Lifestyle medicine (LM) takes an evidence-based approach to the prevention and management of many conditions affecting women; however, no dedicated competency framework currently guides its application across the life span. We aimed to develop a comprehensive set of core competencies for women's health-focused lifestyle medicine. Building on existing American and International Boards of Lifestyle Medicine (ABLM/IBLM) frameworks, we convened an international, interdisciplinary expert committee including physicians from obstetrics and gynecology and primary care, representing the United States, Asia, the Middle East, and South America. A modified Delphi process was used to evaluate consensus on proposed competencies, with agreement assessed on a Likert scale with defined terms for consensus. All 7 committee members completed the Delphi survey, and all 73 competency statements reached consensus. The final framework comprises 73 competencies organized into 11 categories: fundamental knowledge; the 6 lifestyle medicine pillars; clinical assessment and management processes; behavior change strategies; mental health; and contextual determinants, including social determinants of health and trauma-informed care. This consensus-derived framework provides the first structured foundation for integrating lifestyle medicine into women's health education, clinical training, certification, and practice. Its adoption has the potential to advance more equitable, preventive, and person-centered care for women globally.

The Clinical Dementia Rating Scale (CDR), the Ascertain Dementia 8 (AD8), the Mini-Cog, the Verbal Fluency Test (VFT), the Community Screener for Dementia (CSI-D), the Rey Auditory Verbal Learning Test (RAVLT), and the Activities of Daily Living Scale (ADL) represent seven commonly employed methods for community cognitive impairment screening in China that have garnered limited attention. This study aimed to assess the discriminatory power of these seven tests when administered concurrently in a single screening to detect cognitive impairment in the absence of a gold standard.

We conducted a cross-sectional survey among 1,506 elderly people aged 60 and above in the community. The cognitive and social functions of the elderly population were evaluated by using the Seven scales. The characteristics related to demographics and health were collected through questionnaire surveys, and the correlations and consistencies of the Seven scales with cognitive impairment were analyzed respectively. Multifactor logistic regression model was used to analyze the risk factors of cognitive impairment in each scale.

The positive screening proportions for the seven scales-CDR, ADL, AD8, CSI-D, Mini-Cog, VFT, and RAVLT-were 61.1%, 33.7%, 38.0%, 37.1%, 53.7%, 39.3%, and 52.9%, respectively. Agreement on cognitive impairment risk between each pair of scales was fair-to-moderate (Kappa: 0.32-0.645, all p < 0.001). Screening results differed significantly across the seven scales by age, educational, marital status, epilepsy, cerebral infarction, brain atrophy, and depression (all P < 0.001). Notably, Screen-positive proportions for cognitive impairment rose significantly with increasing age (p < 0.001); the ≥ 80-year-old group showed the highest proportions across scales. Conversely, higher educational attainment was associated with lower risk of screening positive for cognitive impairment (p < 0.001).

Our study identified a relatively high screening positivity proportion for cognitive impairment in Chongqing, Age, Sex, Education, Marital status, Brain atrophy, Anxiety, and Depression are risk factors for screening positivity. The identified screening positivity for cognitive impairment varied across different neuropsychological assessment methods, indicating that assessment choice should be tailored to population characteristics rather than applying a one-size-fits-all approach. Selecting the appropriate tool can improve sensitivity and reduce missed diagnoses.

Autism spectrum disorder (ASD) is currently diagnosed through behavioral observations and evaluations, but there is still a lack of objective and consistent biomarkers. Children and adolescents with ASD exhibit impairments in advanced social, emotional, and cognitive functions, such as a lack of empathy. In general, the concept of empathy encompasses several socio-emotional and cognitive components based on interacting brain circuits. Identification of disease-related biomarkers at the brain network level could provide a crucial avenue for advancing ASD imaging research and improving diagnostic accuracy.

This study examined 80 individuals with ASD aged 6-16 years old and 50 matched control subjects, using resting-state functional magnetic resonance imaging and clinical psychological assessment datasets. Specifically, a set of functional brain networks was constructed using dictionary learning and sparse coding (DLSC) in a group-wise manner. Then, the localized common functional brain networks from both the ASD and matched control groups were automatically decomposed into a set of regions of interest (ROIs) for further functional connectivity analyses.

Using the derived functional connectivity matrix, we investigated three parameters, namely, correlation, partial correlation, and tangent embedding, to differentiate participants with ASD from control subjects. We achieved classification accuracies of 95%, 100%, and 100%, respectively, indicating that the proposed DLSC method could extract representative and characteristic brain ROI atlases for both ASD and control participants. Further analysis of functional connectivity results showed that ASD participants had multiple atypical connections, especially those connecting the left inferior temporal and left inferior parietal regions, which belonged to the temporoparietal junction (TPJ), and connections related to the right insula and anterior cingulum, which belonged to the salience network (SN). Together, our results suggest that individuals with ASD exhibited a lower empathy capability than control subjects.

Our results suggest that DLSC can effectively extract robust brain ROI atlases. Functional connectomes with high differentiation powers were mainly distributed within the brain networks of SN, social brain networks (SBNs), and the theory of mind (ToM) network (including the TPJ hub). Children and adolescents with ASD exhibited lower empathy capabilities than control subjects, which may be attributed to dysfunctions in the salience and social brain networks.

https://www.chictr.org.cn, identifier ChiCTR-ROC-17012877.

Long COVID has been an important health concern in children and adolescents, yet factors associated with its development remain incompletely understood. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are widely prescribed for pediatric neuropsychiatric conditions and may influence immune and autonomic pathways involved in postinfectious symptoms. Here we show associations between SSRI/SNRI use and long coronavirus disease (COVID)-related outcomes in a retrospective cohort of 110,955 children and adolescents with pre-existing neuropsychiatric conditions across 37 US health systems participating in the National Institutes of Health Researching COVID to Enhance Recovery consortium. SSRI/SNRI use was not associated with clinician-recorded long COVID diagnosis but showed heterogeneous associations with individual symptoms. Lower risks were observed for some symptoms, including fever, chills and hair loss, whereas higher risks were observed for neurological and systemic outcomes, including postural orthostatic tachycardia syndrome, cognitive dysfunction and fatigue. These findings suggest that antidepressant exposure may be associated with differing post-COVID symptom patterns in youth and warrant further investigation.

Research and clinical practice on childhood maltreatment largely rely on retrospective self-reports. However, self-reports are often considered unreliable due to concerns about memory biases and shifting subjective appraisals. Here, in a meta-analysis of 49 studies including n = 38,332 individuals followed for an average of 2.4 years (range = 2 months to 12 years), we found that retrospective self-reports of maltreatment are overall highly stable (r = 0.79). However, stability was lower in population-representative samples than in clinical or convenience samples, for neglect compared with abuse, and in children compared with adults. In children, but not adults, stability declined with longer follow-up. These findings challenge the view that retrospective self-reports are inherently unstable, although further research is needed to investigate long-term stability. Reshaping trauma-related appraisals may require deliberate intervention and might be most effective during childhood when memories appear more malleable.

Depression has been linked to reduced size of subcortical regions and abnormal functional connectivity in frontal and default mode networks. However, recent meta-analyses have failed to identify significant converging correlates of depression across the literature such that a conclusive mapping of the neuroimaging correlates of depression remains elusive. We leveraged 23,417 participants across 6 population datasets to comprehensively establish the neuroimaging correlates of depression. We found reductions in gray matter volume/cortical surface area associated with depression in the frontal cortex, anterior cingulate and insula, confirming previous studies showing the importance of prefrontal and default mode regions in depression. Our findings demonstrate multiple surprising results, including a lack of depression correlates in subcortical brain regions and significant depression correlates in somatomotor and visual regions. Overall, these results shed new light on key brain regions involved in the pathophysiology of depression, updating our understanding of the neuroimaging correlates of depression symptoms.

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition associated with significant functional impairment. Acupoint stimulation (AS), encompassing techniques such as electroacupuncture, acupuncture, and transcutaneous electrical acupoint stimulation, is a widely used therapeutic approach. However, a comprehensive synthesis of evidence regarding its efficacy and safety as an adjunctive therapy for OCD is needed.

This systematic review and meta-analysis aimed to evaluate the efficacy and safety of AS as an adjunctive treatment for OCD.

A comprehensive literature search was conducted across seven electronic databases from their inception to February 2026. Randomized controlled trials (RCTs) investigating AS for OCD were included. Two reviewers independently screened records, extracted data, and assessed methodological quality using the Cochrane Risk of Bias tool (ROB 2.0). Statistical analyses were performed using Review Manager 5.4.

This review included 23 RCTs involving 1,713 participants. Compared with the controls, AS was associated with greater improvement in OCD. It was associated with a statistically significant reduction in obsessive-compulsive symptoms as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (MD = -3.14, 95% CI [-4.46, -1.81], p < 0.00001) and also associated with improvements in anxiety and Clinical Global Impression (CGI) scores, and other secondary outcomes. The combination of AS with both pharmacotherapy and CBT yielded the largest Y-BOCS reduction among subgroups examined (3 studies; MD -3.50, 95% CI [-4.34, -2.66]; p < 0.00001). Regarding safety, the AS group had fewer reported adverse events than medication controls (RR = 0.17, 95% CI [0.06, 0.51], p < 0.0001). Subgroup analyses suggested that acupoint prescriptions containing PC6 and a treatment frequency of 20-40 times may be associated with the largest point estimate, though this comparison is exploratory.

This meta-analysis found that AS, whether used alone or as an adjunct to pharmacotherapy or CBT, was associated with a mean reduction of approximately 3.14 points on the Y-BOCS. On a 0-40 scale, with substantial heterogeneity across studies, variable control conditions, and inconsistent methodological quality, this reduction is statistically significant but of uncertain clinical relevance. The evidence does not support a firm conclusion that AS is clinically effective, and the safety data are insufficient to establish AS as safe. Further high-quality trials with standardized protocols are needed.

CRD420251070503.

The long-term consequences of attention deficit hyperactivity disorder (ADHD) in females remain underrecognized both in research and clinical practice. Multimorbidity (two or more long-term conditions) is increasingly viewed as a key outcome yet its prevalence, complexity and sociodemographic determinants are understudied in this group. Here, in this longitudinal cohort study, we examined the combined influence of childhood socioeconomic deprivation and ADHD diagnosis on multimorbidity risk in women in early adulthood (that is, aged 18-32 years) and used latent class analysis to explore clustering patterns. Three findings emerged: females with childhood ADHD had a significantly higher risk of adult multimorbidity; childhood ADHD and socioeconomic deprivation increased this risk both in isolation and synergistically, with 39% of the multimorbidity burden attributable to their interaction; and distinct multimorbidity clusters emerged, with the most adverse marked by psychiatric complexity. These results highlight girls with ADHD from disadvantaged backgrounds as a high-risk group requiring earlier, integrated care.

The biological mechanisms underlying major neuropsychiatric disorders remain largely elusive. Given the frequent association of immune dysregulation with these conditions, we used blood-derived multi-omics data from 1,274 healthy adolescents in the IMAGEN cohort to identify transdiagnostic biomarkers and mechanisms that could inform diagnosis and treatment. We first conducted genome-wide analyses to identify single nucleotide polymorphisms associated with DNA methylation and gene expression, with findings replicated in external datasets. These quantitative trait loci were further explored through Mendelian randomization analyses across 6 neuropsychiatric disorders (attention deficit hyperactivity disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, schizophrenia and insomnia), leading to the identification of 73 putatively causal CpG sites and 62 genes that were either unique to individual disorders or, as in the case of MRPL2, shared among the disorders. Notably, the identified genes were significantly enriched in pathways linked to both psychiatric and autoimmune diseases, suggesting a shared genomic architecture between autoimmune and neuropsychiatric disorders. Two-step Mendelian randomization and colocalization analyses revealed potential transdiagnostic regulatory pathways, in which the expression of three genes (MAD1L1, MRPL2 and HLA-DRB1) mediated the effects of CpG methylation on schizophrenia and insomnia. Specifically, DNA methylation at cg06770790 repressed MRPL2, which was putatively causal for insomnia (β = -0.38, P = 1.29 × 10^-4) and schizophrenia (β = -0.38, P = 1 × 10^-4). Conversely, increased expression of MAD1L1 and HLA-DRB1, driven by methylation at several CpG sites, was potentially causal for schizophrenia. Our findings highlight key molecular mechanisms and genes implicated in neuropsychiatric disorders, offering promising new targets for therapeutic intervention.

Perinatal arterial ischemic stroke (AIS) affects 1 in 4000 live births. Dystonia, affecting ~20% of children following AIS, is characterized by involuntary muscle contractions and abnormal movements. Why some develop dystonia post AIS, while others do not, remains unclear. We hypothesized that dystonia after AIS is associated with two key features: lesions involving frontal-basal ganglia network regions and corresponding disruptions in motor oscillatory activity.

Monozygotic twin brothers aged 11 years were recruited to a study investigating neural correlates of motor control in post-stroke dystonia. Brain magnetic resonance imaging (MRI) assessed lesion localization, volume, and white matter structure. Magnetoencephalography measured timing and localization of neural oscillations during movement execution and inhibition on the "go"/"no-go" task. Clinical history was obtained from charts. Neurological outcome was evaluated with the Pediatric Stroke Outcome Measure (PSOM).

MRI showed mirrored hemispheric lesions in the twins, with additional basal ganglia involvement in Twin A. Diffusion tensor imaging revealed lower corticospinal tract integrity in Twin A. MEG in Twin A revealed increased frontal theta (4-8 Hz) during correct inhibition. Sensorimotor gamma was reduced for Twin A but upregulated for Twin B during contralesional hand movement. Clinically, Twin A had a PSOM score of 2 (moderate motor and cognitive deficits); Twin B scored 0 (no deficits).

Our findings suggest that dystonia following perinatal AIS is associated with altered frontal-basal ganglia network function, with increased frontal recruitment reflecting compensatory disinhibition during motor control.