Real-world evidence on the long-term use of dupilumab in very young children with moderate-to-severe atopic dermatitis (AD) remains limited. Observational data are needed to complement clinical trial findings by describing treatment outcomes in routine clinical practice.

This multicenter retrospective study included children aged 6 months to 5 years with moderate-to-severe AD treated with dupilumab through the Italian Named Patient Program. Clinical assessments were performed at baseline and at weeks (W) 16, 24, 36, and 52. Disease severity, quality of life, and symptom burden were evaluated using the Eczema Area and Severity Index (EASI), Children's Dermatology Life Quality Index (c-DLQI), pruritus-numeric rating scale (P-NRS), and sleep-numeric rating scale (S-NRS). EASI-50/75/90 responder rates were calculated at each time point. Safety data were collected throughout treatment. Growth parameters were monitored between baseline and W52.

Forty-seven children were included. Dupilumab led to rapid and progressive improvement of AD severity, with mean EASI decreasing from 26.1 at baseline to 2.7 at W52 (-89.7%). Marked improvements were also observed in quality of life (-91.3% in c-DLQI), itch intensity (-82.5% in P-NRS), and sleep disturbance (-82.7% in S-NRS). At W52, EASI-75 and EASI-90 responses were achieved by 79.5% and 59.0% of evaluable patients, respectively. Dupilumab was well tolerated, with treatment-emergent adverse events occurring in 10.6% of patients, all mild or moderate and none leading to discontinuation. Weight- and height-for-age z-scores significantly increased over 52 weeks; no child newly developed values below -2 standard deviations, although 1 child remained below this threshold at W52. Percentile-based analyses yielded consistent results, confirming the absence of negative effects on growth.

Dupilumab was effective and well tolerated over 52 weeks in children aged 6 months to 5 years with moderate-to-severe AD, providing sustained skin clearance, symptom relief, and quality-of-life improvement. These findings support dupilumab as a valuable long-term therapeutic option in very young children with uncontrolled AD in clinical practice.

In addition to biological factors, human social behavior, societal structures, and environmental contexts significantly influence the human microbiome. This review examines how socially relevant factors relate to the microbiome to clarify underlying mechanisms and health impacts, aiming to inform effective preventive and therapeutic strategies.

We synthesized relevant literature from PubMed using a biopsychosocial framework, integrating structural socio-political and contextual factors to elucidate interactions between social behavior and the microbiota.

Social behavior shapes the microbiome through complex biological, psychological, and socio‑cultural pathways, with health consequences involving immune, mental, and metabolic functions. Future research should clarify the fundamental drivers of this relationship, identify individual differences, and employ longitudinal designs to measure sustained effects.

Depression in older adults has been associated with negative health outcomes, such as dementia. Previous research has demonstrated that green and blue spaces, defined as areas of vegetation or bodies of water respectively, are beneficial to mental health, although the biological mechanisms are poorly understood. One of the mechanisms proposed is DNA methylation (DNAm). DNAm is an epigenetic process that alters gene expression. Changes in methylation have been observed in those with depression, and associated with green space exposure, while blue spaces have been shown to reduce the risk of depression. Using a mechanistic review approach, we investigated the relationships of green space and depression with DNAm with the aim of identifying potential overlapping mechanisms. In the environmental search, keywords such as 'green space' and 'DNAm' were combined. In the mental health search, keywords such as 'DNAm' and 'depression' were combined. From a total of 45 695 papers returned, four studies on green space, and five studies on depression met the eligibility criteria for this review. All included studies reported significant or suggestively significant methylation sites. No overlapping CpG sites were identified when comparing methylation changes found in response to green space and depression. Changes in the RGS12 gene were associated with both depression and green space exposure. DNAm is a biological mechanism that may contribute to the impact of exposure to green space; further research is warranted to better understand DNAm as a mechanistic pathway between green space and depression.

The surgical options for medically refractory trigeminal neuralgia (TN) are diverse, with limited comparative evidence. This study evaluates and compares pain-free period and time to recurrence for patients who underwent microvascular decompression (MVD), gamma knife radiosurgery (GKRS), and radiofrequency ablation (RFA).

A retrospective review of patients with medically refractory TN over a 10-year period from 2009 to 2018 at a tertiary neurosurgical center was performed. Patients with at least 1 year of follow-up after the treatment procedure were included. Clinical details, radiological records, intraoperative findings, and treatment details of radiosurgery and ablative procedures were recorded.

A total of 189 patients were included, the mean age being 52.54 (± 13.3) years, with a male:female ratio of 1.52:1. The mean duration of symptoms was 70.19 (± 57.6) months, with 86.3% of patients presenting with type 1 neuralgia. The median follow-up duration was 84, 100, and 67 months for MVD, GKRS, and RFA, respectively. The percentages of patients with favorable outcomes (Barrow Neurological Institute Pain Intensity Score [BNI I-IIIa]) were 87.8, 67.3, and 66.5%, respectively, for MVD, GKRS, and RFA. The median pain-free intervals were 65, 59, and 36 months, with recurrence rates of 24.2, 25, and 40.5% for MVD, GKRS, and RFA, respectively.

This study reaffirms MVD as the best first-line treatment for medically refractory TN, with GKRS being a useful alternative in patients who are surgically unfit or unwilling, and an optimum second-line treatment for those with recurrences. RFA is useful as an adjunct in patients unfit for surgery, with a high initial efficacy albeit with high recurrence rates.

Glomus tumors are rare, slow-growing, hypervascular skull base tumors and frequently involve critical neurovascular structures. Surgical resection is technically challenging and is associated with high morbidity rates due to lower cranial nerve injury and CSF leak. Gamma knife radiosurgery (GKRS) has revolutionised the management of these lesions with high clinical and tumor control rates and a low side effect profile. In this study, we have attempted to study the tumor and clinical control rate along with the prediction factors.

This is a retrospective data review of all patients with glomus jugulare tumors from 2010 to 2023 who underwent GKRS in our center. Clinical, neuroimaging, and radiosurgical treatment were re-reviewed, and all patients' prognostic factors for clinical and tumor control were analyzed.

The study included 95 patients. The median age was 45 years, with three-fourths of our patients being female, 69 (72.6%). Hearing loss was the most common symptom. The median marginal dose at the 50% isodose line was 16 Gy. The mean tumor volume was 8.7 cc, and the mean treatment volume was 8.3 cc. The tumor control rate in our study period was 96.9%. Younger age and Glasscock-Jackson type 1 were found to be worse and a good prognostic factor, respectively. The clinical control rate in our study was 93.9%, with no related significant prognostic variable in our study.

Gamma knife is a safe and effective treatment option for these formidable tumors with a very low complication rate.

Substance use disorders (SUDs) pose significant mental health challenges due to their chronic nature, health implications, impact on quality of life, and variability of treatment response. This systematic review critically examines the application of machine learning (ML) algorithms in predicting and analyzing treatment outcomes in SUDs. Conducting a thorough search across PubMed, Embase, Scopus, and Web of Science, we identified 28 studies that met our inclusion criteria from an initial pool of 362 articles. The MI-CLAIM and CHARMS instruments were utilized for methodological quality and bias assessment. Reviewed studies encompass an array of SUDs, mainly opioids, cocaine, and alcohol use, predicting outcomes such as treatment adherence, relapse, and severity assessment. Our analysis reveals a significant potential of ML models in enhancing predictive accuracy and clinical decision-making in SUD treatment. However, we also identify critical gaps in methodological consistency, transparency, and external validation among the studies reviewed. Our review underscores the necessity for standardized protocols and best practices in applying ML within SUD while providing recommendations and guidelines for future research.

The online version contains supplementary material available at 10.1007/s11469-024-01403-z.

Preclinical and clinical evidence has implicated inflammation in the pathophysiology of depression. Abnormal cytokine levels in blood, cerebrospinal fluid, and post-mortem brain samples have been associated with depression. To our knowledge, however, a comprehensive analysis of cytokine protein levels in brain samples from patients with depression has yet to be conducted in major components of the limbic system such as the ventromedial prefrontal cortex (vmPFC). This region plays a crucial role in depression, impacting cognitive control, emotional regulation, and executive functions. In the current exploratory study, we performed a comprehensive profiling of 72 cytokines, chemokines and growth factors in well-characterized vmPFC samples from 34 depressed suicides and 14 matched sudden-death controls. A human antibody array (RayBio®, chemiluminescent detection) was used to measure all markers. In depressed suicide samples, no significant increase in any cytokine, chemokine or growth factor was detected compared to controls. In comparison, in an independent cohort we measured the levels of 43 inflammatory markers in plasma samples from 141 depressed living subjects and 36 controls using the Mesoscale Discovery V-plex assay. Our analyses indicated no significant difference in the levels of pro- or anti-inflammatory markers in the plasma of cases vs controls. We also conducted a detailed morphological analysis of Iba1-immunostained microglia in vmPFC gray matter samples from 28 depressed suicides and 13 healthy controls. The distributions of the various morphological phenotypes assessed were similar between groups, suggesting that microglia/macrophages do not display signs of morphological changes in the vmPFC of depressed suicides. Taken together, these complementary experiments do not provide evidence of depression-associated neuroinflammatory changes in the vmPFC, at least in the samples analyzed.

Obsessive-Compulsive Disorder (OCD) can present significant challenges to individuals mental health, characterized by intrusive thoughts and repetitive maladaptive behaviors. Recent research into alternative treatments has highlighted psychedelics, notably psilocybin, for their potential therapeutic benefits in various psychiatric disorders, including OCD. This case study evaluated the impact of self-administered, low-doses of psilocybin, commonly referred to as microdosing, on symptom reduction and cognitive flexibility in OCD, with a focus on identical twins discordant for the condition.

The study documents the experiences of one twin diagnosed with OCD who began a regimen of low-doses of psilocybin containing mushrooms, while the other twin, unaffected by OCD, served as a comparison. Case X was diagnosed with OCD by a general practitioner in the Danish healthcare system. Following years of severe OCD, case X began a self-medicated regimen consisting of psilocybin containing mushrooms, corresponding to 1-5 mg of psilocybin, every 3^rd day. The other twin, case Y, who remained unaffected by OCD, and did not take psilocybin containing mushrooms. Cognitive flexibility was evaluated in both cases using a set-shift task. The affected twin reported a notable reduction in OCD symptoms, along with improvements in emotional regulation and overall well-being. However, despite these symptomatic improvements, deficits in cognitive flexibility remained present compared to the unaffected twin.

This case study underscores the potential of low-doses of psilocybin as a promising avenue for mitigating symptoms of OCD. Nevertheless, the observed disparity in cognitive flexibility highlights the nuanced nature of OCD pathology, suggesting that while low-doses of psilocybin may alleviate certain symptoms, it may not fully address underlying cognitive impairments. Further research employing larger sample sizes and rigorous longitudinal designs is imperative to elucidate the mechanisms underlying the therapeutic effects of psilocybin low-doses in OCD, offering insights into its broader applicability as a treatment modality.

[This corrects the article DOI: 10.3389/fpsyt.2026.1798373.].

Police officers are exposed to elevated psychological risks due to both operational and organizational stressors. Additionally, police officers tend to resort to avoidant coping strategies, which exacerbate poor mental health outcomes, such as burnout and PTSD.

This study aims to examine clinical symptoms (stress, anxiety, depression), coping styles, and perceived stressors among police forces from Catalonia, Spain. A total of 741 officers completed an online survey comprising DASS-21, PSQ-Op, PSQ-Org, Brief COPE and brief open-ended questions.

Overall, both operational and organizational stressors were significant predictors of clinical symptoms, with the latter revealing a more pronounced impact. Avoidant coping emerged as the strongest risk factor for distress, while problem-focused coping emerged as a possible protective factor, especially against depression. Both gender and years of service influenced coping strategies: i) female officers reported higher use of adaptive coping, while male officers scored higher in avoidant coping; and ii) more experienced officers reported lower anxiety symptoms but also lower use of active coping strategies.

These findings underscore the importance of addressing both organizational culture and individual-level factors in promoting psychological resilience, while considering gender and career stage to support sustainable mental health within police forces.