Although there is a high number of aging populations globally, these elderly populations face the challenges of emergency mental health issues, with often inadequate health care facilities. This article aimed to map and synthesize evidence on the management of mental health emergencies in the elderly population in the World Health Organization (WHO) regions. Using a scoping review design, the search for articles was guided by Population (elderly ≥ 60 years), Concept (mental health emergencies), and Context (WHO region states). The final 25 articles included publications from 2003 to 2021, spanning multiple WHO regions except the African.

To evaluate the association between depression and suicidal ideation (SI) screening results among patients in a pediatric and adolescent gynecology clinic and to determine whether associations differ between school and summer periods.

This retrospective cross-sectional study included patients aged ≥ 13 years who completed both the Patient Health Questionnaire-2 (PHQ-2) and Ask Suicide Screening Questions (ASQ) from June 2023 to April 2025. Depression was defined as a PHQ-2 score ≥ 3; SI was defined as any affirmative ASQ response. Simultaneous positive/negative combinations were evaluated, and associations were tested using chi-square or Fisher's exact tests.

Among 1,481 patients, PHQ-2 and ASQ scores were significantly associated (p < 0.0001). Negative PHQ-2 screens corresponded to negative ASQ screens in 1,192 (92.5%) patients. However, 97 (7.5%) patients screened negative for depression but positive for SI, including one (0.1%) with severe SI. Positive ASQ screens were more frequently associated with positive PHQ-2 screens (40.6%) than negative PHQ-2 screens (7.5%). All severe ASQ scores occurred during the school year.

Screening for depression alone is insufficient to identify all adolescents at risk for suicidality. Dual screening with PHQ-2 and ASQ enables more comprehensive identification of at-risk patients in pediatric and adolescent gynecology settings, thereby enabling practitioners to connect such patients with the necessary mental-health resources.

Clinical decision making (CDM) is a vital competence required by nurses, particularly emergency nurses. This study aimed to investigate the relationship between organizational justice and CDM among emergency nurses.

A cross-sectional correlational design was used with 221 emergency nurses from three major public hospitals in Hai'l City, Northeastern Saudi Arabia, from April to June 2025. Data were collected using a sociodemographic characteristics survey, Nursing Decision-Making Scale, and Organizational Justice Questionnaire. The direction and strength of the association between nurses' CDM and organizational justice were measured using Pearson's correlation coefficient (r). Multiple linear regression analysis was used to identify predictors of CDM.

Registered nurses, charge nurses, staff working more than five days per week, and staff who reported higher organizational justice demonstrated significantly higher levels of nursing CDM (p < 0.05). In contrast, regular night shifts were significantly associated with lower CDM (p = 0.009). A significant positive correlation was found between nursing CDM and organizational justice (r = 0.320, p < 0.001), with a corresponding linear R² value of 0.102, indicating that approximately 10.2% of the variance in nursing CDM can be explained by organizational justice.

This study demonstrates the vital role of organizational justice in influencing emergency nurses' CDM. The findings indicated that nurses' perceptions of procedural justice significantly influenced their engagement and satisfaction in clinical settings.

Research using the multidimensional sleep health (MDSH) framework has increased globally, often relying on self-report measures. The Ru-SATED scale and Sleep Health Index (SHI) are common self-report measures of MDSH, but comparative data on their measurement properties and contextual characteristics remain limited. Seven electronic databases were searched for measurement properties and uses of the two scales over the past twelve years. This review identified 19 psychometric validation studies concerning two original and 17 cross-cultural, and summarized contextual comparison of MDSH measures and frameworks. Measurement properties of both measures were assessed with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline, and contextual comparisons were conducted narratively. Both measures exhibited acceptable psychometric properties across diverse cultural settings, with the SHI findings showing greater consistency than those of the Ru-SATED scale. Aggregating the Ru-SATED and SHI frameworks fully covered the sleep characteristics assessed by five instruments grounded in the World Sleep Society initiative, encompassing regularity, satisfaction, alertness, timing, efficiency, duration, and disorder. Notably, the SHI framework incorporates targeted sleep disorder assessment while the Ru-SATED framework specifically excludes such assessment, highlighting the distinct focus and scope of each tool. Instrument selection depends primarily on research purpose, study sample, and intended use. We recommend characterizing both sleep health and sleep disorders to fully capture the complex relationships between sleep and health outcomes.

This study aimed to evaluate the clinical efficacy of acupuncture combined with gradual benzodiazepine dose reduction in patients with benzodiazepine-dependent insomnia (BDI) and to assess associated withdrawal outcomes.

A total of 64 patients with BDI were randomly assigned to either the acupuncture plus gradual benzodiazepine reduction group (ARB, n = 32) or the placebo acupuncture plus gradual benzodiazepine reduction group (PARB, n = 32). Treatments were administered five times per week for 4 weeks, followed by an 8-week observation period. The primary outcomes were changes in Insomnia Severity Index (ISI) scores and the drug reduction rate of benzodiazepines (DRRB). Secondary outcomes included the rate of successful discontinuation and scores on the Fatigue Scale-14 (FS-14).

Sixty-three patients completed the trial (ARB group, n = 32; PARB group, n = 31). Patients in the ARB group demonstrated significantly greater reductions in ISI scores compared with those in the PARB group (p = 0.005 for week 4-week 0 and week 12-week 0 comparisons). The DRRB was also significantly higher in the ARB group compared with the PARB group (p = 0.002 for week 4-week 1 and p < 0.001 for week 12-week 1). At week 12, the ARB group additionally demonstrated lower FS-14 scores and a higher rate of successful benzodiazepine discontinuation.

Acupuncture combined with gradual benzodiazepine reduction significantly reduced insomnia severity and promoted benzodiazepine discontinuation in patients with BDI.

Nucleobase-containing peptides (nucleopeptides) represent a unique class of biohybrid molecules that combine the structural versatility of peptides with the functional properties of nucleobases, enabling programmable self-assembly and selective molecular interactions. These features position nucleopeptides as promising tools for biomedical and supramolecular applications. Here, we report the synthesis and characterization of a novel nucleopeptide derived from a tryptophan dipeptide (WW) functionalized with a thymine (T) base, termed WWT. Circular Dichroism and UV-Vis spectroscopy revealed distinctive spectral features and supramolecular organization in solution, confirmed by Dynamic Light Scattering. Binding studies showed no detectable interaction with DNA or RNA, whereas measurable spectral perturbations indicated affinity for bovine serum albumin. Metal-binding experiments with Ni(II) and Cu(II) further highlighted the influence of these ions on the modulation of WWT's optical properties, while computational modelling using HDOCK complemented the experimental data by predicting aggregation modes and protein-binding interfaces. To explore biological relevance, we integrated controlled exposure of IMR-90 human fibroblasts and Jurkat T lymphocytes with proteomics and metabolomics, identifying time-dependent modulation of pathways linked to metabolism, RNA/DNA processing, and T-cell signaling. Functionally, WWT enhanced fibroblast migration without altering lysosomal, mitochondrial, or cytoskeletal organization. Overall, this study provides the first combined synthetic, spectroscopic, computational, and multi-omics evaluation of WWT properties and effects, revealing its organized supramolecular behaviour, selective biomolecular interactions, and potential pro-regenerative properties.

Obsessive-compulsive disorder (OCD) frequently emerges during adolescence, a critical period for the development of static and dynamic properties of large-scale brain networks. Although previous studies have reported altered static connectivity in adolescents with OCD, the temporal organization of functional networks during this stage remains largely unexplored.

We analyzed resting-state fMRI data from 40 adolescents with OCD and 40 age- and sex-matched healthy controls. Group independent component analysis (ICA) was used to identify intrinsic connectivity networks (ICNs). A sliding-window approach and k-means clustering were applied to derive dynamic brain states, while graph-theoretical metrics (strength, local efficiency, clustering coefficient) were computed to assess nodal variability over time. Group comparisons were performed using general linear models controlling for age and sex, and symptom correlations were tested using partial correlation analyses.

Compared to controls, OCD patients spent significantly less time in a globally integrated brain state characterized by strong intra- and inter-network connectivity. At the local level, reduced temporal variability was observed in the striatum, thalamus, and dorsolateral prefrontal cortex, key nodes of the cortico-striato-thalamo-cortical (CSTC) circuit. Notably, reduced striatal variability correlated with greater OCD symptom severity and decreased time in the integrated brain state.

These findings reveal disrupted dynamic network integration and reduced functional flexibility in adolescents with OCD, both globally and locally. This multilayered impairment may reflect early pathophysiological mechanisms and offers potential targets for age-sensitive neuromodulation strategies.

ChiCTR2400092275, Chinese Clinical Trial Registry (www.chictr.org.cn).

Pre-frailty is a high-risk state prevalent in older adults, representing a critical window for intervention. Pickleball, a popular paddle sport, offers a unique blend of physical activity and social engagement, but its efficacy in reversing pre-frailty remains understudied. This study aimed to investigate the effects of an 8-week pickleball training program on pre-frailty, physical fitness, 24-hour movement behaviors, and quality of life in community-dwelling older adults.

72 older adults [age: median (interquartile range) = 67 (5)] with pre-frailty were randomly assigned to either a pickleball intervention group (n = 36) or a control group (n = 36). The pickleball group participated in supervised 8-week pickleball sessions, while the control group maintained their usual lifestyle. Outcomes included frailty status, functional fitness, 24-hour movement behaviors (assessed using accelerometers and compositional data analysis), and quality of life. Analyses followed an intention-to-treat principle with multiple imputation for missing data. Between-group differences in pre-frailty reversal rates were assessed using Fisher's exact test and absolute recovery increase. Generalized estimating equation models were used to evaluate Group × Time interactions for outcomes.

After 8 weeks, 42% of the pickleball group transitioned from pre-frailty to non-frailty, compared to 8% in the control group (p < 0.001). Statistically significant improvements were observed in functional fitness, including the 30-second chair stand [β = 4.89, p < 0.001], 30-second arm curl [β = 3.70, p < 0.001], back scratch [β = 3.27, p = 0.003], and 6-minute walk distance [β = 31.10, p = 0.041]. Quality of life improved for both physical [β = 2.37, p = 0.040] and mental health scores [β = 4.83, p = 0.001]. Compositional data analysis showed a favorable shift in movement behaviors, with reduced sedentary time [β = -37.19, p = 0.028] and increased light physical activity [β = 17.43, p = 0.033] in the pickleball group.

An 8-week pickleball intervention effectively reversed pre-frailty, improved functional fitness, and enhanced quality of life. These findings suggest pickleball as a promising exercise for preventing frailty and promoting healthy aging.

Chinese Clinical Trial Registry ChiCTR2500098832. Registered March 13, 2025.

Mild traumatic brain injury (mTBI) is often considered low risk, yet growing evidence suggests that outcomes may differ by sex, and when explored, also by gender. We examined sex-associated differences in structural injury, acute-care complications, and neuropsychiatric diagnoses for patients with mTBI.

This retrospective cohort study used the TriNetX Global Health Research Network to identify adults (≥18 years) diagnosed with mTBI (Glasgow Coma Scale 13-15) between 2010 and 2022. Patients were identified using ICD-10 codes (S06, S09, R40.2411-R40.2413), with exclusion of moderate and severe TBI. Outcomes were assessed at 1 month, 6 months, 1 year, and 2 years. Propensity score matching (1:1) was performed to balance demographic and clinical characteristics. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression.

Among 26,829 patients with mTBI, 9,999 (37.3%) were female and 16,830 (62.7%) were male. After matching, 9,649 patients remained in each cohort. Female patients had significantly lower odds of intracranial lesions, including epidural hematoma (OR 0.59, 95% CI 0.46-0.76) and subdural hematoma (OR 0.79, 95% CI 0.73-0.87), as well as lower odds of mortality, intensive care unit admission, neurosurgical intervention, and systemic complications across follow-up. In contrast, females demonstrated higher odds of anxiety (OR range 1.86-1.95) and depression (OR range 1.63-1.81) at all time points.

In this large cohort, women with mTBI exhibited lower structural and acute-care burden but higher long-term neuropsychiatric sequelae. These findings highlight the importance of sex- and gender-informed approaches to acute risk stratification and longitudinal mental health follow-up after mTBI.

Stress engages coordinated psychological, neuroendocrine, autonomic, and neural processes that enable adaptation to environmental demands but may contribute to vulnerability when stress is prolonged, uncontrollable, or socially evaluative. Functional neuroimaging has become central to psychoneuroendocrinology by enabling direct investigation of how acute stress shapes brain activation and connectivity and how these neural responses interact with hypothalamic-pituitary-adrenal axis regulation. This editorial introduces the Special Issue "Effects of stress on brain activation changes: Recent developments" and outlines key conceptual and methodological advances in the field. We highlight progress from endocrine-marker-based stress research toward brain-based models of stress, emphasizing evidence from scanner-based paradigms such as the Montreal Imaging Stress Task and ScanSTRESS, as well as emerging multimodal approaches including fNIRS, PET, EEG, and harmonized large-scale analyses. We discuss recent developments concerning exposure-time effects, network-level models of stress processing, and the importance of functional connectivity. We further emphasize the need to account for individual and contextual variability, including sex, gender, developmental stage, clinical vulnerability, and real-world stress relevance. This Special Issue invites contributions that use neuroimaging to advance mechanistic, translational, and reproducible models of stress-related brain function.