Strengthening patient safety culture (PSC) is essential for enhancing clinical practice, teamwork, and nursing leadership in surgical settings. However, evidence on interventions that promote PSC in operating rooms (ORs) in low- and middle-income countries remains limited.

To evaluate the association between a multifaceted intervention and PSC perceptions among OR professionals in a resource-limited setting.

A quasiexperimental, nonrandomized before-and-after study with a concurrent control group was conducted over 21 months across 12 ORs in two tertiary hospitals in Tunisia. One hospital served as the intervention site and the other as the control site. All eligible healthcare professionals (n = 347; surgeons, anesthesiologists, nurses, OR specialized nurses, and assistant caregivers) were invited to participate. The intervention focused on implementing the Surgical Safety Checklist (SSC) and included team-based training, practice runs, awareness campaigns, local nurse champions, continuous mentorship, and audit and feedback processes. Data were collected at three time points (baseline, postintervention, and follow-up) using the French version of the Hospital Survey on PSC. All data were anonymized to ensure confidentiality.

The intervention was associated with significant and sustained improvements in four key dimensions of PSC: "Organizational learning-continuous improvement" increased from 37.7% to 50.6%, "Teamwork within units" from 47.6% to 59.1%, "Communication openness" from 27.2% to 46.2%, and "Teamwork across units" from 29.2% to 37.5%. The overall perceived level of safety increased from 70.7% at baseline to 82.4% postintervention and was sustained at follow-up.

A multifaceted intervention focusing on SSC implementation and incorporating team-based training, continuous feedback, and supported practice was associated with improved PSC perceptions in a resource-limited setting. Such approaches may support the sustainable integration of safety protocols into routine surgical practice.

Findings highlight the critical role of nurse champions and the active engagement of OR managers in leading safety initiatives. Structured implementation support, including mentorship, continuous training, and audit and feedback, may facilitate adherence to the SSC. For perioperative nursing leaders in resource-limited settings, strong leadership engagement and organizational support are essential to sustain long-term implementation of safe surgical practices.

Volunteers working in earthquake-stricken areas have personally experienced or witnessed many traumatic events.The aim of this study is to investigate the levels of post-traumatic stress disorder (PTSD), anxiety, and depression in individuals who volunteered during a highly destructive earthquake.

A descriptive research design was conducted between 20.03.2023 and 20.06.2023, with the study population consisting of volunteers who went to the earthquake-stricken area. An online survey was used as the data collection tool and was distributed to volunteers involved in earthquake-related activities through non-probability sampling via communication groups. The survey included sociodemographic questions, the Generalized Anxiety Disorder 7-item scale (GAD-7), the CES-Depression Scale, and the Post-Traumatic Stress Disorder (PTSD) Checklist.

A total of 237 volunteers responded to the survey. The frequencies of anxiety, depression, and PTSD among participants were 23.6% (n = 56), 58.6% (n = 139), and 13.9% (n = 33), respectively. Multivariable logistic regression showed that participants without earthquake-related training had lower odds of anxiety (aOR = 0.35, 95% CI: 0.16-0.76) and depression (aOR = 0.52, 95% CI: 0.29-0.95). Female sex was associated with higher odds of depression (aOR = 3.87, 95% CI: 2.00-7.50) and PTSD (aOR = 2.71, 95% CI: 1.26-5.82), while non-healthcare workers had higher odds of depression (aOR = 1.85, 95% CI: 1.01-3.37).

Volunteers working in earthquake-stricken areas are at a high risk of depression, anxiety, and PTSD. Therefore, providing appropriate psychosocial support to volunteers involved in disaster response is essential for protecting and maintaining their mental well-being.

While successful aging focuses on physical health and disease prevention, active aging offers a broader framework encompassing social participation and security. Health literacy is considered a vital tool in achieving these outcomes, yet its specific impact on the synergy between both aging paradigms requires further exploration.

This study aims to evaluate the relationship between health literacy, successful ageing, and active ageing among older adults and to identify the factors associated with active ageing levels.

This descriptive and cross-sectional study was conducted between October 2024 and May 2025 at the Metropolitan Municipality's Active Aging Service Center in Antalya, Türkiye. The study included 306 participants aged 65 and over. Data were collected using a Demographic Information Form, the Active Ageing Scale, the Successful Ageing Scale, and the Turkish Health Literacy Scale. Data analysis included descriptive statistics, independent samples t-test, Chi-square, Pearson correlation, and Multiple Linear Regression.

The study involved 306 older adults with an average age of 67.79 ± 3.56 years (79.4% of participants were women, and 70.6% were university graduates). Whilst the majority of participants reported having a chronic illness (66.0%) and taking medication regularly (64.7%), 58.5% engaged in regular physical exercise and 80.7% engaged in regular mental activities. The mean total score for the Active Ageing Scale was 190.10 ± 39.37, for the Successful Ageing Scale it was 57.74 ± 7.61, and for the Health Literacy Index it was 32.97 ± 9.53. Bivariate analyses revealed that higher levels of education, income, regular physical exercise and mental activity were significantly associated with better health literacy and ageing outcomes (p < 0.05). Furthermore, positive correlations were found between active ageing, successful ageing and health literacy (p < 0.01). Multiple linear regression analysis showed that the model statistically significantly predicted active aging and explained 56.4% of the total variance (R² = 0.564, p < 0.05). While age, mental activity, and health literacy emerged as significant predictors, education and regular exercise were found to be insignificant.

Health literacy is a key factor of active and successful ageing. To promote active ageing, older adults care centres should prioritise health literacy.

Aggression in mental disorders (AMD) is a prevalent symptom, poses difficulties to the clinical setting and has far-reaching societal implications. The biological basis of different manifestations, developmental courses, and disease-specific mechanisms remains largely unknown. The lack of understanding of the complex mechanisms underlying AMD due to the heterogeneity of aggression and psychiatric disorders themselves, will be addressed by studying a longitudinal transdiagnostic cohort of patients suffering from mental disorders dimensionally quantified with respect to aggressive behavior.

Capitalizing on the Research Domain Criteria "negative valence system" (NVS) and "cognitive system" (CS), multilevel measurements of behavioral and biological systems provide a harmonized dataset at three study sites (Frankfurt, Mannheim/Heidelberg, Aachen; 900 adults, 200 children/youth) including forensic satellites (n = 150). A cross-sectional matched control group (300 adults, 100 youth) will also be included.

The goal of the study is to provide a multilevel characterization of patients, assessing dimensional phenotypic measures across time points and diagnoses, to finally define aggressive biosignatures.

The present study has been registered at https://drks.de/register/en/trial/DRKS00035731 (number of registration: DRKS00035731; date of registration: 20/02/2025).

The perinatal period is marked by heightened vulnerability to maternal depression and anxiety symptoms, which have been associated with early child socio-emotional development, including difficult temperament. This longitudinal study investigated whether prenatal maternal depression and anxiety symptoms predicted infant difficult temperament at 12 months through parallel mediation by postnatal maternal symptoms and perceived partner support. Given emerging evidence on sex differences in the associations between prenatal maternal distress and early socio-emotional development, exploratory multi-group analyses by child sex were also conducted. Pregnant individuals were recruited (October 2020-September 2022) for the Resilience and Perinatal Stress during the Pandemic (RESPPA) study in Quebec, Canada. Measures included the EPDS, GAD-7, ICQ, and perceived partner support assessed via self-reported online questionnaires. Path analyses (N = 1422) were conducted using data from the third pregnancy trimester (T1), three months postpartum (T2), and 12 months postpartum (T3). Separate models were estimated for depression and anxiety symptoms. Greater prenatal depression symptoms predicted higher infant difficult temperament scores, with postnatal depression symptoms and perceived partner support fully mediating this association. Similar findings emerged for anxiety. No significant sex differences were observed. Findings highlight postnatal maternal depression and anxiety symptoms and perceived partner support as potential screening and intervention targets to promote infant development.

The putamen plays a key role in motor control, learning, and cognition, with abnormal putamen volumes associated with neuropsychiatric disorders. Using data from the ABCD study, we performed a genome wide association study (GWAS) of putamen volumes, followed by replication and pathway enrichment analyses. We next evaluated the shared genetic architecture of putamen volume and neuropsychiatric disorders-including depression, schizophrenia, Parkinson's, ADHD, bipolar, and OCD- using SNP associations from this and prior GWASs. We identified 142 genome-wide significant SNP associations in White participants. Most identified SNPs were in gene regulatory regions and in the neuronal growth-linked genes, DCC and DSCAM. Sixteen of the seventeen most significant associations observed in White participants were also observed in non-White participants. Seventeen known SNPs from prior GWASs of putamen volume were also replicated in our ABCD analysis, including five of the eight most significant GWAS SNPs. There was considerable genetic heterogeneity between White and non-White participants in putamen-linked SNPs with significant differences between the minor allele frequencies across the two groups (Wilcoxon rank-sum test Exact prob < 0.0001). We identified a key pathway (REACTOME_DSCAM_INTERACTIONS) associated with putamen volume that involves DSCAM gene, netrin-1 protein and/or DCC gene. In addition, 28 unique SNPs from prior GWASs of neuropsychiatric disorders were strongly associated with putamen volume at Bonferroni-corrected significance, while 41 SNPs shared by at least three disorders were associated with putamen volume at a 0.05 threshold. Our findings provide deeper insights into the shared genetic architecture and cross-population differences in genetic associations of putamen volume.

Behavioral variant frontotemporal dementia (bvFTD) is an irreversible neurodegenerative disorder characterized by progressive changes in personality and behavior. Magnetic Resonance Imaging (MRI) is widely used to detect and assess structural brain alterations associated with the disease. However, due to the low prevalence of bvFTD among neurodegenerative diseases causing the dementia syndrome, conventional machine learning approaches may struggle to capture comprehensive feature representations. Therefore, this study proposes two late fusion frameworks that integrate a 3D convolutional neural network and a multilayer perceptron (MLP) for improved bvFTD diagnosis.

A total of 5,928 participants were included, comprising 3,415 healthy controls (HC), 2,276 Alzheimer's disease (AD), and 237 bvFTD, resulting in a class imbalanced setting with bvFTD as the minority class. To address class imbalance, bvFTD data were initially augmented. A 3D-DenseNet was used to extract features from 3D T1-weighted MRI scans, while an MLP-based model was applied to regional brain volumetric measurements obtained from automated MRI-based brain segmentation. Twelve CNN models with different hyperparameter configurations were trained. Models with and without data augmentation, as well as two fusion-based approaches, were evaluated using accuracy, F1-score, and area under the curve (AUC).

Both fusion strategies improved accuracy, F1-score, and AUC compared to the baseline model without data augmentation. Notable improvement was also observed for the bvFTD class, with up to a 120% increase in F1-score. In one of the fusion frameworks, an accuracy of 0.95 ± 0.01 was achieved for bvFTD vs. HC classification. The results demonstrate the effectiveness of the fusion-based approaches compared to non-fused models, outperforming several state-of-the-art methods.

The proposed frameworks demonstrate that data augmentation and fusion strategies can improve accuracy, F1-score, and AUC, with statistically significant gains. Overall, the frameworks improve diagnostic performance and support the identification of relevant biomarkers associated with bvFTD pathology.

Dystonia with anarthria and/or aphonia (DAnAp) represents a distinctive phenotype manifesting across lifespan. Frequently associated with genetic disorders, early recognition is critical for diagnosis and management.

To provide practical recommendations for the clinical evaluation of patients with DAnAp, enhancing recognition and facilitating targeted diagnostic workup.

We retrospectively reviewed patients with dystonia and anarthria/aphonia due to established genetic causes across the lifespan at The Hospital for Sick Children and Toronto Western Hospital. Demographic, clinical, genetic, and neuroradiological data were reviewed. Cases were categorized based on the age of onset of neurological symptoms: neonatal (0-4 weeks), infantile (4 weeks - 1 year), early childhood (1-8 years), late childhood/adolescence (8-18 years) and adulthood (>18 years).

Fifty-four patients were included, with a mean age of 15.8 years at last assessment (range: 17 months-53 years). We identified 39 distinct genetic etiologies including channelopathies, G-protein-related disorders, developmental and epileptic encephalopathies and metabolic disorders. Most (92%) presented before the age of 8 years, with symptom onset in infancy (37%), early childhood (32%) and neonatal period (24%); only four presented later. Early-onset cases demonstrated more severe phenotypes, including global developmental delay (100% of neonatal cases), seizures (54% of neonatal cases) and absent speech acquisition. Therapeutic interventions included deep brain stimulation in 12 patients, targeted gene or disease-specific therapies were available for three patients in our cohort.

Dystonia with anarthria/aphonia is genetically heterogeneous and predominantly early-onset, with severe neurodevelopmental impairment. Early genetic diagnosis is essential to guide management as targeted therapies emerge.

Compound Ciwujia Granules (CWJ) have shown antidepressant-like effects, but the neural and molecular mechanisms underlying these effects remain unclear. This study aimed to investigate the mechanisms by which CWJ ameliorates anxiety- and depression-like behaviors.

A 6-week chronic unpredictable mild stress (CUMS) model was established in rats, and behavioral tests were performed to assess the antidepressant-like effects of CWJ. Resting-state functional magnetic resonance imaging (rs-fMRI), in vivo fiber photometry, and chemogenetic manipulation were used to identify the brain region and neuronal population involved in the effects of CWJ. Transcriptomic analysis combined with network pharmacology was used to predict candidate molecular pathways, which were further validated by quantitative real-time polymerase chain reaction, immunofluorescence, western blotting, and pharmacological interventions.

CWJ increased the open-arm ratio in the EPM, reduced FST immobility, and lowered serum corticosterone (CORT) levels in CUMS rats. Convergent rs-fMRI, c-Fos immunostaining, and fiber photometry identified that the dorsomedial prefrontal cortex (dmPFC) was a key brain region involved in the antidepressant-like effects of CWJ. CWJ increased glutamatergic neuronal activity and reduced neuroinflammatory responses associated with TNF-related inflammatory signaling in the dmPFC. Moreover, pharmacological activation of TNF-related inflammatory signaling partially attenuated the behavioral benefits of CWJ, supporting the involvement of  TNF-related inflammatory signaling in mediating its antidepressant effects.

These findings suggest that CWJ attenuated CUMS-induced anxiety- and depression-like behaviors by restoring dmPFC glutamatergic neuronal activity and suppressing TNF-related neuroinflammation in the dmPFC.

Traditional categorical diagnoses often fail to capture the dimensional nature of psychiatric disorders such as depression and anxiety. Natural Language Processing (NLP) offers a promising approach to extract dimensional constructs relevant to psychopathology from clinical documentation. In this cross-sectional study, we analyzed clinical notes from 358 psychiatric patients treated at McLean Hospital and enrolled in the "Psychometrics at McLean" (PAM) study to examine the alignment between NLP-derived Research Domain Criteria (RDoC) constructs and psychometric assessments of depression, anhedonia, and anxiety. RDoC scores for Positive Valence Systems (PVS) and Negative Valence Systems (NVS) were extracted using NLP methods previously validated at the group level and compared with standardized clinical assessments: Positive Valence Systems Scale (PVSS), Quick Inventory of Depressive Symptomatology (QIDS), Snaith-Hamilton Pleasure Scale (SHAPS), and Generalized Anxiety Disorder-7 (GAD-7). Significant associations were observed between depression (QIDS) and both PVS (β = -0.42, p = 0.008) and NVS (β = 0.45, p = 0.015); anhedonia (SHAPS) and both PVS (β = -0.39, p = 0.005) and NVS (β = 0.36, p = 0.030); and anxiety (GAD-7) and NVS (β = 0.29, p = 0.049), but not anxiety and PVS. These results are consistent with theoretical accounts in which both PVS and NVS are implicated in depression, whereas anxiety primarily involves NVS. These findings demonstrate that NLP-derived RDoC scores align with established clinical measures, providing evidence of convergent validity with symptom-based measures and of discriminant validity, most notably the selective association of anxiety with NVS. NLP-derived RDoC scores may offer a scalable approach for characterizing dimensional psychopathology; however, longitudinal and predictive validation will be required before applications such as treatment-response monitoring can be supported.