Quality of life (QoL) is a core outcome in schizophrenia. Guided by the biopsychosocial model, this study examined whether social functional impairment and internalized stigma independently predict QoL and mediate the impact of depressive symptoms on QoL among clinically stable patients in rural China.

In a multicenter cross-sectional survey (Chaohu City, September-October 2022), 796 clinically stable adults with schizophrenia were recruited via stratified random sampling. Participants completed standardized assessments: Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Social Disability Screening Schedule (SDSS), Social Impact Scale (SIS), and WHOQOL-BREF. Analyses included hierarchical regression (entering demographics/health, health behaviors, clinical symptoms [PHQ-9, ISI], and psychosocial factors [SDSS, SIS]) and parallel mediation analysis (PROCESS Model 4).

PHQ-9, ISI, SDSS, and SIS scores differed significantly across QoL groups (all *p* <0.001). Hierarchical regression showed that explained variance increased from 2.9% (Model 1) to 21.8% (Model 4). After adjusting for all covariates, depressive severity (β = -0.230), social disability (β = -0.161), and stigma (β = -0.153) were robust negative predictors of QoL (all *p* <0.001). Mediation analyses revealed a significant total effect of depression on QoL (-0.037, 95% CI [-0.046, -0.027]). This effect was partially mediated by social disability (indirect effect: -0.005, 95% CI [-0.008, -0.002]; proportion: 13.5%) and stigma (-0.006, 95% CI [-0.009, -0.003]; 16.2%), with a significant total indirect effect accounting for 29.7% of the total effect.

Social functional impairment and internalized stigma were independent predictors of QoL and statistically mediated the relationship between depressive symptoms and poorer QoL in clinically stable schizophrenia. Moving beyond symptom control to integrated interventions targeting these psychosocial pathways is crucial for enhancing QoL, especially in resource-limited rural settings.

Community-acquired pneumonia (CAP) remains a major cause of morbidity in children. Although severity assessment tools are available, they are not specifically designed to predict the development of a broad spectrum of pulmonary and systemic complications. This study aimed to identify admission factors associated with complicated pneumonia (CP) in hospitalized children with CAP and to develop a practical risk scoring model for early risk stratification.

Patients hospitalized with CAP were classified into two categories: uncomplicated CAP and complicated pneumonia. Independent predictors for the development of complicated pneumonia were identified.

Multivariate logistic regression identified the following as independent risk factors for complicated pneumonia: older age (OR: 1.011; p < 0.001), hypotension (OR: 28.083; p < 0.001), altered mental status (OR: 5.033; p = 0.024), low haemoglobin values (OR: 0.835; p = 0.015), leukopenia (OR: 3.197; p = 0.040), increased neutrophil-to-lymphocyte ratio levels (OR: 1.045; p = 0.049), hyponatremia (OR: 2.840; p < 0.001), hypoalbuminemia (OR: 6.489; p < 0.001) and increased C-reactive protein levels (OR: 1.034; p = 0.039). The scoring system demonstrated a sensitivity of 82% and a specificity of 79%.

We identified admission characteristics associated with the development of pulmonary and systemic complications in hospitalized children with CAP and developed a complication-focused risk scoring model based on routinely available parameters. The model showed good performance within this retrospective cohort and may support early risk stratification. Prospective multicentre validation is required to confirm its generalizability and clinical utility.

Lithium is the only true mood stabiliser as it is able to both treat and prevent mania and depression. In practice, its popularity has declined despite discovering it has anti-suicidal and neuroprotective properties. Here, we argue for recognition of its benefits and advocate for its clinical use more widely.

This study explored the effect of including parents in embodied arts-based therapy sessions with neurodivergent adolescents. The aim was to understand how parental involvement might influence the development of skills essential for mental well-being, including communication, boundary setting, and emotional regulation. Guided by an interpretive paradigm within a qualitative research approach, the study used purposive sampling to select three parent-adolescent pairs from the Gauteng Province of South Africa. Data were generated through group observations, artworks, journals, and semi-structured interviews, and analysed thematically. The findings indicated that participants in each parent-adolescent pair perceived the joint sessions as supportive and meaningful, contributing to improved communication, strengthened relationships, and enhanced self-expression. The embodied nature of the process created a non-intimidating therapeutic space that facilitated clearer expression of needs and emotions. The study concludes that parent-inclusive embodied arts-based therapy can enhance therapeutic outcomes for neurodivergent adolescents, particularly when opportunities for joint engagement are integrated alongside individual therapeutic work. The primary contribution of the study lies in demonstrating the value of collaborative, embodied approaches in supporting the mental health and relational well-being of neurodivergent adolescents and their families.

This study aimed to examine the relationship between psychological well-being and aggression among handball players and to determine whether exercise addiction mediates this relationship.

A descriptive, cross-sectional, and correlational design was used. The population consisted of players competing in the Turkish Handball Leagues during the 2024-2025 season, and 442 athletes participated using a non-probability sampling method. Data were collected via an online survey including a personal information form, the Psychological Well-Being Scale, the Buss - Perry Aggression Questionnaire, and the Exercise Addiction Inventory.

Psychological well-being showed a significant negative correlation with aggression (r = -0.242, p < 0.001). Exercise addiction was positively associated with both psychological well-being (r = 0.212, p < 0.001) and aggression (r = 0.105, p = 0.027). Mediation analysis indicated that exercise addiction significantly and partially mediated the relationship between psychological well-being and aggression (indirect effect 95% CI: 0.0246-0.1654). The direct effect of psychological well-being on aggression remained significant (β = -0.7093, p < 0.001).

Higher psychological well-being was associated with lower aggression among handball players, whereas exercise addiction was associated with both higher psychological well-being and higher aggression and emerged as a partial statistical mediator of this relationship. These findings may help inform future studies and preventive strategies focusing on athlete mental health and behavioral regulation. However, because of the cross-sectional design, causal inferences cannot be drawn.

Neuropathic pain (NP) is a prevalent chronic pain disorder that severely impairs the physical and mental health of patients, affecting 6.9%-10% of the general population. The dorsal root ganglion (DRG) is a crucial locus in the pathogenesis of NP. However, the underlying mechanisms by which DRGs contribute to this condition remain incompletely understood.

High-throughput sequencing data of DRGs was downloaded from the Gene Expression Omnibus (GEO) and integrated for analysis. Differential expression analysis combined with multiple machine learning methods was employed to identify candidate genes associated with NP in DRGs. The spared nerve injury (SNI) model was used to assess gene expression patterns. Small interfering RNA-mediated knockdown of the target gene was performed to evaluate its functional role. Bioinformatics analysis and chromatin immunoprecipitation (ChIP) experiments were conducted to explore the transcriptional regulation of the target gene.

Sez6l was identified as a candidate gene upregulated in DRGs. In the SNI model, Sez6l was significantly upregulated. Knockdown of Sez6l reduced the expression levels of inflammatory cytokines (IL-6, TNF-α, and IL-1β) and alleviated mechanical allodynia and thermal hyperalgesia in SNI mice. Bioinformatics analysis and ChIP experiments suggested that Foxo1 may enhance the transcription and expression of Sez6l. Mechanistically, Sez6l promoted NP by activating the Wnt5a/Ca²⁺ signaling pathway in DRGs.

Our findings suggest that Sez6l, which is transcriptionally regulated by Foxo1, facilitates neuropathic pain through activating the Wnt5a/Ca²⁺ signaling pathway in DRGs.

Despite the increasingly visible anti-Asian racism, primary data collection studies highlighting both discrimination and resilience experiences are limited. Informed by Asian Critical Theory (AsianCrit), this study examined the associations among discrimination, resilience, and mental health of Asian and Asian American (AAA) older adults. Between 2023 and 2024, primary data were collected through surveys offered in English, Hmong, and Korean. A total of 126 community-dwelling AAA adults aged 50 and older were recruited, of whom nearly two-thirds lived in urban areas. Descriptive and multivariate regression analyses examined the associations among discrimination, resilience, and psychological well-being, controlling for known covariates. Higher levels of discrimination were associated with greater severity of depression, increased anxiety, and poorer mental health. Conversely, higher levels of resilience were associated with better psychological well-being. We highlight the impacts and innovative approaches to support AAA older adults and other minoritized communities.

Accurate prediction of therapeutic pressure for Continuous Positive Airway Pressure (CPAP) therapy is essential for effective treatment of Obstructive Sleep Apnea (OSA). Existing methods often rely on complex sleep-related parameters and small sample sizes, limiting their generalizability. This study aims to develop a more accessible, data-driven model using readily available demographic and physiological variables to predict CPAP pressure, improving both accuracy and scalability.

We employed a machine learning approach, integrating decision trees, gradient boosting algorithms (LightGBM, XGBoost, CatBoost), and neural networks to predict therapeutic pressure. Forward selection based on the Akaike Information Criterion (AIC) was used to identify the most relevant variables. The model was trained on a dataset of 2,092 patients, with model performance assessed using mean absolute error (MAE).

The most influential variables identified were BMI, neck circumference, and waist-to-hip ratio. Among the algorithms, LightGBM achieved the highest predictive accuracy, with the lowest MAE. Ensemble methods, such as voting, did not improve performance beyond LightGBM alone. Subsample analyses revealed that prediction accuracy varied across BMI ranges and ventilator brands.

The study demonstrates that BMI and other physical parameters play a pivotal role in determining CPAP pressure, offering a simplified yet effective prediction model. This approach has significant potential for clinical applications, particularly in resource-limited settings, where access to complex sleep studies may be restricted. Future research could enhance the model by incorporating real-time physiological data and expanding data collection to diverse populations.

A growing body of evidence suggests that exposure to environmental noise is linked to the development of cardiovascular disease (CVD). Here, we used two-sample Mendelian randomization (MR) to investigate whether noise-related DNA methylation (DNAm) alterations are causally associated with CVDs and their risk factors.

Publicly available genome-wide association study data on cardiovascular outcomes and epigenome-wide association study data on noise-related alterations in DNAm were used. Thirteen cytosine-phosphate-guanine sites previously associated with noise exposure were selected as exposures, and genetic instruments (methylation quantitative trait loci) were obtained from the Genetics of DNA Methylation Consortium. Summary-level data for six CVDs (heart failure, coronary heart disease, peripheral atherosclerosis, atrial fibrillation/flutter, arrhythmia, and ischemic stroke) and six CVD risk factors (body mass index, sleep, hypertension, hyperlipidemia, type 2 diabetes, and total cholesterol) were extracted. Primary causal estimates were derived using an inverse variance-weighted method. The robustness of these findings was evaluated using supplementary sensitivity analyses, including MR-Egger, weighted median, weighted mode, and Wald ratio.

Among 13 noise-related DNAm sites, 11 (84.6%) were significantly associated with at least one CVD outcome, with most (10/11) showing risk-enhancing effects. Specifically, cg13402217 (located in the SNX27 gene) and cg16218477 (located in the C7orf50 gene) were repeatedly linked to elevated risks of CVD outcomes, such as heart failure (odds ratio [OR], 0.897; 95% confidence interval [CI], 0.884-0.911, P  = 3.243E-46) and coronary heart disease (OR, 0.999; 95% CI, 0.998-0.999, P  = 2.213E-10). Conversely, cg19270309 (located in the ENPP7 gene) was associated with protective CVD outcomes; for example, it was associated with a lower risk of coronary heart disease (OR, 0.996; 95% CI, 0.993-1.000, P  = 2.984E-02). The sensitivity analysis results were consistent with the above results.

Our findings provide novel causal evidence that environmental noise influences CVDs and the related risk factors through DNAm alterations.

Physical activity is one of the modifiable risk factors for non-communicable diseases. According to the World Health Organization PA country report for India, 25% of adult males and 44% of adult females are physically inactive.

This review seeks to explain the implementation of community-based interventions on physical inactivity associated with non-communicable diseases. A search was carried out on PubMed, Scopus and Embase to source the relevant articles.

The review focused on assessing the implementation of community-based interventions for physical inactivity between January 2015-February 2024. The review included primary studies that are published on the implementation of community-based interventions on physical inactivity to control non-communicable diseases.

The scoping review includes 31 articles that met the inclusion criteria out of the 823 records identified. 75% of the studies included were conducted in USA, Europe and 25% were from LMICs. The major facilitators were internal motivation, peer support, health education, and availability of trained personnel to support implementation of interventions. The major barriers were socio-economic constraints, maintenance of facilities, distance from the facility, and poor understanding of positive lifestyle change. The review underscores the potential of effective implementation plans to promote physical activity and mitigate these barriers through evidence-based strategies which need to be integrated early in the intervention design phase.

By advancing evidence-based practices and tailoring interventions to local contexts, stakeholders can effectively promote active lifestyles and contribute to population-wide health improvements. Some implications for practice include the incorporation of behavioural theories in the design phase to improve adoption and impact, increasing collaboration particularly with the education sector and the use of digital tools within interventions.