Preterm birth alters typical brain development due to complex exposures related to neonatal illness, pain management, and brain injury. Despite an increased understanding of neonatal brain injury on developmental outcomes, the association of cerebellar maturation with school-age motor and cognitive function remains incompletely understood. The current study evaluated neonatal clinical factors associated with regionally specific cerebellar volumes and white matter pathways at 8 years of age in children born preterm (24-32 weeks of gestational age).

Neuroimaging, clinical, and behavioral data were collected from 130 children born very preterm (24-32 weeks' gestational age) at BC Women's Hospital. Cerebellar subregions were automatically segmented using CerebNet, and cerebellar white matter connectivity was assessed using tractography. The relationships between cerebellar subregion volumes and neonatal clinical factors were examined using constrained principal component analysis. Cognitive and motor neurodevelopmental outcomes related to cerebellar volume and connectivity were also investigated.

Neonatal clinical factors including mechanical ventilation, number of invasive procedures, and opioid exposures were associated with reduced cerebellar volumes in specific subregions. Acute neonatal mortality risk (i.e., SNAPPE-II) was negatively associated with cerebellar connectivity at 8 years. Reduced cerebellar volumes and structural connectivity were related to poorer cognitive and motor outcomes.

In very preterm children, neonatal illness severity and exposure to invasive procedures and opioids are associated with reduced cerebellar volumes, connectivity, and poorer neurodevelopmental outcomes at 8 years.

Sturge-Weber syndrome (SWS) symptoms frequently overlap in neurological acute crises (ACs) presenting with seizures, stroke-like episodes (SLE), and headaches. Recent efforts to develop a prospective drug trial highlighted the need for a new outcome measure capable of quantifying these symptoms during an SWS AC. We aimed to develop such a measure and evaluate its practical application.

The Sturge Weber Acute Crisis (SWAC) index was developed based on clinical care guidelines and experience. We retrospectively applied the SWAC to an open-label prospective drug trial published in 2020; SWAC scores were assigned for every AC during 6-month baseline and treatment phase periods.

Six of 10 subjects experienced 670 ACs; only 78/670 ACs were included in the primary quantitative analyses (one subject was an extreme outlier) and 71/78 events were single-symptom while 7/78 included multiple symptoms. Three of six subjects experienced improved median seizure total score; all three improved their median SLE total score. Three of five subjects with headache improved their median headache total score. Poisson-log GLMM models demonstrated significant improvements in composite severity and total, SLE duration and total, and headache severity and total index scores.

The newly developed SWAC index, applied retrospectively, reflected site-PI clinical experience, quantified the severity and duration of SWS ACs ranging from mild to severe, and better enabled comparison of treatment versus baseline responses. These results support additional studies with the SWAC index to further assess clinical utility and use in future treatment trials in SWS.

This study examined factors associated with coronary artery disease (CAD) among adults with metabolic syndrome using nationally representative survey data.

A secondary analysis was conducted using data from the seventh (2016~2018) and eighth (2019~2021) Korea National Health and Nutrition Examination Surveys. Participants included 9,877 adults aged ≥ 19 years who met the National Cholesterol Education Program Adult Treatment Panel III criteria for metabolic syndrome. Complex sample analysis was applied, accounting for stratification, clustering, and weighting. Variables included sociodemographic, clinical, mental health, health behavior, and nutritional factors.

The prevalence of CAD among adults with metabolic syndrome was 5.6%. Older age, elevated systolic blood pressure, and higher total cholesterol were independently associated with CAD. Compared with adults aged 19~49 years, the adjusted odds ratios were 5.02 (95% confidence interval [CI] = 1.12~22.46) for those aged 50~59 years, 6.48 (95% CI = 1.16~36.04) for 60~69 years, and 7.77 (95% CI = 1.40~43.13) for ≥ 70 years. Participants with systolic blood pressure of 120~139 mmHg and ≥140 mmHg had 2.56 (95% CI = 1.10~5.95) and 3.69 (95% CI = 1.16~11.78) times higher odds, respectively. Total cholesterol levels of 200-239 mg/dL were associated with 3.65 times higher odds (95% CI = 1.13~11.78).

Advanced age, elevated blood pressure, and borderline-to-high cholesterol were significantly associated with increased likelihood of CAD in adults with metabolic syndrome. These findings underscore the importance of early risk assessment and targeted preventive interventions for this high-risk population.

This study aimed to identify the factors influencing health-related quality of life (HRQoL) in Korean patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD).

A cross-sectional study was conducted with 130 outpatients diagnosed with NTM-PD at Pusan National University Hospital between August and November 2023. Data were obtained using validated questionnaires assessing symptom experience, illness uncertainty, health-promoting behaviors, and HRQoL. Clinical characteristics were extracted from medical records. Statistical analyses included descriptive statistics, t-tests, analysis of variance, Pearson correlation coefficients, and multiple regression analysis performed with SPSS version 27.0.

The mean physical and mental HRQoL scores were 46.82 ± 6.33 and 43.95 ± 11.42, respectively, both significantly lower than the population norm of 50. Physical HRQoL was negatively associated with symptom experience (B = -0.48, p < .001) and illness uncertainty (B = -0.08, p = .004), with these variables explaining 40%-53% of the variance. Mental HRQoL was adversely affected by symptom experience (B = -0.89, p < .001) and illness uncertainty (B = -0.15, p = .001), while positively associated with health-promoting behaviors (B = 0.15, p = .001), family cohabitation (B = 4.93, p = .045), and obesity status (B = 9.24, p = .004). Together, these factors explained 53-55% of the variance in mental HRQoL.

HRQoL in patients with NTM-PD is significantly impaired and influenced by multiple factors. Evidence-based nursing interventions should emphasize symptom management, reduction of illness uncertainty, promotion of health-promoting behaviors, and strengthening of family support systems to optimize patient outcomes and overall well-being.

Cognitive Disengagement Syndrome (CDS) is characterized by symptoms such as daydreaming, slowed behavior, and mental confusion, but remains understudied outside of ADHD populations. CDS has recently emerged as a potential transdiagnostic construct, yet most investigations have been limited to ADHD samples. To further clarify the clinical profile of CDS, research is needed in pediatric mood disorder populations and comorbid presentations. This study examined predictors of caregiver-reported CDS symptoms in a racially and socioeconomically diverse sample of treatment-seeking outpatient youth (N = 697), with attention to psychiatric diagnoses (ADHD and mood disorders), youth demographics, caregiver education, and number of other psychiatric diagnoses. A 5-item CBCL-based CDS index demonstrated acceptable psychometric performance and was used to capture youth CDS levels. Hierarchical regression revealed that mood disorder diagnosis was the strongest and most unique predictor of elevated CDS symptoms, followed by ADHD diagnosis, with the comorbid group (ADHD+Mood) showing the highest CDS levels. Clinical and structural factors, including mood and ADHD diagnoses, number of other psychiatric diagnoses, Black racial identity, lower caregiver education, and older age, each independently predicted CDS severity. These findings support CDS as a clinically meaningful construct extending beyond ADHD and underscore the importance of contextually informed, transdiagnostic assessment. Implications are discussed through a developmental psychopathology framework, emphasizing equifinality.

The primary objective of this study is to elucidate the role of age at menarche in depression in adulthood and explore the implications of this association.

We conducted a study involving 9,826 adult female participants from the National Health and Nutrition Examination Survey (NHANES) between 2015 and August 2023. Age at menarche was categorized as early (<12 years), normal (12-14 years), or late (≥15 years). Depression was assessed using the 9-item Patient Health Questionnaire (PHQ-9) and clinical diagnoses. Logistic regression and restricted cubic spline analyses were performed to address the study objectives. In addition, subgroup analyses were conducted based on demographic, lifestyle, and clinical characteristics.

The depression group had a significantly higher proportion of young adults (aged 18-30 years) compared to the nondepression group (26.46% vs. 20.52%, p < .001). Conversely, the nondepression group included a greater proportion of older adults (over 60 years) than the depression group (29.53% vs. 23.98%, p < .001). After comprehensive adjustments, early menarche was significantly associated with increased depression risk (adjusted odds ratio [aOR] = 1.224, 95% confidence interval [CI]: 1.003-1.493, p = .047). Restricted cubic spline analyses revealed an L-shaped nonlinear pattern (p for nonlinearity = 0.006), with optimal age at menarche around 12 years. Subgroup analyses confirmed consistent associations without significant interactions.

Early menarche is linked to increased depression risk, especially among women aged 18-30 years. Menarche at 12 years may serve as a key point for early intervention to prevent depression in young women.

Cerebral microbleeds (CMBs) and cortical superficial siderosis (cSS) are increasingly recognized in patients with cognitive impairment and are considered markers of cerebral small vessel disease and cerebral amyloid angiopathy (CAA). However, their associated variable and cognitive impact remain under-characterized in memory clinic populations.

We retrospectively reviewed 2923 patients referred for cognitive complaints who underwent brain MRI at the University Health Network (Toronto, 2014-2022). Of these, 137 patients with CMBs and/or cSS were compared with 278 control patients without hemorrhagic findings, sampled at an approximately 2:1 ratio from the CMB/cSS-negative pool. We analyzed vascular-associated variable, Fazekas-rated white matter hyperintensities (WMH), lesion location and cognitive performance (Mini-Mental State Examination or Montreal Cognitive Assessment). Probable CAA was classified using Boston Criteria v2.0.

CMBs and/or cSS were present in 4.7% of the cohort. Of the 137 cases, 103 had CMBs only, 9 had cSS only and 25 had both. Thirty-one patients (22.6%) met criteria for probable CAA. The CMB/cSS group was older, had higher rates of hypertension and had greater WMH burden. Cognitive scores were lower in the CMB/cSS group, but in multivariable models, only lower education remained a significant predictor. WMH severity showed a stronger association with cognitive performance than the presence or topography of CMBs or cSS.

CMBs and cSS co-occur with vascular-associated variables and WMH burden, while their independent association with cognition is modest in cross-sectional analyses. The proportion meeting probable CAA supports diagnostic relevance. Considering hemorrhagic markers alongside WMH may better characterize vascular contributions to dementia in routine clinical assessment.

Autism spectrum disorder (ASD) is associated with a variety of mental health conditions, including dissociation. In addition to high rates of trauma exposure, vulnerability for dissociation in autism may be heightened by social differences, cognitive inflexibility, and sensory sensitivities. This study examined dissociative symptoms across levels of autistic traits using existing clinical data from 716 individuals receiving mental health care ("clients") in Australia. Clients completed the Multidimensional Inventory of Dissociation-60 (MID-60), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), and the Adverse Childhood Experiences Questionnaire (ACE-Q) or Life Events Checklist for DSM-5 (LEC-5). Clients were grouped according to their RAADS-R scores, measuring autistic traits. Analyses first compared those with high autistic traits (HA; ≥120; n = 338) to below-threshold autistic traits (BA; <120; n = 378). The latter group was then subdivided into those with moderate autistic traits (MA; 65-119; n = 214) and low autistic traits (LA; <65; n = 164) for more comprehensive analysis. HA clients had the highest scores on all trauma and dissociation measures and subscales, and clinically elevated dissociation was significantly more prevalent among HA clients (68%) than BA clients (33%; OR = 4.42) and LA clients (15%; OR = 12.59). MA clients also scored higher than LA clients in almost all domains. Autistic traits and dissociation severity were significantly correlated overall and for all subscales, with the strongest correlations found for the RAADS-R Sensory-Motor domain. All relationships remained significant after controlling for ACEs. This highlights the need for routine screening and tailored interventions addressing both autistic traits and dissociation.

Daylight exposure is an environmental determinant of human health, yet measuring real-world exposure at scale remains a major challenge. Large population studies frequently rely on self-reported time spent outdoors as a proxy for daylight exposure, although the validity of this measure remains uncertain. We evaluated the agreement between daily self-reported outdoor daylight exposure and objective light measurements obtained from wearable sensors and investigated whether depressive symptoms influence this agreement. A total of 172 adults living in two Brazilian metropolitan regions were monitored for up to 44 consecutive days, yielding over 5,800 matched days of subjective and objective exposure data. Objective measures included device output illuminance, photopic illuminance, and melanopic equivalent daylight illuminance (EDI). Agreement was assessed across the light exposure thresholds and durations using Lin's concordance correlation coefficient and ROC analyses. Moderate agreement was observed between self-reported and actigraphy-based daylight exposure. The highest concordance occurred at light levels consistent with outdoor daylight (>1000 l× for photopic illuminance and melanopic EDI; >750 l× for device illuminance). A minimum of 30 min of outdoor daylight exposure was the duration most accurately self-reported. Depressive symptoms did not affect these agreement patterns. These findings support the use of simple self-report questionnaires to estimate outdoor daylight exposure in clinical applications and in studies examining how environmental factors shape health.