Infants admitted to neonatal intensive care units are at increased risk of hearing loss, yet early identification remains challenging. Understanding circulating biomarkers of hearing loss may improve risk stratification and inform targeted surveillance and intervention.

To assess whether biological factors measured in bodily fluids predict hearing loss in neonates admitted to the neonatal intensive care.

Systematic review and meta-analyses were conducted (registration ID: CRD42024531492). Comprehensive searches were undertaken to identify peer-reviewed studies published between 2000 and 2025 evaluating fluid biomarkers and hearing outcomes in neonates. Risk of bias was assessed across five domains. Biomarkers were grouped by biological domain and synthesised narratively. Where feasible, random-effects meta-analyses were performed using odds ratios and restricted maximum likelihood estimation for calculation of pooled effect sizes.

Eighty-six studies were included, predominantly retrospective cohorts with substantial methodological heterogeneity. Elevated bilirubin exposure (n = 44 studies) was consistently associated with hearing loss, with unbound bilirubin demonstrating superior predictive performance. Infective conditions (n = 32 studies), particularly congenital cytomegalovirus, meningitis, and invasive fungal infections showed significant associations with hearing loss. Risk of bias was moderate to high across studies, driven by inconsistent hearing outcomes measures, poor repeatability of biomarker measures and limited inclusion of risk factors and confounders which affect biomarker concentrations.

Systemic neonatal biomarkers, particularly unbound bilirubin and infective markers, show consistent associations with hearing loss, though high heterogeneity limits precision. Evidence was heterogeneous and largely exploratory. Future studies should utilise integrated databases where data have rigorous confounder adjustment, standardised biomarker assessments, and validated hearing outcome measures to identify clinically meaningful biomarkers of hearing loss.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024531492.

Acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD) frequently result in hospitalization of the patients. The sleep health of patients admitted to the hospital with COPD exacerbations may be overlooked. The objective of this study was to assess and define the prevalence of sleep and mental health complaints among patients admitted with acute exacerbations of COPD.

In this prospective study, patients admitted with an episode of COPD exacerbation at a local community hospital were given a list of questionnaires pertaining to sleep and mental health. These questionnaires included the Beck Depression Inventory (BDI-II), the Functional Outcomes of Sleep Questionnaire (FOSQ), the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI). Questionnaires were administered in a stable, steady state on discharge.

53 patients filled out the questionnaires. 50.9% of patients reported poor sleep quality with scores indicative of chronic insomnia, and 41.2% of patients reported excessive daytime sleepiness on the PSQI. 64% of patients indicated abnormal total scores (<18) on the FOSQ, with 84.3% of patients reporting severe impairment in social outcomes. Clinical depression BDI scores >9) was seen in 73% of patients.

Our results indicate a significant prevalence of sleep and mental health comorbidities in patients hospitalized for acute COPD exacerbations and highlight the need for screening tools and clinical interventions to reduce the burden of these comorbidities.

Major depressive disorder (MDD) is a prevalent psychiatric condition associated with significant suicide risk. Sequential accelerated theta-burst stimulation (aTBS), which integrates time-efficient stimulation with sequential modulation of multiple targets, represents a promising neuromodulation strategy. However, the efficacy and safety of sequential aTBS in adults with MDD and active suicidal ideation remain unexplored. This study aims to evaluate the therapeutic safety and effect of sequential aTBS on suicidal ideation in adults with MDD, and to explore its associated neurophysiological mechanisms using electroencephalography-derived P300 event-related potentials.

This study is a single-blind, randomized controlled trial. Fifty-six adults with MDD will be recruited and randomly assigned (1:1) to receive either active sequential bilateral Dorsolateral Prefrontal Cortex (DLPFC) aTBS (10 weekday sessions; 3600 pulses per session) consisting of continuous theta-burst stimulation (cTBS) applied to the right DLPFC followed by intermittent theta-burst stimulation (iTBS) applied to the left DLPFC, or sham stimulation. The primary outcomes will be response and remission rates based on the 17-item Hamilton Depression Rating Scale (HAMD-17). Secondary outcomes will include the Beck Depression Inventory-II (BDI-II), the Columbia Suicide Severity Rating Scale (C-SSRS), and electroencephalography (EEG)-derived electrophysiological markers of cognitive processing (P300). Safety and tolerability will be systematically evaluated throughout the study using the Treatment Emergent Symptom Scale (TESS) to record stimulation-related adverse events. Outcome measures will be assessed at baseline, immediately after the 10-day intervention, and at 2-week and 4-week follow-ups to evaluate the short-term sustainability of treatment effects.

The results of this study will provide information regarding the efficacy and safety of sequential aTBS for MDD, evaluating its feasibility and thereby laying a foundation for future clinical interventions and scientific research.

https://www.medicalresearch.org.cn/index, identifier ChiCTR2500109181.

Smoking cigarettes remains a leading modifiable risk factor for preventable health conditions. In the United States, the health burden of smoking disproportionately impacts low-income individuals. Multimorbidity is common in this group, complicating treatment and worsening outcomes. Identifying multimorbidity clusters can support targeted, individualized interventions. This study aimed to identify multimorbidity clusters among individuals who smoke and experience economic hardship and provide clinical recommendations to enhance health outcomes.

Individuals who smoke and experience economic hardship (N = 60) were recruited from the San Francisco Health Network (SFHN) and were assessed for physical and mental conditions. Cluster analysis was conducted using a Mixture of Bernoulli (MoB) model to identify subgroups of participants based on co-occurring physical and mental health conditions. Relative risks (RRs) were calculated to compare the likelihood of each condition across clusters, and 95% confidence intervals were used to assess statistical significance.

Cluster analysis identified three groups: Physical Multimorbidity, Mental-Physical Multimorbidity, and Lower Health Burden. Gender was significantly associated with cluster membership: males were more likely to be in the Physical Multimorbidity cluster, and females were more likely to be in the Mental-Physical Multimorbidity cluster (p < 0.01). Findings should be interpreted cautiously given the small sample size and exploratory nature of the cluster analysis.

Individuals who smoke and experience economic hardship exhibited three multimorbidity clusters-Physical Multimorbidity, Mental-Physical Multimorbidity, and Lower Health Burden-indicating both overlapping and distinct patterns of chronic health conditions. Chronic pain was common across the more complex clusters, whereas depression and anxiety characterized the Mental-Physical Multimorbidity cluster. These findings highlight the need for tailored and person-centered smoking cessation strategies that address both shared and unique physical and mental health challenges in this high-risk population.

Employees are severely affected by psychological distress, poor cardiometabolic health, and reduced productivity. Meditation has emerged as a potential strategy to enhance overall health. This systematic review synthesised the effectiveness of meditation for improving employees' mental health and cardiometabolic risk (CMR) markers across 132 randomised controlled trials (145 intervention groups and 23,080 participants). Most interventions were Mindfulness and Transcendental Meditation, conducted in the USA, and targeting healthcare professionals and educators. Results showed that meditation significantly improved perceived stress (g = -0.51), distress (g = -0.49), job stress (g = -0.53), anxiety (g = -0.38), depression (g = -0.39), well-being (g = 0.41), resilience (g = 0.38), and sleep (g = -0.33), with most effects sustained within three-month follow-ups. Effects on perceived stress, distress, and well-being were sustained at long-term follow-up. Interventions did not show statistically significant differences in blood pressure, cortisol level, heart rate variability, or inflammatory markers. The findings require cautious interpretation due to moderate-to-substantial heterogeneity, high risk of bias, and limited CMR marker studies. The evidence certainty was moderate for well-being and sleep, and low to very low for the remaining outcomes.

Autism spectrum disorder (autism) and schizophrenia spectrum disorders (schizophrenia) exhibit overlapping social and neurocognitive impairment and considerable neurobiological heterogeneity. Blood-oxygen-level-dependent (BOLD) signal variability captures the brain's moment-to-moment fluctuations, offering a dynamic marker of neural flexibility that is sensitive to cognitive capacity. This study aimed to examine intra-regional BOLD signal variability during rest and task across schizophrenia, autism, and typically developing controls (TDC) to explore transdiagnostic patterns of brain signal variability and their relationship with cognitive and functional outcomes. Intra-regional BOLD variability, measured by mean squared successive difference (MSSD), was obtained from resting-state and empathic accuracy task fMRI in 176 SSD, 89 autism, and 149 TDC participants. ANCOVAs, controlling for age, sex, and motion, assessed group differences in intra-regional and network-level BOLD variability and dimensional associations with social cognition, neurocognition, social functioning, and symptom severity. Both autism and schizophrenia exhibited lower BOLD signal variability than TDC across rest and task, with reduced variability observed in somatomotor, visual, and auditory networks (pFDR < 0.01). Greater network variability was positively associated with better social cognitive, neurocognitive, and functional scores across the sample. Resting-state variability showed stronger group-based differences and cognitive associations than task-based variability. BOLD signal variability is positively associated with social cognition, neurocognition, and social functioning across groups, suggesting that variability impacts cognitive efficiency and behavior. Reduced variability in autism and schizophrenia may indicate similar patterns of neural rigidity among these related conditions, positioning BOLD variability as a potential biomarker for neural flexibility and a valuable target for future transdiagnostic clinical interventions.

This study aimed to investigate the prevalence of postpartum depression (PPD) and anxiety disorders among postpartum mothers. Additionally, it examined the effect of comorbidity on PPD.

This study included 206 mothers with babies between 0 and 6 weeks of age who visited the pediatric department for routine health checks. First, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and demographic data were collected from the participants. Subsequently, the Edinburgh Postnatal Depression Scale, the Multidimensional Scale of Perceived Social Support, the Beck Anxiety Inventory, and the Maternal Attachment Inventory were used to evaluate all mothers.

We found that 6.8% (n=14) of the mothers evaluated had PPD, and 21.4% (n=44) had an anxiety disorder. The most common anxiety disorder was generalized anxiety disorder (16.0%, n=33). The percentage of females with comorbid PPD and anxiety disorder was 3.8%. We then compared the postpartum and non-PPD groups in terms of socio-demographic characteristics and found a significant difference pertaining only to economic status. Socio-economic status was lower in the group with PPD. In addition, social support received during pregnancy was significantly lower in the group with PPD. A history of depression (including peripartum depression) and/or comorbid psychiatric disorders was identified as related to PPD.

This study suggests that anxiety disorders are common among postpartum women and are three times more common than PPD within this group. Furthermore, 57.1% (8/14) of the females in our study with PPD also suffered from an anxiety disorder.

Psycholytic therapy, utilizing psychoactive compounds such as d-lysergic acid diethylamide (LSD) to enhance psychoanalytically oriented therapy, was once the most common form of psychedelic-assisted psychotherapy. Despite its historical prominence, little attention has been given to the reasons behind its decline, and there is a lack of standardized guidance for new clinical trials. This review addresses the diversity of psycholytic methods and their association with effectiveness and safety.

A realist review was conducted in which studies were identified via a comprehensive bibliography of publications on psycholytic therapy with entheogens from 1948 to 1995. Intervention variables were examined in relation to rates of adverse events and diagnosis-adjusted improvement, allowing for an analysis of risk factors and practices associated with positive outcomes.

Analysis of studies published from 1954 to 1965 revealed several features conducive to successful therapy: using a flexible, intuitive therapeutic approach; promptly correcting transference issues; maintaining therapist presence throughout; providing more than ten treatment sessions and extensive preparatory work; incorporating creative activities during integration; using maximal tolerated doses; and avoiding abrupt pharmacological termination.

Psycholytic therapy has shown potential to significantly improve severe mental health conditions, especially when trust in the therapist is fostered. Developing a strong therapeutic relationship helps address trauma-based responses resistant to psychotherapy alone, while rapid resolution of internal conflicts may ease the subsequent integration process.

Experiential avoidance is the unwillingness to come into contact with aversive internal experiences. Trauma exposure is associated with greater experiential avoidance and insomnia symptoms. Experiential avoidance may perpetuate insomnia symptoms in patients with posttraumatic stress disorder (PTSD). We examined the relationship between experiential avoidance and insomnia symptoms among veterans with PTSD (based on the Clinician-Administered PTSD Scale for DSM-5).

The sample included 93 veterans (M = 54.7 years; 86.0% male) who attributed their sleep disturbance onset to experiences of trauma on the CAPS-5. Experiential avoidance, insomnia, sleep disturbance, daytime sleepiness, and daytime consequences were measured with the Brief Experiential Avoidance Questionnaire (BEAQ), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and International Classification of Sleep Disorders (ICSD) items. We conducted multiple linear regressions with age, sex, and BEAQ as the independent variables and sleep variables as the dependent variables.

There were significant positive associations between the BEAQ and the ISI, PSQI daily disturbance factor, ESS, and ICSD daytime consequences.

Greater experiential avoidance was associated with worse insomnia symptoms and consequences, particularly daytime dysfunction. Experiential avoidance may be an overlooked, but relevant treatment target for patients with comorbid insomnia and PTSD.

Childhood mental health (MH) problems are a major public health concern due to their high prevalence and well-documented adverse consequences, and are often under-recognized and untreated. Less effective parental emotion socialization practices play a critical role in the emergence of childhood MH problems, influencing children's socioemotional development. Emotion-focused parenting programs, such as Tuning in to Kids^® (TIK), could be a promising approach to promote parents' emotion coaching skills, enabling children to understand and regulate their emotions more effectively, while also supporting parents in managing their own emotions. Prior evidence supports TIK's efficacy in improving children's and parents' MH outcomes across several countries; however, TIK's efficacy has not yet been explored in Southern Europe. This study aims to provide a process and efficacy evaluation of TIK for parents of preschool-aged children in Portugal.

This trial is a parallel two-arm randomized clinical trial, which includes both process (i.e., feasibility and acceptability) and efficacy evaluation (i.e., change in primary and secondary outcomes and moderated effects) of Tuning in to Kids^® in Portugal. A minimum of 152 parents/legal guardians (> 18 years old) with at least one child between 3 and 6 years old will be enrolled. Parents will be randomly assigned to the intervention group or waiting list control group (76 per condition), through blocked randomization, with allocation concealment. Participants in both conditions will complete self-report questionnaires assessing primary (parental emotion socialization) and secondary (parents and children functioning dimensions) outcomes at baseline, post-intervention, and follow-up (2 months post-intervention). Longitudinal data will be analyzed using linear mixed-effects models accounting for repeated measures within participants.

We anticipate that the Portuguese version of Tuning in to Kids^® will be feasible, acceptable and effective in improving parent emotion socialization (e.g., more adjusted parents' beliefs and reactions to children's emotions and emotion regulation skills), and parents' and children's psychological functioning (e.g., less parenting stress and reduced children's emotional/behavioral difficulties). If achieved, these findings will support TIK's use in promoting MH among families.

The clinical trial is registered at ClinicalTrials.gov (Identifier: NCT07350083, date assigned January 13, 2026).