Global health systems are increasingly challenged by shifting patterns of communicable diseases, non-communicable diseases, and injuries. While these patterns have been widely studied in low- and middle-income settings, there is limited evidence describing how they manifest in emergency department utilization within high-income, migrant-dense contexts such as Dubai. This study aimed to examine temporal trends in emergency department utilization by disease categories and their demographic and clinical correlations in Dubai, UAE, from 2021 to 2025.

A retrospective observational study was conducted using electronic health records of 15,679 ED visits from January 2021 to June 2025 at the Emergency Department. Diagnoses were classified into communicable diseases, non-communicable diseases, injuries, and ill-defined conditions according to WHO ICD-10-CM guidelines. Descriptive statistics were used to summarize patient characteristics and disease burden. Temporal trends were assessed across study years. Multivariable Poisson regression models were applied to examine associations between demographic and clinical factors and emergency department utilization, with results reported as incidence rate ratios and 95% confidence intervals. A p-value ≤ 0.05 was considered statistically significant.

NCDs increased by 44% (n = 1416), which included cardiovascular, digestive, and respiratory diseases. CDs have increased by 13% (n = 297), with respiratory infections being the most common, which peaked in 2023. Injuries increased by 66% (n = 324), especially among males and the younger age group. Ill-defined diseases declined by 26% (n=-1064), although they remained common in the older population. Compared to burden of disease in people aged 0 to 19 years, people aged 20-39 and 40-59 showed a higher relative risk of 8% and 9% [aRR: 1.08; 95%, CI: 1.08-1.09; aRR: 1.09, 95% CI: 1.08-1.09], while people aged 60-79 and over 80 reported a 12% and 16% higher likelihood, respectively [aRR: 1.12; 95%, CI: 1.11-1.14; aRR: 1.16, 95% CI: 1.13-1.19].

These findings highlight the need for integrated strategies linking emergency, primary, and preventive care, alongside policy measures focused on migrant health, occupational safety, and NCD prevention.

Neurodegeneration is accelerated by Type 2 diabetes mellitus through adipokine dysregulation, insulin resistance, oxidative stress, and neuroinfl ammation. This could link metabolic imbalance to Alzheimer's disease, Parkinson's disease, and cognitive decline. The aim of this review is to clarify the roles of adipokines in type 2 diabetes-induced neurodegeneration, their molecular pathways, and the possible neuroprotective potential of antidiabetic agents.

Literature was searched in PubMed, Google Scholar, and Scopus for Englishlanguage articles published up to November 2025, using keywords like adipokines, diabetes mellitus, neurodegeneration, neuroinfl ammation, and antidiabetics.

Results highlight those elevated levels of pro-infl ammatory adipokines, such as TNF-α, IL-6, and resistin, together with reduced levels of neuroprotective adipokines, including adiponectin and leptin, may drive NF-kB activation, suppression of Nrf2 signaling, and amyloid and tau pathology. This is further exacerbated by oxidative stress and mitochondrial dysfunction. Antidiabetic agents like metformin, GLP-1 agonists, thiazolidinediones, and SGLT2 inhibitors restore adipokine balance, enhance AMPK/PPARγ signaling, and show cognitive benefi ts in mild cognitive impairment cohorts per clinical trials.

In conclusion, repurposing antidiabetics via biomarker-guided multiple therapies off ers disease-modifying promise for type 2 diabetes-linked neurodegeneration, necessitating large randomized controlled trials in prediabetic populations. (Neuropsychopharmacol Hung 2026; 28(2): 102-114) Keywords: Adipokines, Type 2 diabetes mellitus, Neurodegeneration, Neuroinfl ammation, Antidiabetic agents.

Metabolically healthy non-obese (MHN) individuals are considered at low cardiometabolic risk, yet a subset may harbor unfavorable visceral adiposity not captured by conventional anthropometric measures, including waist circumference (WC) and BMI.

We conducted a prospective cohort study of 22,040 UK Biobank participants (median follow-up 4.2 years [interquartile range 3.4-5.6]) defined as MHN (BMI < 30 kg/m², absence of diabetes or concurrent hypertension and hyperlipidemia). Visceral (VAT) and subcutaneous adipose tissue (SAT) volumes were quantified from whole-body MRI using a validated deep learning framework. Sex-specific VAT/SAT ratio cutoffs were derived from the German National Cohort based on prevalent cardiometabolic disease and applied to the UK Biobank. The primary outcome was incident major adverse cardiovascular events (MACE); the secondary outcome was incident type 2 diabetes. Categorical net reclassification improvement (NRI), quantifying the net proportion of individuals correctly reclassified between predefined risk categories, compared VAT/SAT ratio versus WC as competing classification approaches. Cox proportional hazards models assessed associations with outcomes after stepwise adjustment for age, sex, smoking, WC, and BMI. Nested models with and without VAT/SAT ratio were compared to test for added value beyond other factors.

The VAT/SAT ratio improved risk classification over WC for MACE (NRI 0.088, 95%CI 0.019-0.158, p = 0.013) and diabetes (NRI 0.102, 95% CI 0.024-0.181, p = 0.010). High VAT/SAT ratio independently predicted MACE (adjusted hazard ratio [aHR] 1.30, 95%CI 1.02-1.66, p = 0.037) and diabetes (aHR 1.77, 95% CI 1.34-2.33, p < 0.001) after full adjustment. Adding VAT/SAT to fully adjusted models improved discrimination for MACE (C-index 0.694 vs. 0.690, p = 0.036) and diabetes (C-index 0.723 vs. 0.715, p < 0.001).

The VAT/SAT ratio identifies MHN individuals at elevated cardiometabolic risk beyond conventional anthropometric measures, with particularly strong associations for incident diabetes. These findings support the concept of opportunistic imaging-based risk assessment and provide the prognostic foundation for future trials investigating whether targeted intervention in VAT/SAT-reclassified individuals improves outcomes.

Emergency departments (EDs) are often the first point of contact for individuals in mental health crisis. In rural Australia, health professionals face distinctive challenges shaped by limited resources, workforce shortages and overlapping professional and community roles. These conditions influence how health professionals perceive, engage with and respond to people experiencing mental health crisis. To explore how health professionals working in a rural emergency department perceive their work with people presenting with mental illness. A qualitative design using semi-structured interviews was employed with nine participants (six nurses and three medical officers) from a rural ED in South West Queensland. Data were analysed using Braun and Clarke's Reflexive Thematic Analysis. Three interrelated themes captured participants' perceptions: safety as relational and negotiated practice, education and training as relational and experiential learning and small-town mentality. Findings suggested that care in rural EDs is sustained less by systems and protocols than by human connection, local knowledge and moral endurance. Participants described navigating safety through empathy and teamwork, constructing learning through shared experience rather than formal training and managing the tensions of visibility, stigma and relationships in close-knit communities. Work with people with mental health illness in rural emergency settings is perceived as relational, adaptive and context bound. Building sustainable rural mental health responses may benefit from embedding specialist support, accessible education and reflective spaces that honour both professional wellbeing and community interdependence.

This research examines the intersection of education and political systems, exploring how instructional practices align with neoliberal policies. Education is often viewed as a means to address societal issues such as unemployment and inequality; however, its emphasis on creativity, critical thinking, and ethical considerations may sometimes be overlooked. A shift toward fostering critical engagement and societal development could be benefi cial.

Using a descriptive approach, this study retrieved articles from the Web of Science and Scopus databases.

In Iran, the education system has undergone notable changes since the Islamic Revolution in 1979, primarily aligning with ideological objectives. While enrollment rates have increased, the system appears to face challenges such as outdated curricula, structural ineffi ciencies, centralized governance, and limitations in teacher training. Although reforms have aimed at reinforcing ideological priorities, their impact on fostering innovation and global competitiveness remains uncertain. Additionally, regional disparities and gender inequalities continue to be areas of concern. Key challenges may include an overreliance on rote learning, limited adoption of modern pedagogical methods, and insuffi cient coordination between research and policy implementation. Teacher motivation could also be aff ected by inadequate wages and institutional support, potentially infl uencing the overall quality of education. Furthermore, both teachers and students encounter barriers to accessing equitable and high-quality education, which may hinder educational progress. Psychological concerns among Iranian students appear to be rising, possibly due to academic stress, suboptimal educational environments, and family dynamics. Research suggests that supportive family and school settings may play a signifi cant role in improving mental wellbeing, motivation, and self-perception. Adolescents, in particular, seem to benefi t from strong familial bonds, which could positively impact their mental health and academic performance. Based on these fi ndings, it may be advisable to consider reducing political infl uence in education, modernizing curricula, investing in teacher re-training, and integrating psychological support within schools. Decentralizing governance and fostering innovation could contribute to a more dynamic and responsive education system.

While Iran's education system has made strides in enrollment, addressing these structural and pedagogical challenges could enhance its ability to prepare students for the demands of modern society while supporting their psychological and social well-being. (Neuropsychopharmacol Hung 2026; 28(2): 115-130) Keywords: Educational, Iran, Psychology, current trends.

There is still insuffi cient data whether problematic internet use (PIU) is linked with physical symptoms associated with mental disorders, particularly among student demographics.

This study was conducted to determine whether problematic internet use (PIU) in adults is associated with physical symptoms linked to mental disorders.

An anonymous online survey included the nine-item Problematic Internet Use Questionnaire (PIUQ-9) to measure PIU and the 15-item Patient Health Questionnaire (PHQ-15) to measure physical symptoms associated with mental disorders. Depression symptoms were measured with the Patient Health Questionnaire (PHQ-9) and anxiety symptoms with the seven-item General Anxiety Disorder (GAD-7) scale. The study included 207 students (mean age: 23 ± 3 years, 83.6% women).

Signifi cant correlations were identifi ed between PIUQ-9 scores and physical symptoms. Multivariable regression analysis, adjusting for age, gender, and PHQ-9 and GAD-7 scores, revealed associations between PIU and physical symptoms: extremity/joint pain (β = 0.161, p = 0.019), sexual dysfunction (β = 0.145, p = 0.032), chest pain (β = 0.135, p = 0.047), and fatigue (β = 0.214, p = 0.005).

High levels of PIU in young adults were associated with physical symptoms linked to mental disorders irrespective of age, sex, depression, and anxiety symptoms. (Neuropsychopharmacol Hung 2026; 28(2): 57-65) Keywords: internet addiction disorder, anxiety, depression, medically unexplained symptoms, mental disorders.

Over 700,000 suicides occurring globally each year are a major public health issue. Railways and metros provide a lethal means of suicide, mainly occurring by persons under train (PUT) events. Restriction of means has been shown to be effective in reducing suicides and is increasingly being prioritized in railway settings, e.g., using physical barriers. Here, we instead investigated the changes in suicidal behavior on metro platforms following the implementation of an AI-based CCTV detection system.

We used longitudinal data about PUT due to suicidality in the Swedish metro system in Stockholm (2010-2025). A controlled interrupted time series (CITS) analysis, as well as uncontrolled analyses, were used to test if an AI-CCTV implementation in Q4 2021 (at 14 stations) was associated with decreased rates of PUT due to suicidality, compared to the other 86 stations as controls. We also evaluated secondary outcomes (e.g., suicide deaths and train-traffic cancellations). Sensitivity analyses assessed the robustness of the primary model. A separate exploratory analysis examined an extended post-period, which included multiple heterogeneous system-wide exposures.

Rates of PUT due to suicidality were lower after AI-CCTV implementation, in analyses with (IRR = 0.27, p < 0.05) or without (IRR = 0.41, p < 0.05) controls. Secondary outcomes showed consistent point estimates, e.g. death by suicide after PUT (IRR = 0.3), safeguarded individuals (IRR = 0.8) and less cancelled train-kilometers in the metro system. The robustness of the changes in PUT and death by suicide outcomes were confirmed by Bayesian sensitivity analyses using weak priors.

Implementation of AI-CCTV as described herein was associated with lower rates of PUT due to suicidality at metro stations, as well as changes in the same direction for e.g. deaths by suicide and less cancelled train-kilometers. This preliminary study of AI-CCTV in the metro system provides a specific example of how such an intervention may support suicide prevention in the metro system, at least in the short-term.

A piezoelectric drill can fenestrate semicircular canals while preserving the membranous labyrinth.

Semicircular canal surgery carries a high risk of impairing auditory and vestibular function, limiting potential benefit to a small subset of patients. A piezoelectric drill might selectively disintegrate bone while sparing the membranous labyrinth and its endolymphatic compartment. Such selectivity could be particularly advantageous for patients who may benefit from vestibular implantation or semicircular canal plugging but have functional hearing and/or vestibular function.

Formalin-fixed human temporal bones were included after skeletonizing ('bluelining') the semicircular canals. A piezoelectric drill with an oval-shaped osteoplasty insert was then used to drill 2 fenestrations in each semicircular canal. These locations were cleaned, and the integrity of the membranous labyrinth was assessed at each fenestration site with a surgical microscope.

In total, 60 fenestrations were made in 30 semicircular canals from 10 temporal bones. The membranous labyrinth was intact at all these fenestration sites.

Piezoelectric surgery appears feasible for consistently fenestrating the semicircular canals while preserving the membranous labyrinth. It may enable safer semicircular canal procedures, such as vestibular implantation, in patients with residual inner ear function.

Cardiovascular disease (CVD) is one of the major chronic non-communicable diseases worldwide, with high incidence and mortality. This study aims to investigate the association of the triglyceride-glucose index-to-waist-to-height ratio (TyGI-WHtR) with CVD and its subtypes [myocardial infarction (MI) and stroke] in middle-aged and older Chinese adults.

This prospective cohort study was based on 3 follow-up surveys of the China Health and Nutrition Survey (CHNS) from 2009 to 2015. A total of 5 395 participants aged 40 to 80 years who were free of CVD at baseline and had participated in at least 2 survey waves were included. Cox proportional hazards models were used to evaluate the associations of TyGI-WHtR with CVD and its subtypes. Weighted generalized additive models and smooth curve fitting were applied to explore potential nonlinear relationships. Time-dependent receiver operating characteristic (ROC) curves assessed predictive performance, and Kaplan-Meier analysis was used to calculate cumulative incidence of CVD across different groups.

During a median follow-up of 72 months (interquartile range: 48 to 72 months), 210 incident CVD events were recorded, including 126 strokes and 92 MIs. Among them, 8 patients had both MI and stroke. After adjustment for confounders, each one-standard-deviation (SD) increase in TyGI-WHtR was associated with a significantly higher risk of incident CVD [adjusted hazard ratio (HR)=1.397, 95% confidence interval (CI) 1.111 to 1.758] and incident MI (adjusted HR 1.747, 95% CI 1.241 to 2.460), while no statistically significant association was observed with stroke (adjusted HR=1.198, 95% CI 0.890 to 1.613). Compared with lowest quartile, participants in the highest TyGI-WHtR quartile had significantly increased risks of CVD and MI (both P for trend <0.005), whereas no such trend was observed for stroke (P for trend=0.103). Further analyses revealed a nonlinear association between TyGI-WHtR and CVD. When TyGI-WHtR was <4.804, HR was 2.121 (95% CI 1.350 to 3.333); when it was ≥4.804, HR was 1.066 (95% CI 0.754 to 1.507). The nonlinear inflection point for stroke was 4.477, while the association with MI remained linear [ln(likelihood ratio)=0.212]. Time-dependent ROC analysis showed that the area under the curve of TyGI-WHtR for predicting CVD was 0.629, with a sensitivity of 77.3%, and specificity of 43.2%.

In middle-aged and older Chinese adults, TyGI-WHtR is an independent risk factor for incident CVD, particularly MI, but is not independently associated with stroke. Moreover, its predictive ability for CVD demonstrates a nonlinear saturation-threshold effect, with risk significantly increased only when TyGI-WHtR is below 4.804.

Isoflurane-induced neuroinflammation triggers cognitive impairment in aged mice, but its underlying mechanism remains unclear. This study investigated the molecular mechanism by which isoflurane promotes glycolytic reprogramming to cause cognitive dysfunction in aged mice and identified potential therapeutic targets. 18-month-old mice were placed in an anaesthetic induction chamber containing 2% isoflurane (ISO) for 2 h to induce anaesthesia; this procedure was repeated daily for 5 days to establish a model of age-related cognitive impairment in mice. Behavioural studies in mice were conducted using the Y-Maze, contextual fear conditioning test (CFCT), Novel Object Recognition (NOR) test, and water maze test. Immunofluorescence analysis was employed to detect changes in the expression of microglia-related proteins PGK1, Hip, iNOS, Arg1, and P65. RT-PCR was employed to detect changes in mRNA expression levels of GLUT2, PKM2, HK2, and LDHA, which are associated with cellular metabolic reprogramming. ELISA was used to measure alterations in TNF-β, IL-4, IL-10, IL-6, IL-1β, and TNF-α cytokines. ISO enhanced glycolytic flux via PGK1, thereby driving microglia polarization toward the pro-inflammatory M1 phenotype and triggering neuroinflammation, ultimately leading to cognitive impairment in mice. Supplementing the glycolytic intermediate FBP reversed the anti-inflammatory effects induced by PGK1 knockdown, confirmed that PGK1 exerted its effects through the "PGK1-glycolysis axis." Mechanistically, PGK1 knockdown effectively suppressed M1 polarization of microglia while promoting their transition to the anti-inflammatory M2 phenotype. This significantly mitigated ISO-induced neuroinflammation and neuronal injury, ultimately improving cognitive function in mice. These findings reveal that PGK1 serves as a key molecular link between ISO anaesthesia and neuroinflammatory cognitive impairment. Targeting and inhibiting PGK1 exerts neuroprotective effects by reprogramming microglial glucose metabolism and phenotype, providing novel theoretical insights and potential therapeutic strategies for preventing ISO-induced neurological complications.