged to request meetings with FDA for advice on a specific drug development program.”

Leaders and laggards

  • Q32 Bio (Nasdaq: QTTB) shares nearly doubled, leaping 91% from $11.21 to $21.38 July 13 after the autoimmune and inflammatory disease drug developer announced positive 36-week topline results from Part B of the Phase IIa SIGNAL-AA trial (NCT06018428) assessing bempikibart in patients with severe or very severe alopecia areata. Q32 said it saw clinically meaningful efficacy data on the primary endpoint of mean percent change from baseline in SALT score, with a reduction from baseline of 35.3% in the prespecified modified intent to treat (mITT) analysis. The company also reported that 40.0% of patients (10/25) achieved SALT-20 response at Week 36 in the mITT analysis, while 30.3% of patients (10/33) achieved SALT-20 response at Week 36 in the ITT analysis of all enrolled patients.
  • Veradermics (NYSE: MANE) shares yo-yoed this past week, climbing 12% from $110.17 to $123.70 Wednesday after the pattern hair loss drug developer announced positive topline results from its open-label Phase II Study 207 trial (NCT06527365) assessing VDPHL01, an extended-release oral minoxidil formulation, in women with mild-to-moderate pattern hair loss. Veradermics said most study participants reported improved hair coverage at Month 2, with approximately 88.9% of patients dosed once daily and 90.0% dosed twice daily reporting “improved” or “much improved” outcomes at Month 6. Participants dosed once daily showed a mean increase in non-vellus target area hair count (TAHC) of 22.7 hairs/cm² at Month 6, an average that rose to 23.3 hairs/cm² in twice daily dosed patients. The mini surge was short-lived, however, as investors more than gave back the gain, selling off shares to send them tumbling 14% to $105.83 Thursday amid possible investor questions about whether the good clinical news was already reflected in the stock price.

The post StockWatch: Lilly’s Up-to-$3.8B Deal for AtaiBeckley a Good Trip for Psychedelic Drugs, Analysts and Investors Agree appeared first on GEN – Genetic Engineering and Biotechnology News.

Development and validation of the digital well-being scale using university students

IntroductionDigital technologies are central to university students’ academic, social, and personal lives, offering opportunities for learning and connection while also introducing challenges such as distraction, emotional strain, and difficulties with self-regulation. Despite increasing interest in digital well-being, there is a lack of comprehensive, psychometrically sound instruments specifically designed to assess digital well-being among university students. This study developed and validated the Digital Well-Being Scale (DWS) for use in higher education.MethodsA cross-sectional survey was conducted among 1,533 undergraduate and postgraduate students from a public university in Ghana. Scale development involved literature review, expert evaluation, pilot testing, and psychometric validation. Exploratory factor analysis (EFA) was used to identify the underlying factor structure, followed by confirmatory factor analysis (CFA) to evaluate construct validity. Reliability, convergent validity, discriminant validity, and measurement invariance across gender were also assessed.ResultsEFA supported a six-factor solution comprising Task Interference, Digital Safety and Responsible Use, Perceived Control and Satisfaction, Digital Life Balance, Emotional Regulation, and Digital Dependence and Frustration. Following CFA-based refinement, a 41-item scale was retained. The six-factor first-order model demonstrated excellent fit to the data and outperformed a higher-order model. The DWS showed satisfactory internal consistency, convergent validity, and discriminant validity across all dimensions. Measurement invariance analyses supported configural and metric invariance across gender, although scalar invariance was only partially supported.DiscussionThe DWS provides a theoretically grounded and psychometrically robust multidimensional measure of digital well-being among university students. The findings suggest that digital well-being encompasses behavioural, emotional, cognitive, self-regulatory, and responsible dimensions of digital engagement rather than representing a single, unidimensional construct. The scale offers a valuable tool for research, screening, and intervention aimed at understanding and promoting digital well-being and digital mental health in higher education settings.

Immersive Technologies in Forensic Mental Health and Prison Settings: Scoping Review

<strong>Background:</strong> The application of immersive technologies, particularly virtual reality, has expanded rapidly across health care domains, including mental health, rehabilitation, and education. These technologies enable the creation of controlled, interactive, and ecologically valid environments that can support therapeutic interventions, skill development, and behavioral assessment. Within forensic mental health services (FMHS) and prison settings, where individuals often present with complex psychological needs in restrictive and highly regulated environments, immersive technologies offer potential advantages such as safe simulation of real-world scenarios, enhanced engagement, and personalized intervention delivery. However, despite increasing interest, the evidence base remains fragmented, and questions persist regarding effectiveness, ethical implications, and feasibility of implementation in secure and resource-constrained contexts. <strong>Objective:</strong> Interest in immersive technologies in FMHS and prison settings is growing, yet their role remains unclear. This scoping review mapped current uses, highlighted opportunities, and identified key gaps and considerations for future implementation. <strong>Methods:</strong> A scoping review of English-language publications (2010-2025) was conducted using the Scopus, PubMed, and CINAHL databases. Data extraction followed the Joanna Briggs Institute framework, and thematic analysis explored benefits, drawbacks, and implementation barriers. <strong>Results:</strong> Thirty sources were identified. Primary research focused mainly on virtual reality for therapy, skill training, education, and assessment. There was evidence suggesting benefits such as increased engagement, emotional regulation, skill acquisition, autonomy, and improved clinician-patient dialogue. However, the studies were small, heterogeneous, and inconsistently reported, with limited long-term follow-up. Implementation barriers included institutional, ethical, and technical constraints and limited personalization and end user involvement. Co-design and participatory approaches surfaced as key enablers of acceptability, relevance, and safe use. <strong>Conclusions:</strong> The existing evidence base is preliminary and exploratory but indicates that immersive technologies may have potential value in FMHS and prison contexts. Current findings should be interpreted cautiously because studies are small, heterogeneous, and rarely include long-term follow-up. More robust evidence, careful implementation, and meaningful end user input are needed to support safe, relevant, ethical, and effective use. The emphasis on coproduction and guidance for safe, user-centered implementation is a novel contribution.

Playing the Long Game for Youth Mental Health: A conversation with Grassroot Soccer on the power of sport and partnership


By Mai El Shoush, Partnership Campaign Manager, SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute


Few events unite the world quite like the FIFA World Cup, demonstrating soccer’s unique ability to connect people across cultures and communities. As millions tune in, the moment offers a timely reminder on how sports can reach young people far beyond the field. This belief underpins the work of Grassroot Soccer, a valued partner of the SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute. They utilize the power of soccer to advance youth mental health — and have reached more than 25 million young people around the world through this approach.

The partnership incorporates three interconnected areas:

  • Building capacity for frontline workers
  • Generating evidence
  • Contributing to thought leadership on child and adolescent mental health in low-resource settings

The 2026 Men’s World Cup in North America and the upcoming 2027 Women’s World Cup in Brazil present an important opportunity for the organization to take its mental health programming from sub-Saharan Africa and adapt it to the U.S. context.

We spoke with Grassroot Soccer’s Mental Health Specialist Charmaine Nyakonda about the organization’s approach, the impact of their collaboration with SNF, and the growing role of sports in improving the mental health of young people and communities globally.

Playing the Long Game for Youth Mental Health: A conversation with Grassroot Soccer on the power of sport and partnership
Grassroot Soccer’s Mental Health Specialist, Charmaine Nyakonda

As international attention increasingly turns towards soccer’s global reach with the 2026 FIFA Men’s World Cup, what role can sports play in advancing youth mental health care across diverse communities?

Soccer is the most popular and accessible sport in the world. From the largest global stages like the World Cup to the most remote rural villages, it’s played everywhere on the planet. As the World Cup shows, soccer has the power to captivate across geographies, cultures, and time zones.

Soccer (and sport in general) is a powerful tool that teaches youth important life skills and character-building lessons like resiliency, hard work, courage, trust, and teamwork. On top of this, soccer’s universal appeal across diverse communities means using the language of the game can also be an effective way to break through the stigma around sensitive but pressing topics like mental health. This is why Grassroot Soccer uses soccer as a teaching tool for mental health.

Grassroot Soccer has successfully touched the lives of millions of young people across settings worldwide. What has the team learned about the universal role that sports can play in supporting mental health, resilience, and social connection?

Across our programs, soccer serves as a universal entry point that hooks young people and meets them where they are. From there, our play-based activities use soccer games and metaphors to make learning about mental health fun and engaging. They break down stigma and create safe spaces where young people can feel comfortable opening up and being vulnerable. This drives exceptional participation and completion rates.

Importantly, our signature soccer-based mental health promotion and prevention program, called MindSKILLZ, is guided by core mental health design principles. This includes grassroots co-creation, trauma-informed practice, relationship-centered delivery, and strengths-based learning — which ensures that programs are ethical, culturally grounded, and safe for adolescents in both stable and crisis-affected settings.

“Soccer (and sport in general) is a powerful tool that teaches youth important life skills and character-building lessons like resiliency, hard work, courage, trust, and teamwork.”

What elements of Grassroot Soccer’s approach do you believe could serve as a transferable blueprint for other organizations seeking to improve outcomes for young people in different sectors and communities?

Our commitment to co-design with young people: We believe that young people are the experts on their lives and needs, so we intentionally apply the principle of “Nothing about us without us” to our work. We put this into practice by engaging young people at every point in the program life cycle to ensure our work meets their needs, from design to implementation to evaluation.

In 2023, Grassroot Soccer officially launched a Youth Advisory Committee (YAC) composed of young leaders that serves as an internal advisory and advocacy body for the organization. The Committee consists of SKILLZ Coaches, Master Coaches, and trainers between the ages of 18 to 30 from the communities we serve.

Mental health integration: Mental health promotion and prevention must be woven into every service that young people access. Mental health is both a driver and an outcome of young people’s overall well-being. Unaddressed mental health challenges undermine progress in HIV, sexual and reproductive health, education, and other youth development areas. And those same factors profoundly shape young people’s mental health in return.

What has made the partnership with the SNF Global Center particularly valuable, and what role do cross-sector and multidisciplinary partnerships play in expanding support and opportunities for young people?

The diverse cultural perspectives from Greece, Brazil, the United States, and South Africa — and especially youth voices — have enriched our understanding of the barriers young people face, the values that motivate them, and the creative solutions they come up with when it comes to mental health.

We’ve also benefited tremendously from the scientific and clinical expertise at the SNF Global Center. We were able to co-develop an open-access, near-peer emotional support online training that aims to enhance the capacity of frontline workers to identify, refer, and support common mental health problems among children and adolescents. This is especially important in low-resource settings.

Additionally, through thought leadership and advocacy collaboration, this partnership has been valuable in contributing to an important shift in the global conversation to framing low-resource settings (the Global South) as sources of innovation that can positively impact the Global North.

Playing the Long Game for Youth Mental Health: A conversation with Grassroot Soccer on the power of sport and partnership

Over the years, what has most reinforced your belief in the power of soccer to support youth mental health, and what examples best bring that impact to life?

We’ve seen a few powerful stories of impact in humanitarian settings, where the need for mental health care is at its greatest but resources are at its most limited.

For example, in 2024, relentless downpours following a tropical cyclone caused rivers in Malawi’s Nkhotakota and Karonga districts to overflow, leading to widespread flooding impacting over 150,000 people and forcing many displaced residents to seek refuge in makeshift internally displaced person (IDP) camps.

In the camps, people had no access to mental health and psychological support services or safe spaces, and youth were not attending school. The Malawi Ministry of Health identified a major gap in mental health support for adolescents and young people and called on Grassroot Soccer to deliver MindSKILLZ to respond to this need.

Grassroot Soccer’s response team focused heavily on play, coping skills development, and trauma-informed support, creating critical psychological and physical safe spaces for youth within the camp environment.

Looking ahead, how would you like to see the conversation evolve at the intersection of sports, youth well-being, and mental health?

Firstly, we would like to see the conversation move beyond asking whether adolescent girls and young women like to play sports and instead asking, “What can we unlock when they do?”

For too long, sports (and soccer in particular) have been understood as primarily a significant part of adolescent boys’ and young men’s lives only. That assumption has shaped who gets access, who feels welcome, and whose well-being is centered. Grassroot Soccer’s own programming challenges this directly — we have reached more adolescent girls than boys, and in doing so have created space for girls to reconstruct gendered ideas about soccer. The conversation on sports, youth, and mental health needs to evolve to view sports games like soccer as universal tools that can transcend gender norms, age, and socio-economic background to support young people.

At the same time, we want to see the conversation take adolescent boys’ mental health more seriously, not less. Qualitative insights from Grassroot Soccer show that rigid masculine norms remain a profound barrier for boys.

More broadly, we ultimately want to see the conversation shift from individual resilience to multi-systemic access and inclusive enabling environments. Young people need culturally grounded, safe environments that work for them — and include them in design and delivery to help them develop into healthy adults who carry that capacity forward.

Playing the Long Game for Youth Mental Health: A conversation with Grassroot Soccer on the power of sport and partnership

What do you see as the greatest opportunities for the next generation of young people, and what must we do collectively to help make that future possible?

With the largest generation of adolescents coming of age, their ability to live healthy and productive lives will have a profound impact on not just their own life trajectories, but also on the world. Tackling critical global issues from poverty to climate change will require a generation of young people who are strong, healthy, and empowered — and their mental health is central to all this.

At Grassroot Soccer, we are committed to investing in youth mental health to realize a world where mental health challenges have been normalized. We want young people to understand their own mental health, have practical coping skills to deal with frustration and aggression, and recognize the value in seeking support from others. This will help develop a population with reduced symptoms of depression and anxiety, as well as overall improved mental well-being. Then we can collectively realize our vision for a better future.

Through the SNF Global Center, the Child Mind Institute partners with organizations around the world to strengthen child and adolescent mental health systems by combining scientific expertise, local leadership, evidence-based innovation and youth voices. Grassroot Soccer is one example of how cross-sector partnerships can expand access to mental health support in communities where young people already learn, connect, and thrive.

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Altered tryptophan metabolism as a contributor to cognitive impairment in chronic kidney disease: a narrative review

Approximately 40% of patients with chronic kidney disease (CKD) experience cognitive impairment (CI), which is strongly associated with increased mortality. CI is driven by multiple factors, including vascular injury, accumulation of uremic toxins, disruption of the blood–brain barrier, and chronic inflammation. Recent evidence suggests that kidney disease and neurocognitive decline are mechanistically linked through dysregulated tryptophan metabolism. Tryptophan is metabolised through three main pathways: the kynurenine, indole, and serotonin pathways, each producing bioactive metabolites with distinct neurophysiological effects. The hallmarks of CKD include chronic inflammation, gut microbial dysbiosis, and impaired renal clearance, all of which alter tryptophan metabolism. Inflammation drives tryptophan metabolism towards the kynurenine pathway, increasing the formation of neurotoxic compounds that promote oxidative stress, excitotoxicity, and neuronal injury. However, reduced availability of tryptophan for serotonin synthesis impairs serotonergic signalling and neurotransmission, as well as melatonin biosynthesis, thereby contributing to circadian rhythm disturbances and impaired glymphatic clearance. Concurrently, gut dysbiosis and reduced renal clearance promote the accumulation of indole-derived uremic toxins, leading to endothelial dysfunction, neuroinflammation, and disruption of the blood–brain barrier. This review highlights the current evidence of dysregulated tryptophan metabolism in CKD and its impact on the pathogenesis of neurocognitive complications. The review also discusses potential biomarkers and therapeutic strategies, including kynurenine pathway inhibitors, gut microbiota modulation, uremic toxin adsorption, melatonin supplementation and personalised medicine to mitigate cognitive impairment in CKD.

Opinion: MAHA is rewriting the vocabulary of American mental health care

At a May MAHA Institute summit organized around the theme of “overmedicalization,” the health secretary announced an action plan to promote psychiatric deprescribing. At first look, it seemed innocuous. The Substance Abuse and Mental Health Services Administration (SAMHSA) would study prescribing trends and publish fact sheets. Medicare would clarify how clinicians can be paid for the attentive work of tapering a patient off of a medication (which is already a part of routine clinical care). Webinars would teach prevention and “holistic” care. A technical expert panel would convene over the summer to make further recommendations. 

In reality, this announcement, and the steady stream of actions over the past 18 months, mark a quiet rewriting of the vocabulary of American mental health care — a massive rhetorical shift enacted while programs and protections that would actually solve the problem are dismantled.

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Academic burnout in higher education: a multimodal study of resting-state EEG microstate correlates beyond trait anxiety, depressive symptoms, and self-efficacy in Chinese undergraduates

BackgroundAcademic burnout is a mental-health-relevant outcome of higher-education stress, but its relationship with spontaneous brain dynamics remains unclear. EEG microstates are quasi-stable scalp-potential configurations indexing millisecond-level transitions between large-scale resting brain states. This study tested whether resting-state EEG microstate dynamics are associated with academic burnout beyond trait anxiety, depressive symptoms, and general self-efficacy as perceived coping capacity.MethodsParticipants were 330 Chinese undergraduates (94 men, 236 women; mean age = 18.31 years, SD = 0.84). They completed self-report measures and an eyes-closed resting-state EEG recording. Academic burnout total score was the primary outcome. Covariate-adjusted partial correlations examined burnout–microstate associations. Hierarchical regression tested the incremental value of selected microstate markers.ResultsHigher academic burnout was associated with higher trait anxiety (r = 0.539, p < 0.001), higher depressive symptoms (r = 0.526, p < 0.001), and lower general self-efficacy (r = -0.474, p < 0.001). After adjustment for age, sex, trait anxiety, depressive symptoms, and general self-efficacy, greater burnout was associated with shorter microstate D duration (partial r = -0.196, q = 0.0049), higher microstate C occurrence (partial r = 0.172, q = 0.0081), shorter mean microstate duration, and higher mean occurrence. The psychological block explained substantial variance in burnout (R² = 0.417); adding microstate D duration and microstate C occurrence produced a small but significant improvement in model fit (ΔR² = 0.025, p = 0.001). In a scale-midpoint sensitivity analysis, the higher-burnout group showed shorter class D duration after covariate adjustment (adjusted B = -3.38 ms, 95% CI [-6.12, -0.64], p = 0.016). Dimension-specific analyses indicated that microstate associations were mainly evident for dejection and low sense of accomplishment, not the behavioral (improper-behavior) component.ConclusionAcademic burnout in undergraduates was primarily linked to internalizing distress and lower perceived coping capacity. Resting-state EEG microstate dynamics, especially shorter class D duration, provided modest incremental information, suggesting reduced temporal persistence of a canonical resting-state configuration among students with higher burnout. These findings do not establish a diagnostic EEG marker or a burnout-specific neural mechanism, but support multimodal, context-sensitive research on academic stress and mental health in higher education.

enDigital Postpartum Support for Early Risk Identification Among Postpartum Women: Formative Randomized Evaluation and Exploratory Predictive Modeling Study

Background: The postpartum period represents a critical window for maternal health, yet many individuals lack sustained support and timely identification of physical and mental health risks. Digital health interventions offer a scalable approach to extend care beyond clinical settings. Yet, key elements, including real-world challenges, usability, and effectiveness of such platforms, are insufficiently characterized in this literature. Objective: This study aimed to conduct a formative randomized evaluation to assess the feasibility, engagement, and preliminary signals of impact of the Joyuus platform and to examine the potential for early identification of postpartum health risks. Methods: We conducted a 12-week randomized evaluation with postpartum participants recruited through community-based organizations. Participants were randomized to either the Joyuus intervention or standard postpartum care. Primary and secondary outcomes included the Barkin Index of Maternal Functioning, the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory, and the Connor-Davidson Resilience Scale. Analyses were conducted using an intention-to-treat approach with linear regression models adjusting for baseline values. Engagement metrics (ie, sessions, time on site, and feature use) were captured through in-app analytics. An exploratory predictive model was developed using baseline clinical, behavioral, and demographic variables to identify individuals at risk for postpartum depression. Results: Baseline characteristics were generally balanced across arms, and no statistically significant differences were observed in education, income, or marital status. No statistically significant differences were found between treatment and control groups in the 12-week changes for the primary or secondary outcomes. Mean EPDS scores were 9.7 in the intervention group and 9.3 in the control group. In the sample, 60 (45.5%) of the 132 participants met the criteria for elevated depression (EPDS score ≥11 or a positive response to question 10 on self-harm), indicating a high burden of symptoms within the study population. Engagement with the platform was highest during the first 4 weeks. Among intervention participants, 80% created an account. Participants reported high levels of perceived usefulness, ease of use, and relevance of content. Qualitative analysis of open-ended survey responses highlighted limited awareness of postpartum-specific resources and a preference for simple, accessible information. An exploratory predictive model demonstrated a recall of 0.89 and a precision of 0.73 in identifying individuals at risk for postpartum depression, suggesting the feasibility of early risk identification using integrated data inputs. Conclusions: Joyuus demonstrated feasibility and acceptability but did not produce statistically significant improvements in maternal functioning or maternal health outcomes over 12 weeks. Joyuus identified high rates of depressive symptoms and early engagement patterns, which suggest an opportunity for earlier identification of risk and intervention during the postpartum period. Exploratory modeling results indicate the potential for data-driven approaches to support earlier detection. Future work includes optimizing engagement strategies and expanding validation of predictive detection to improve postpartum surveillance and outcomes. Trial Registration: ClinicalTrials.gov NCT05876559; https://clinicaltrials.gov/study/NCT05876559?cond=postpartum%20joyuus&viewType=Card&rank=1