Maintaining sustainable mental health is an increasing societal challenge in Japan, where psychological distress and sleep problems have become major public health concerns. This study examined how three culturally grounded dimensions of self-construal-Subjective Self (SS), Objective Self (OS), and Autonomous Self (AS)-relate to both positive and negative indicators of psychological adjustment among Japanese adults. This study aimed to examine whether internally guided forms of self-regulation (SS and AS) function as psychological resources, whereas externally guided self-regulation (OS) operates as a potential vulnerability factor in a culturally tight social context. By simultaneously examining multiple indicators of adjustment, this research clarifies how culturally shared self-regulatory patterns are linked to distress and sleep difficulties that affect large segments of the population. From a public health perspective, the findings highlight socially reinforced risk and protective patterns that can inform population-level prevention and mental health promotion in settings such as schools, workplaces, and communities, rather than relying solely on individual clinical intervention. These results underscore the importance of integrating cultural psychology into public health frameworks aimed at promoting sustainable mental health in contemporary and increasingly diverse social environments.

Local networks between General Practitioners (GPs) and Parish Ministers (PMs) have been piloted in Denmark to address the lack of collaboration between the two groups in order to strengthen existential and spiritual support in primary care. Evidence on how such collaborations are experienced by practitioners is limited.

The objective was to explore the experience of GPs and PMs participating in locally established interdisciplinary networks.

Within a Ricoeur-inspired phenomenological hermeneutical framework, we conducted five focus group interviews with five GPs and nine PMs from four Danish localities engaged in a step-by-step, participant-validated networking manual. Data was analyzed using a three-level process, including naïve reading, structural analysis, and critical interpretation and discussion.

Participants described the collaboration as an educational, relationship-building process that required time and trust. Four themes emerged: (1) sharpening professional identity (GPs reframed limits of "fixing," and PMs broadened pastoral scope); (2) building relationships (mutual prejudices surfaced and were dismantled; in-person meetings were pivotal); (3) serving the patient's perspective better (PMs offered a non-clinical space for existential issues; early patient involvement energized groups); and (4) envisioning PMs' role in primary care (promise of complementarity vs. value of remaining outside formal health system documentation).

Locally grown GP-PM networks can reframe practice for both professions and open a pragmatic pathway for addressing patients' existential concerns. Relationship-building and early, appropriate patient inclusion appear central to momentum. Further research should examine patient outcomes and feasible models for collaboration that preserve confidentiality and role clarity.

Homeless individuals are vulnerable, and a high burden of mental health problems is suspected. We aim to identify the prevalence and key predictors of probable depression and anxiety among homeless individuals in Germany during the Coronavirus disease-2019 (COVID-19) pandemic.

Nationwide multicentre cross-sectional study including clinical, laboratory, and questionnaire-based data on the health of homeless individuals in Germany.

Data were used from the National Survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic. Probable depression and anxiety were determined using the Patient Health Questionnaire 9 and the General Anxiety Disorder 2 questionnaire. Logistic regression analysis was used to identify key predictors of probable depression and anxiety.

A high prevalence of probable depression (26.8% [95% CI: 23.2-30.3]) and anxiety (27.2% [95% CI: 23.7-30.7]) was found. Logistic regressions showed both probable depression and anxiety associated with being female (depression: OR 1.80 [95% CI: 1.06-3.03]; anxiety: OR: 1.69 [95% CI: 1.03-2.76]), daily use of any illegal substances (depression: OR 3.20 [95% CI: 1.87-5.49]; anxiety: OR 2.04 [95% CI: 1.21-3.45]), and fear of contracting COVID-19 (little fear, depression: OR: 1.81 [95% CI 1.01-3.23], some fear, anxiety: OR: 2.52 [95% CI: 1.31-4.83]). Probable depression was associated with longer durations of homelessness (OR: 1.004, [95% CI: 1.001-1.007].

Probable depression and anxiety are highly prevalent in homeless individuals throughout. Key predictors may help to identify individuals in need and design targeted interventions.

Genetic polymorphisms contribute to inter-individual variability in cardiometabolic risk and quality-of-life outcomes, yet their clinical relevance often remains unclear due to population heterogeneity and reliance on single-variant analyses. Integrative approaches combining genetic and phenotypic data may improve the characterization of complex disease profiles, particularly in orthopedic populations burdened by cardiometabolic comorbidities. This study included 289 patients scheduled for orthopedic surgery. Polymorphisms in the vitamin D receptor (VDR; ApaI, FokI, BsmI), catechol-O-methyltransferase (COMT rs4680), and opioid receptor mu 1 (OPRM1 rs510769) genes were genotyped. Clinical, anthropometric, hematological, biochemical, and quality-of-life (SF-36) data were collected. Unsupervised k-means clustering was applied to standardized phenotypic variables to identify homogeneous patient subgroups. Inter-cluster differences were assessed using analysis of variance and chi-squared tests. Three distinct patient clusters were identified, characterized by specific combinations of cardiometabolic, inflammatory, and quality-of-life features. VDR polymorphisms were differentially distributed across clusters associated with differences in body mass index, hypertension prevalence, and inflammatory status. COMT and OPRM1 variants were primarily associated with variability in physical and mental quality-of-life dimensions. The cluster-based approach revealed multidimensional clinical heterogeneity not captured by conventional univariate analyses. Integrating genetic polymorphisms with clinical and quality-of-life data may support the identification and interpretation of distinct cardiometabolic profiles among orthopedic patients. Cluster-based stratification represents a valuable framework for capturing complex patient heterogeneity and supports future precision-oriented research in orthopedic and cardiometabolic populations.

Alzheimer's disease (AD) is the most common cause of neurocognitive disorder, and the integration of cognitive assessment with biological markers remains essential for clinical characterization. The Clock Drawing Test (CDT) is a brief and widely used screening tool assessing visuospatial and executive functions, which may reflect underlying neurodegenerative processes. This study investigated the diagnostic performance of the CDT and its association with cerebrospinal fluid (CSF) biomarkers within the A/T/(N) research framework. Ninety-seven patients with mild or major neurocognitive disorder were classified as AD or non-AD according to CSF amyloid-β, phosphorylated tau, and total tau profiles, and compared with 36 healthy participants. All subjects underwent a comprehensive neuropsychological evaluation, including the CDT scored using the quantitative-qualitative method proposed by Rouleau et al. Group comparisons, ROC analyses, and regression models adjusted for age, sex, and education were performed. CDT scores effectively distinguished patients from healthy participants, showing large effect sizes, and modestly differentiated AD from non-AD profiles, particularly on the Hands subscale. Diagnostic accuracy was fair, with adjusted AUC values ranging from 0.65 to 0.75. Lower CDT performance was significantly associated with higher CSF total tau levels, while associations with amyloid-β and phosphorylated tau were not robust after correction. These findings suggest that the CDT is sensitive to cognitive impairment severity and shows limited but meaningful relationships with neurodegenerative biomarkers, supporting its role as a practical complementary tool alongside biological assessment.

The ADAM (a disintegrin and metalloproteinase) family, a class of transmembrane proteases with multiple biological functions, plays pivotal roles in processes of proteolytic ectodomain shedding, which are enabled by its unique structural characteristics. In recent years, advancements in molecular biology techniques have led to the progressive identification of shed substrates from ADAM members, whose aberrant expression or dysregulation is closely implicated in the initiation and progression of liver diseases. This review systematically outlines the core domain architecture and biological functions of ADAM proteases, summarizes their major shedding substrates, and elaborates the molecular mechanisms by which the ADAM members regulate the pathophysiological processes of liver diseases. By synthesizing current research advances and unresolved challenges, this work aims to establish a theoretical foundation and propose future research directions for the development of ADAM-based diagnostic markers, targeted therapeutics, and clinical translation in liver diseases.

Autism spectrum disorders (ASDs) are defined as a large spectrum of phenotypes whose basic definition is deficiency in social interactions, particularly during pediatric stages. Through clinical evaluations, it would be challenging to diagnose since the symptoms may be disregarded or controversial. Hence, molecular approaches could be powerful for differential and certain diagnosis. Moreover, considering the possible genetic complexity of the disease, the rates of molecular diagnosis remain insufficient. Nevertheless, the number of newly identified ASD-monogenic inheritance relationships is escalating daily. This underscores the increasing importance of comprehensive molecular tests, such as whole exome sequencing (WES), which encompass all relevant genes. Furthermore, reporting population-specific variants is critical to validate already listed ones and decipher novel ones. In the present study, we aimed to document the disease-related variants in Turkish patients with ASD.

This study evaluated the WES outcomes of 75 ASD patients with normal results in Fragile X testing, cytogenetic analysis, and molecular karyotyping. All patients were diagnosed with ASD based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

The average age of the participants was 8.2 (±5.0) years. A higher percentage of the participants was male (73.3%) compared with female (26.7%). Eighteen patients (24%) had pathogenic or likely pathogenic (LP) variants, while 34 (45.3%) exhibited variants of unknown significance (VUS). In 30.7% of the cases, no clinically relevant variants were found. The MECP2 gene was most frequently affected, followed by EP300 and PTEN. Additionally, four patients carried novel de novo missense variants in the KMT2C, MECP2, PTEN, and TRRAP genes.

Genetic diagnosis of ASD would be useful for confirming the underlying etiologies, devising personalized therapeutic strategies, and offering family counseling. Although WES has been employed in ASD patients for an extended period, the identification of gene and variant spectra across diverse cohorts and the discovery of novel variants continues to hold significant scientific importance.

Background/Objectives: Phelan-McDermid syndrome (PMS), caused by either chromosome 22q13.3 deletions or pathogenic/likely pathogenic variants in the SHANK3 gene, is a rare neurodevelopmental disorder. Behavioral issues greatly impair the quality of life for affected individuals and their families. This genotype-phenotype study intended to further characterize key behavioral features and their genetic and metabolic correlates in PMS. Methods: We conducted a cross-sectional analysis of data on 56 individuals with PMS. Autistic and related behaviors were assessed with the Autism Diagnosis Interview-Revised (ADI-R) and adaptive behavior skills were assessed with the Vineland Adaptive Behavior Scales-Third Edition (Vineland-3), both covering multiple aspects of communication, socialization and abnormal behaviors. Genetic diagnostic information on deletions or pathogenic variants was supplemented with the sequencing data of nine candidate genes on 22q13.3. Metabolic data were obtained using the Biolog Phenotype Mammalian MicroArray plates (PM-M). Results. Every subject in the cohort presented either prominent autistic behavior or adaptive behavior impairment, 55.4% of them meeting the ASD cutoff in every ADI-R domain and 92.9% scoring in the lowest level of adaptive behavior (range of 20-70). Individuals with SHANK3 variants had lower adaptive behavioral skills than those with 22q13 deletions regardless of deletion size, while genomic parameters were largely unrelated to ADI-R scores. Metabolic profiling identified unique profiles of individuals with PMS compared with controls, while distinct profiles distinguished those who met or did not meet the ADI-R ASD cutoff. Cluster analyses revealed groups of individuals with ASD and other clinical features. Conclusion. This study highlighted the importance of SHANK3 in adaptive behavioral skills and uncovered potential metabolic biomarkers of therapeutic relevance.

Background: Methamphetamine (MA) use in people living with HIV (PLWH) has been linked to neurocognitive and behavioral dysregulation. We hypothesized that PLWH with active MA use (MAHIV) would show poorer cognitive performance, greater emotional and sleep burden, higher behavioral risk, and alterations in circulating biomarkers of immune activation and neuronal injury, relative to PLWH without MA use and HIV-negative Controls. Methods: Cross-sectional analytic study of 121 adults: PLWH with MA use (MAHIV, n = 40), PLWH without use (n = 42), and HIV-negative Controls (n = 39). Outcomes were ART discontinuation, physical activity, neurocognition (MoCA), depression (BDI), anxiety (GAD-7), sleep (PSQI), and substance use (ASSIST). Circulating biomarkers measured by ELISA: sCD14, neuron-specific enolase (NSE), S100B, and neurofilament light chain (NfL). Results: MAHIV participants had more frequent ART discontinuation than PLWH and the lowest physical activity. Chemsex with polysubstance use, condomless sex, and multiple partners were most prevalent in MAHIV. This group showed the highest anxiety and depressive burdens, and the greatest sleep disturbances. Global cognition (MoCA) was lowest in MAHIV, with significant deficits in executive function, memory, attention, and language; 82.5% had at least mild cognitive impairment. sCD14 was significantly higher in MAHIV than in PLWH and Controls, and NSE was elevated in both MAHIV and PLWH versus Controls. sCD14 correlated inversely with MoCA and positively with GAD-7 and BDI-II. Conclusions: Among PLWH, MA use is associated with greater ART nonadherence, syndemic mental-health and sleep disturbances, broader neurocognitive deficits, and elevations in circulating sCD14 and NSE. The sCD14-cognition and sCD14-mood relationships highlight chronic immune activation as a candidate pathway for neurocognitive and affective impairment and support sCD14 and NSE as potential stratification and monitoring biomarkers in MA-using PLWH.

Background/Objectives: Axial spondyloarthritis (axSpA) is a chronic systemic inflammatory disease that adversely affects both physical and mental health. This cross-sectional study aimed to examine the associations between spondyloarthritis features (SpA-fs) and disease-related variables (DRVs: disease duration, Visual Analogue Scale, Ankylosing Spondylitis Disease Activity Score [ASDAS], Bath Ankylosing Spondylitis Disease/Functional Activity Index), as well as potential correlations with quality of life (QoL) and symptoms of anxiety and depression in women with non-radiographic axSpA (nr-axSpA). Methods: This study included 78 women with nr-axSpA. Data were obtained from medical records and assessed using two validated instruments: the Short Form-36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Results: The mean age of the cohort was 39.8 ± 7.8 years, with a mean disease duration of 4.80 ± 5.37 years and a mean ASDAS of 2.09 ± 1.14. DRVs, correlated positively with HADS scores and negatively with SF-36 scores. Patients with family histories of SpA had significantly lower mental-component SF-36 scores and higher HADS-D scores. Lower quality of life was associated with DRVs, particularly disease duration. Significant associations with depressive symptoms were observed for both SpA features and DRVs. Conclusions: In women with nr-axSpA, both SpA-fs and DRVs are associated with reduced QoL and elevate the risk of anxiety and depression, underscoring the need for thorough patient evaluation that encompasses psychological health.